Childhood immunization rates in the United States continue to rise. According to a just-released survey by the Centers for Disease Control and Prevention, 81% of American children have been immunized with the recommended series of childhood vaccines. But other segments of the population lag far behind.
Sophie Starcevic is a healthy athletic teenager. At least she is now. A year ago, the 16-year-old developed a bad cough. It sounded and felt like a terrible chest cold, kept her up at night and made her vomit. No one - not even her mother Monika Burke - suspected it was pertussis … commonly known as whooping cough. "As a registered nurse I am aware of the importance of vaccination and made sure my children were fully vaccinated," she says. "I had never heard of anyone getting pertussis." Not until her daughter was diagnosed with the disease. Sophie - treated with antibiotics - has fully recovered. But other young people remain at risk. In 2004, there were 19,000 cases of whooping cough. That was nearly double the number from the year before.
Only after Sophie got sick did her family learn that immunity to pertussis wears off after 5 to 10 years. The good news is that a booster shot for whooping cough was recently approved for adolescents. Sophie and her mother are working hard to promote the vaccination. "I am making sure to encourage the parents of her school mates and her social circle to tell them that the vaccine is available," says Monika Burke. "If it happened to Sophie and it can happen to you."
And it can happen with other common, widespread - and preventable - diseases. Each year, hundreds of thousands Americans either die or suffer dramatic health effects from influenza, pneumococcal disease and hepatitis B.
David Neumann heads the Partnership for Prevention, an organization that promotes immunization for treatable diseases. He says while childhood vaccination rates in the United States have climbed to an all-time high, the picture is much different for adults. "For example, at best we immunize 70% of adults 65 years and older against influenza each year," he says. "The percent of seniors receiving the pneumococcal vaccine are even lower. Younger adults are at high risk for influenza and its complications, particularly individuals who suffer from heart, lung and liver disease (and) who have diabetes. We don't do a very good job in reaching those people. Only about 37% of adults in the high risk group between the ages of 50 and 64 receive an influenza vaccine on an annual basis and only 24% of those 18 to 49 years old receive influenza (vaccine) despite being in those high risk groups."
Mr. Neumann urges the adoption of measures that have worked to raise immunization rates among children. The Partnership for Prevention calls for more public funds for getting vaccines to uninsured adults, collaboration among health agencies, and educational programs that raise awareness about the importance of immunization. "Many in the baby boom generation think that we are immortal," he says. "We do well for twenty or thirty years and we end up with chest pain. We go to see a cardiologist. A cardiologist is going to take care of your cardiac issues, but isn't even going to think about influenza immunization or pneumococcal, even if you are in a high-risk group. So there is a lot of provider education that we need to do as well."
Efforts like these have the full support of Stephen Cochi, Acting Director of the National Immunization Program at the Centers for Disease Control and Prevention. However, he cautions that misinformation can quickly erode an immunization campaign. Such was the case in Northern Nigeria in 2003. Rumors circulated that the polio vaccine was linked to AIDS and reproductive disorders. "There was an interruption of vaccination in Northern Nigeria for an entire year," he says. "The poliovirus spread from sub-Saharan Africa from West to East. Thousands of Africa children and Asian children became paralyzed because of this unfortunate debacle. The virus spread across the Red Sea to Saudi Arabia and Yemen and then distantly to Indonesia where there is still a polio outbreak going on."
Despite that setback, Mr. Cochi - a former pediatrician - believes that universal vaccination is an achievable goal. A broad-based public private partnership has initiated a campaign to vaccinate 90% of the world's children by 2015, protecting them from the most common preventable childhood diseases. But Stephen Cochi and other public health experts say this is not enough. They'd like to see immunization benefits extended to people of all ages.
