Health
Breast & Cervical Cancer
Rental Housing
Violent Crime
Self-Sufficiency
Basic Needs
Physical Activity
Nutrition
Minorities
Mental Health
Childhood Immunizations
Heart Disease
Health Care Coverage
Feeling Well
Traffic Crashes
Communicable Diseases
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Why This Measure?
Before widespread immunization in the United States, infectious disease killed or
disabled thousands of children each year. Tens of thousands of cases of paralytic polio
and an average of 450,000 measles cases were reported annually (CDC Childhood Immunization
Facts). We have achieved dramatic success in turning those grim statistics around, but our
very success can cause some of us to forget about the risk and become lax in immunizing
our children. Although Montana law now requires full vaccination before kindergarten, many
younger children are left at risk through neglect or poverty. Immunization levels at age
two reflect the status of the community’s commitment to provide accessible preventive
health care to young children and families.
Lead Indicator
Estimated Percent of Children Visiting Health Care Providers
Who Were Fully Immunized by 24 to 36 Months of Age
Source: MDPHHS
Trend Better Data Rating Availablevv Reliablevv Relevantvvv
How
are we doing?
We compare favorably to other larger Montana
towns in making solid progress toward the Healthy People 2000 goals of:
- Increasing to 90% the proportion of children under two years of age who have completed
their basic series.
- Increasing to at least 95% basic immunization series among children in childcare or
schools.
- Improving the financing and delivery of immunizations for children (and adults) so that
no American has a financial barrier to receiving immunizations.
From 1995 through 1998 Missoula County schools with kindergarten entry level recorded
98 to 99% of incoming students (5 years of age) with "adequate immunization" (MT
DPHHS). However, "adequate immunization" rates for two-year-olds are more
difficult to accurately assess as many toddlers are not seen by health care providers.
What Is full Immunization?
Children need 80% of their vaccinations in the first two
years of life, which requires multiple doses of vaccine and about five visits to a health
care provider. Full immunization by age two consists of required and/or recommended
protection against: diptheria, tetanus, whooping cough, polio, meningitis, hepatitis B,
measles, mumps, and rubella. Hepatitis A protection may be considered for older children.
Spreading
Infections
Missoula has one or more whooping cough
(pertussis) cases almost every year. It is likely that a significant reservoir of
pertussis-susceptible adults exists because of waning immunity years after vaccination.
Adult cases are usually not recognized, but they can infect others (Red Book 1997). Of
infants with pertussis, 70% need to be hospitalized (CDC Fact Sheet).
A 1993 mumps case highlights the need for continuing
vigilance. This person was not vaccinated and probably contracted the disease while out of
the country. Missoula residents travel to many parts of the world, and Missoula hosts
travelers from all over the globe. This increases the likelihood of the introduction of
various vaccine-preventable diseases, which still occur at epidemic levels in many parts
of the world (MCCHD, Health Promotion Division).
And it’s not only communicable diseases from which
youngsters need protection. In early 1998, a nine-day-old infant contracted neonatal
tetanus, a severe, often fatal disease. The baby’s mother had never been immunized,
so her baby didn’t receive any protection during pregnancy which usually lasts a few
months until the vaccine series begins (MCCHD).
The Difference
Immunization Makes
Along with traffic safety (seat belts) and
nonsmoking, the childhood immunization program is listed by CDC as one of the top ten
public health improvements from 1900 to 1999. Two of the many striking improvements that
immunization has made in the lives of children are illustrated below:
Reaching Every Child By Two
One of the most important steps that anyone can take to improve timely vaccination
is to foster public/private partnerships to support immunization efforts. Raising
parents’ awareness about the need for timely immunizations, developing and
coordinating immunization campaigns, and providing assistance with vaccine costs and/or
transportation can increase access to immunization (MCCHD). Many children are covered by
health insurance policies which provide free vaccinations up to two years of age. Sliding
scale fees for childhood vaccinations at the Missoula City-County Public Health Department
are based on income and the number of persons in the household, thus furthering
accessibility by low income families.
Coalitions that include health care providers, representatives of community-based
organizations, and business leaders can make the difference in reaching children,
developing innovative immunization efforts, and ensuring public support. They can provide
important expertise, resources, and volunteer assistance. For example, in the past few
years the Sentinel Kiwanis Club and McDonald’s Hamburgers have teamed up with the
Missoula City-County Health Department to sponsor the Spring Immunization Clinic at
Southgate Mall, making children’s vaccinations affordable for a voluntary $5
donation.
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