The writer is a professor of pediatrics at the Creighton University School of Medicine.
Vaccines changed the course of public health in Nebraska and throughout the United States during the 20th century. Before vaccines, anxious American parents could expect that diseases such as polio, diphtheria, pertussis (whooping cough), measles, meningitis and others would kill or seriously disable tens of thousands of children each year.
The lack of vaccinations is a critical public health issue in Nebraska. It affects not only the children involved but the entire population as well, since some diseases such as whooping cough occur at all ages. Due to a lack of vaccinations, serious diseases thought to have been virtually eradicated in the United States, such as measles, pertussis and mumps, are coming back and infecting not only children but adults as well.
A case in point is the May 2010 outbreak of mumps in central Nebraska where 20 confirmed or probable cases were traced to a high school basketball tournament. While usually a mild disease, mumps can produce swelling of the brain, nerves and spinal cord, which in some cases leads to paralysis, seizures and increased fluid in the brain.
In 1987, after a national mumps epidemic led to nearly 12,850 reported cases, a second dose of mumps vaccination was added to the standard childhood vaccination series. The goal was to prevent disease outbreaks such as the one in central Nebraska.
The State of California has recently declared a pertussis outbreak, and reports of whooping cough are increasing in our community. While the State of Nebraska has not yet declared an outbreak, it is prudent to vaccinate all of those who would benefit from this vaccine as soon as possible.
Unfortunately, despite indisputable proof that vaccines save lives and prevent serious medical consequences, 28.5 percent of Nebraska’s children (younger than school-age) did not receive recommended vaccines in 2008. This 71.5 percent statewide vaccination rate falls far short of the 90 percent standard set by the Centers for Disease Control and Prevention (CDC) and the U.S. Department of Health and Human Services (DHHS).
Nebraska schoolchildren are required by law to be immunized against diphtheria, tetanus, pertussis, polio, measles, mumps, rubella, hepatitis B and varicella (chickenpox) before entering public or private school. Clearly, not all families comply.
The good news is that, in Nebraska, only 2.9 percent of school-age children currently are not fully immunized. In some cases, immunization requirements are waived due to a family’s religious beliefs or a medical determination that immunization would endanger the child or family members.
In many cases, however, children are not immunized due to unfounded fears of adverse effects from the vaccine or the mistaken belief that certain diseases, such as polio or measles, are no longer a threat.
Although school immunization rules in Nebraska have been a boon to preventing devastating illnesses among school-age children, many babies and preschool-age children continue to lack the needed vaccines.
The goal of the CDC’s Childhood Immunization Initiative is to have at least 90 percent of all children immunized by age 2. At 83.9 percent, Nebraska’s immunization rate for 2-year-olds is better than the national average of 76.1 but still below the recommended level, according to the Nebraska Department of Health and Human Services.
To be completely immunized, a 2-year-old needs a series of four doses of diphtheria/tetanus/pertussis vaccine, three doses of polio vaccine, one dose of measles/mumps/rubella vaccine, three doses of Haemophilus influenzae type B vaccine, three doses of hepatitis B vaccine and one dose of varicella vaccine. About 24 percent of America’s toddlers lack one or more doses in this series.
In addition to saving lives and improving the quality of life, immunizations are one of the most cost-efficient ways to prevent disease. For every dollar spent on immunizations, $29 is saved in direct and indirect health costs, according to the Nebraska DHHS.
As another school year approaches, it is incumbent on parents and health care providers to ensure that all Nebraska schoolchildren are adequately vaccinated and that all booster vaccines are up to date.
A web-based immunization registry is under development in Nebraska. However, since all children are not yet included in the registry, parents need to record their children’s vaccinations, beginning at birth.
Through these efforts, the state’s most vulnerable residents can be protected from potentially harmful but avoidable diseases.