WEDNESDAY, Nov. 3 (HealthDay News) -- Vaccination rates for
children insured by commercial plans dropped almost four percentage
points between 2008 and 2009, even though the rate of children on
Medicaid getting vaccinated is rising.
"Rates had been gradually improving in the commercial plans. This was the first time we'd seen a drop -- and it was a pretty big drop," said Sarah Thomas, vice president of public policy and communication for the National Committee for Quality Assurance, which recently released its annual State of Health Care Quality report.
Although vaccination rates last year were still mostly higher
among children in private health plans rather than Medicaid,
researchers and other experts suspect that a counterintuitive trend
in American demographics is at work: Parents in a relatively high
socio-economic bracket -- with more education and relatively high
incomes -- forgoing vaccines because of fears about their safety,
with poor individuals taking good advantage of their access to free
or extremely low-cost care to have their children immunized.
"We didn't really explore the reasons [for the trend], but one leading hypothesis is that parents have decided not to get their children vaccinated because of concerns about the potential for side effects and even autism," said Thomas.
"I would argue that parents are doing what they think is the best for their children; they're just misinformed," said Dr. Robert W. Frenck, Jr, professor of pediatrics at Cincinnati Children's Hospital Medical Center.
The view that vaccinations cause autism -- which is not
supported by scientific research -- is also being publicly touted
by a host of attractive celebrities.
Part of that misinformation may come from "very articulate, very
good-looking movie stars or personalities that are giving
information about how bad vaccines are," Frenck said. "Frumpy,
middle-aged doctors" are extolling the value of immunization and
may not be heard above the fray.
"Another idea is that people have bigger deductibles and that may have created some decreases in the use of these services as parents decide they don't want to spend money," Thomas said.
The report relied on voluntary reporting from 1,000 health plans
covering 118 million Americans, in addition to data from Medicaid,
which provides free or co-payment-only health coverage for some
low-income people who could not otherwise afford it. (In certain
cases, children may be eligible for coverage even if parents are
The authors found a drop in several routine childhood
vaccinations. Measles, mumps and rubella (MMR) vaccines decreased
from 93.5 percent in 2008 to 90.6 percent in 2009; diphtheria,
tetanus and whooping cough rates fell from 87.2 percent to 85.4
percent in that one-year period; and the proportion of kids getting
vaccinated for chickenpox fell from 92 percent in 2008 to 90.6
percent in 2009.
Dr. Gabrielle Gold-von Simson, assistant professor of pediatrics
at NYU School of Medicine, believes the success with the Medicaid
rates "is due to the vaccines-for-children programs and other
programs that are dedicated to supplying vaccines for children at
low or no cost."
"I think that's a public health success in a way," she added.
But experts are worried that the downward trend in more
middle-class families, if it continues, could jeopardize the
"People have to understand there's only one disease that we have eliminated from the earth so far and that's smallpox," Frenck said. That means that other diseases, including polio, are still lurking and could infect anyone who is not vaccinated.
Witness the recent pertussis or whooping cough in California,
which has sickened more than 6,200 people -- the most cases
reported in 60 years -- and killed 10 infants, according to the
state health department.
There have also been outbreaks of mumps among college students,
Thompson is hopeful that recent efforts to promote vaccines as
safe will eventually reverse this trend.
"Vaccines are among the safest and most effective therapies that medicine has available, period, for adults or children, particularly for children since the first vaccines against polio were developed coming on 60 years ago," stated Dr. Lee M. Sanders, associate professor of pediatrics at the University of Miami Miller School of Medicine.
The U.S. Centers for Disease Control and Prevention has more on
childhood vaccine schedule.