Health officials More than one-fourth of Hawaii children 19 to 35 months old are not getting all the immunizations needed to protect their health, according to state health officials.
unsure why rate of
child vaccinations
has been declining
By Helen Altonn
haltonn@starbulletin.comHawaii was doing well on infant immunizations in 1999, then the rate plunged the past two years, said Dr. Paul V. Effler, chief of the state Health Department's Communicable Disease Division.
The reasons are not known but could be related to poverty, low maternal education, more children in the family or families new to the state, he said. Language difficulties and access to care also may be barriers, he said.
Parents also may be confused by the immunization schedules and past reports of vaccine shortages, he said.Effler addressed representatives of more than two dozen concerned organizations yesterday at an Advisory Committee on Infant Immunization meeting at Washington Place.
The sharp drop in infant vaccinations is critical because Hawaii is vulnerable to infectious disease outbreaks, Effler said.
"We can't afford to lower our guard," said state Health Director Bruce Anderson, pointing to people coming in with diseases from places without good vaccination programs.
According to 2001 statistics released by the National Immunization Survey in August, only 73.4 percent of Hawaii infants 19 to 35 months had the four shots recommended for diphtheria, tetanus and pertussis; the three for polio; and the one for measles, mumps and rubella. That leaves nearly 27 percent of children that age without any or all shots needed to protect against those diseases, said Judy Strait-Jones, a public health educator.
Immunizations also are recommended by age 2 for hepatitis B, Haemophilus influenzae type b (Hib) and pneumococcal disease.
Strait-Jones said the state Health Department has received $300,000 from the U.S. Centers for Disease Control for an immunization campaign, and a large portion will be used for radio messages in different languages to encourage infant vaccinations.
Suggestions offered by advisory committee members to achieve full immunization for children at age 2 included gathering more data to identify the problems and establishing a purchasing pool to lower vaccine costs for doctors.
Vaccines that used to cost between $2 and $10 a dose now cost up to $80 a shot, and reimbursements do not cover it, doctors said.
The number of shots involved also may be a turnoff, they said, pointing out that kids need at least 15 shots by age 2 if they get all those recommended, and many get 18. Effler said it is recognized at the national level that more combined vaccines must be pushed to keep immunization rates up.
Back-to-school immunization programs are making a huge difference, with most kids fully vaccinated by then, Anderson said. But the downward trend for infants must be reversed, he said.
Calling on the group to help remedy the situation, he said, "We can't be complacent about this. ... The cost of not vaccinating the population is huge."
Effler said it is not known if kids who are not immunized never see a doctor or if they get some shots and do not finish the series. He said the staff figured out that 70 percent of children who see a doctor fall one shot behind, and at least 20 percent miss three or four.
State Health Department