Progress With Immunizations in Past 20 Years

Childhood immunization coverage in US has grown after Vaccines for Children program

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Measles and polio may be thought of as relics from another time, but it wasn't too long ago that they were major issues for US children. One vaccination program may be largely responsible for the improvement.

A new study from the Centers for Disease Control and Prevention (CDC) focused on changes in vaccine coverage since a national vaccination program began two decades ago.

The researchers estimated that over 300 million childhood illnesses were prevented in the US during this time, thanks to routine childhood vaccinations.

"Talk to your child's pediatrician about vaccinations."

According to the authors of this study, which was led by Anne Schuchat, MD, of CDC's National Center for Immunization and Respiratory Diseases, the CDC's Vaccines for Children (VFC) program began in 1994 in response to a measles outbreak and low immunization levels in the US. Dr. Schuchat and team wanted to examine the effects of the program during the 20 years since it began —  "the VFC era."

The VFC program includes a variety of vaccines that are routinely given to infants, including vaccines for polio, measles, mumps, hepatitis B and pneumococcal disease. The program gives vaccines at no charge to certain eligible children, including the uninsured and underinsured.

To analyze the program's effects, Dr. Schuchat and team utilized data from a number of sources, including the National Immunization Survey and the National Health Interview Survey.

For all vaccines included, coverage increased during the VFC era as compared to the period before the program began.

Coverage of one dose of a measles vaccine has hit the national target of 90 percent every year since 1996 — a marked improvement from the coverage levels of less than 70 percent during the 1989 to 1991 measles outbreak that helped spark the VFC program's creation.

"This report shows the strength of the US immunization program since VFC began; coverage with new vaccines increased rapidly after introduction, and coverage for older childhood vaccines remains near or above 90 percent," the study authors wrote.

Dr. Schuchat and team estimated that this vaccination coverage has prevented around 322 million illnesses, 21 million hospitalizations and 732,000 premature deaths among children born during the past 20 years.

These avoided illnesses included an estimated 3,000 avoided cases of tetanus and over 70 million avoided cases of measles. The researchers also estimated that this saved around $295 billion in direct medical costs.

"It is wonderful to see evidence that the VFC program has worked," said Adam Powell, PhD, health economist and President of Payer+Provider Syndicate.

"It is necessary for a substantial portion of the population to be vaccinated for us to obtain 'herd immunity.' While vaccines are not completely effective, if enough people are vaccinated, diseases cannot easily spread. In a heavily-vaccinated population, people who are not immune despite vaccination or are unable to be vaccinated are protected by their vaccinated peers. Thus, low vaccination rates harm everyone — including people who have been vaccinated," Dr. Powell said.

"It is important for us to continue to quantify the impact of vaccination, as there are a number of people who continue to doubt the relative benefits and risks of vaccination. Measuring the illnesses, hospitalizations, and deaths avoided through vaccination can help bring the discussion into perspective," he said.

Further research is needed to confirm the findings of this study and to explore other factors that may have contributed to increased childhood vaccination coverage in the US.

"Although VFC has strengthened the US immunization program, ongoing attention is needed to ensure that the program addresses challenges and incorporates methods that could improve delivery," stressed Dr. Schuchat and team.

This study was published online April 24 in CDC's Morbidity and Mortality Weekly Report. No conflicts of interest were reported.

Review Date: 
April 24, 2014
Last Updated:
April 30, 2014