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.
Hawaii 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.
ALL INFORMATION, DATA, AND
MATERIAL CONTAINED, PRESENTED, OR PROVIDED HERE IS FOR GENERAL INFORMATION
PURPOSES ONLY AND IS NOT TO BE CONSTRUED AS REFLECTING THE KNOWLEDGE OR OPINIONS
OF THE PUBLISHER, AND IS NOT TO BE CONSTRUED OR INTENDED AS PROVIDING MEDICAL OR
LEGAL ADVICE. THE DECISION WHETHER OR NOT TO VACCINATE IS AN IMPORTANT AND
COMPLEX ISSUE AND SHOULD BE MADE BY YOU, AND YOU ALONE, IN CONSULTATION WITH
YOUR HEALTH CARE PROVIDER.
"A foolish faith in authority is the worst enemy of truth."
-- Albert Einstein, letter to a friend, 1901
"I know of no safe depository of the ultimate powers of the society but the people themselves, and if we think them not enlightened enough to exercise control with a wholesome discretion, the remedy is not to take it from them, but to inform their discretion by education."
-- Thomas Jefferson, letter to William C. Jarvis, September 28, 1820
"What's the point of vaccination if it doesn't protect you from the unvaccinated?"
-- Sandy Gottstein
"Who gets to decide what the greater good is and how many will be sacrificed to it?"