Vaccination Exemption and the Pediatric Health Care Provider
Vaccination Exemption and the Pediatric Health Care Provider
Among children born between 1994 and 2013, vaccinations will prevent approximately 322 million illnesses, 21 million hospitalizations, and 732,000 deaths, resulting in a net savings of $295 billion in direct costs and $1.4 trillion in total societal costs (Whitney, Zhou, Singelton, & Schuchat, 2014). Although U.S. vaccination rates among young children 19 to 35 months of age is more than 90% for four types of vaccines, coverage remains below target for several others (Table 1; Elam-Evans, Yankey, Singleton, & Kolasa, 2014b). Moreover, vaccination rates for teens aged 13 to 17 years fall well below public health goals (Table 2). Notably, wide variation in coverage exists for all ages based on geographic location, as well as selected demographic characteristics (Elam-Evans, Yankey, Jeyarajah, et al., 2014a). In one California county, vaccination rates at kindergarten entry range from 75.4% to 97.5% (Orange County Children's Partnership, 2013).
Importantly, vaccines provide protection through two different mechanisms. First, vaccines protect individuals directly by inducing immunity against a specific disease. Second, vaccines protect individuals from person-to-person transmission through "herd immunity." Herd immunity develops when a sufficiently large portion of a community is immunized against a specific contagious disease such that others are protected against that disease. Herd immunity provides vital protection for those who are not able to receive certain vaccines, such as infants, pregnant women, or immuno-compromised individuals. Not surprisingly, then, periodic outbreaks of common vaccine-preventable diseases, especially measles, mumps, pertussis, and varicella, continue to occur and are frequently associated with geographic clustering of unvaccinated individuals (Atwell et al., 2013).
Abstract and Introduction
Introduction
Among children born between 1994 and 2013, vaccinations will prevent approximately 322 million illnesses, 21 million hospitalizations, and 732,000 deaths, resulting in a net savings of $295 billion in direct costs and $1.4 trillion in total societal costs (Whitney, Zhou, Singelton, & Schuchat, 2014). Although U.S. vaccination rates among young children 19 to 35 months of age is more than 90% for four types of vaccines, coverage remains below target for several others (Table 1; Elam-Evans, Yankey, Singleton, & Kolasa, 2014b). Moreover, vaccination rates for teens aged 13 to 17 years fall well below public health goals (Table 2). Notably, wide variation in coverage exists for all ages based on geographic location, as well as selected demographic characteristics (Elam-Evans, Yankey, Jeyarajah, et al., 2014a). In one California county, vaccination rates at kindergarten entry range from 75.4% to 97.5% (Orange County Children's Partnership, 2013).
Importantly, vaccines provide protection through two different mechanisms. First, vaccines protect individuals directly by inducing immunity against a specific disease. Second, vaccines protect individuals from person-to-person transmission through "herd immunity." Herd immunity develops when a sufficiently large portion of a community is immunized against a specific contagious disease such that others are protected against that disease. Herd immunity provides vital protection for those who are not able to receive certain vaccines, such as infants, pregnant women, or immuno-compromised individuals. Not surprisingly, then, periodic outbreaks of common vaccine-preventable diseases, especially measles, mumps, pertussis, and varicella, continue to occur and are frequently associated with geographic clustering of unvaccinated individuals (Atwell et al., 2013).
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