Opening the door for outbreaks and why herd immunity is essential
Dangerous diseases that had all but been eradicated over the last several decades are back – measles for one. Most of these contagious conditions are preventable with vaccines, but immunization rates began falling during the pandemic and haven’t caught back up.
A recent Centers for Disease Control and Prevention study found that kindergarten vaccination dropped from a 10-year rate of nearly 95% ending in the 2019-2020 school year to 93% in the years since. That equates to hundreds of thousands of un- or under-vaccinated children. This not only puts them at risk for infection but sets the stage for clusters of under-vaccinated groups and opens the door for outbreaks.
Vaccination helps us achieve community immunity, often referred to as “herd immunity,” which describes a community in which enough people have protection against the infection that it becomes protected even if there are still people in that community who are not immune.
“Those people can be neighbors who have some sort of immune deficiency, or the elderly who may have lost their immunity, or infants too young to be immunized. We protect all of them when we choose to vaccinate,” said pediatrician Dr. Sean McKenna. “With diseases such as measles, herd immunity was built by generations of community members who chose to protect their family, friends and neighbors through the simple act of receiving a vaccine. When we lose herd immunity, illnesses like measles are able to find a foothold in our community and then spread through the vulnerable population. That might mean an uncomfortable illness for healthy community members, but can mean severe illness, long-term complications and even death for the vulnerable among us.”
Vaccines protect kids from contagious conditions
The CDC and the American Academy of Pediatrics recommend a routine childhood vaccination schedule to safely protect kids and teens and help them grow into healthy adults. Here are some common vaccine-preventable conditions:
Measles
Measles is a highly contagious virus that causes fever, cough, runny nose, red eyes, loss of appetite and a widespread rash. Vulnerable people (young children, individuals with chronic diseases) can become quite sick and require care in the hospital. As of this article’s publish date, there have been nearly 1,300 cases and three confirmed deaths from measles in the U.S. this year.
The MMR vaccine is given routinely at 1 and 4 years old. The first dose is 93% effective at preventing measles. After the second vaccination, protection goes up to 97%. Children as young as 6 months old can receive the vaccination, which is a good idea if you plan to travel internationally or to an area with known cases of measles.
The MMR vaccine also protects against mumps and rubella. Mumps can result in severe swelling and pain in the salivary glands and jaw, and lead to more serious complications. Rubella typically begins with a red rash on the face that spreads to the rest of the body and is sometimes accompanied by fever and sore throat. While generally mild, it can be very dangerous during pregnancy and for developing babies.
Diphtheria, tetanus and pertussis (whooping cough)
The DTaP vaccine offers protection from three serious bacterial infections – diphtheria, tetanus and pertussis. Diphtheria usually begins in the upper respiratory tract and can spread throughout the body, causing breathing problems, heart failure and paralysis. Tetanus is an infection of the nervous system caused by bacteria that most commonly enters the body through punctured skin. It causes tightening of muscles, especially in the jaw, and can lead to painful stiffness throughout the body, seizures and trouble breathing, among other symptoms. Pertussis, or whooping cough, is an upper respiratory tract and lung infection that causes a severe cough that can last several weeks, and the recovery can last several months.
DTaP is typically given to children in a series of five doses, one at each of the following ages – 2 months, 4 months, 6 months, 15-18 months and 4-6 years. This series develops initial immunity, then a Tdap booster (with reduced doses of the diphtheria and pertussis components) around age 11 provides continued protection. It’s recommended that adults receive that same Tdap vaccination every 10 years.
Polio
Poliomyelitis is a viral disease that gives flu-like symptoms and can lead to brain inflammation and paralysis. There is no cure, but vaccination has helped with prevention in the U.S. since the 1960s. Doses of the polio vaccine are recommended at 2 months, 4 months, 6-18 months and 4-6 years of age.
Varicella (chickenpox)
Before the vaccine became part of the routine childhood immunization schedule in the mid-1990s, getting chickenpox was essentially a rite of passage. Because adults can get especially sick with chickenpox, it was common to encourage the passage from one child to another so they would get it and build immunity before adulthood. Thanks to vaccination, cases have reduced by 97%, sparing kids from the itchy, red, bumpy rash, blisters and scabs – and potentially more serious health problems. Two doses of the varicella vaccine – usually given at 12-15 months and 4-6 years old – are more than 90% effective at preventing the illness.
Flu
While not part of the standard schedule, or a requirement for school enrollment like the others above, the flu vaccine is another important one. Pediatricians and the AAP work hard to make sure children and their families are protected each year so that we can avoid potentially devastating illnesses that can happen with an influenza infection. These can include life-threatening pneumonias, brain inflammation and muscle damage. In addition, the 5-7 days that children are typically sick when they get influenza can cause struggles at school from which it can take months to recover.
It’s worth noting that influenza vaccine coverage among kids reached its lowest point in 12 years in the 2023-24 flu season. The flu virus is tricky and changes from year to year. The flu vaccine is reviewed and modified each year to target the specific strains that are circulating. It’s recommended that everyone 6 months and older get the flu vaccine every fall for prime protection.
Protecting ourselves and contributing to the greater good
Protection through vaccination extends beyond each individual to our communities, our state and our nation.
“Taking care of our own health, and protecting the health of others, can and should be seen as a civic duty,” added Dr. McKenna. “Many diseases that we had controlled in the U.S. are making a return here. It only takes one person to start the spread and endanger so many others.”
Our team is here to care for all kids who need us. Many of our patients have compromised immune systems, such as those battling cancer or with chronic health conditions. This puts them at increased risk in the event of potential exposure to illness-causing viruses and bacteria. The benefits of vaccination extend beyond the person receiving it to everyone in their community. The responsibility falls to each and every one of us. We are proud to help our patients and their families heed that call.
Your child’s doctor can answer all your immunization questions and get them on a schedule to offer the best protection.