Immunization Protects against Disease

• Immunization is one of the most effective ways of protecting against disease. The level of vaccine-preventable disease has been reduced by more than 99 percent since the introduction of vaccines. Reported cases of vaccine-preventable diseases are at, or near, all-time low levels.
  
  
• Before widespread immunization in the United States, infectious diseases killed or disabled thousands of children each year. Tens of thousands of cases of paralytic polio and more than 500,000 measles cases were reported annually.
  
  
• The measles epidemic of 1989-1991 affected more than 55,000 people; 11.000 were hospitalized and about 120 died. A major cause of the measles epidemic was the failure to vaccinate children on time at 12 to 15 months of age.
  
  
• The World Health Organization declared the Western Hemisphere free of polio in 1994. Reported cases have declined by more than 80 percent globally since 1988. These extraordinary results are the direct effect of immunizations against polio.
  
  
• Before a vaccine was developed, Haemophilus influenza type b (Hib) caused more than 10,000 cases of meningitis a year, mostly among infants. In 1995, only 250 cases are known to have occurred.
  
  
• In the 1920's, about 125,000 cases and 10,000 deaths were caused by diphtheria each year. Since 1980, fewer than five cases a year are reported.
  
  
• Childhood illnesses that could be prevented by immunization are still with us. Approximately 3.5 million cases of varicella (chicken pox) are estimated to occur each year. This rate is expected to decrease with the introduction of the new varicella vaccine. Between 5,000 and 10,000 cases or pertussis (whooping cough) occur each year.
  
  

Immunize by Age 2

• Children need 80 percent of their vaccinations in the first 2 years of life. This requires multiple doses of vaccine given in about five visits to a health care provider.
  
  
• The year 2000 goal of the Childhood Immunization Initiative is to have at least 90 percent of all children immunized by 2 years of age with the recommended vaccine series. This series includes four doses of diphtheria/tetanus/pertussis (DTaP or DTP) vaccine, three doses of polio vaccine, one dose of measles/mumps/rubella (MMR) vaccine, three doses of H. influenza type b, and hepatitis B.
  
  
• By 1995, more than 75 percent of the Nation's 2-year-olds received the recommended 4 doses of DTaP or DTP, three doses of polio, and one dose of MMR - the highest level ever recorded. Despite this success, about 25 percent of America's toddlers - or almost 1.4 million children 2 years old or younger - lace one or more doses of this series.
  
  
• All 50 states and the District of Columbia have immunization requirements for children entering daycare and school. There are no such laws ensuring that all children are up to date on their shots by age 2.
  
  
• Children who begin the immunization series late are less likely to complete the series on time than other children. Children who have not received any doses of vaccines by 3 months of age are one-third less likely to be immunized than children who started on time.
  
  

Immunization Saves Money

• Immunization is one of the most cost-effective medical interventions available. For example: For every dollar spent on MMR immunization programs, as much as $21 can be saved in direct and indirect costs.
  
  
• For every dollar spend on the diphtheria/tetanus/pertussis immunization programs, $29 are saved.
  
  
• For every dollar spent on the polio immunization programs, $6 are saved.
  
  

Why Are Children Underimmunized?

• Many parents/caregivers believe their children are fully immunized when they are not. Many providers believe their patients are fully immunized when they are not.
  
  
• No single factor accounts for underimmunization, but various risk factors have been identified, including low parental/caregiver education levels, large family size, low socioeconomic status, nonwhite race, young parental age, use of public clinics, and lack of prenatal care.
  
  
• Inadequate access to medical care, deficiencies in the public health care delivery system, and lack of public awareness are other factors contributing to underimmunization.
  
  
• Some children miss immunizations because their records are misplaced and parents/caregivers and providers are not aware of which vaccinations the child has hand and which are needed. Some states have developed computerized immunization registries that will ensure that all children's records are up to date and complete, even if they move or change health care providers.
  
  
• Opportunities to vaccinate children may be missed because providers are misinformed about contraindications or are unwilling to give more than two vaccines during the visit.
  
  

When to Vaccinate

• General guidelines for immunizations in the first 2 years of life are as follows. Health care providers determine the best schedule for each child.
  
  

  Diphtheria/tetanus/accellular pertussis (DTaP) or diphtheria/tetanus/pertussis (DTP):
  Four vaccinations - at 2, 4, 6, and 15 - 18 months.

  Polio:
  Three options - two shots of inactivated polio vaccine (IPV) at 2 and 4 months, followed by a dose (drops) of oral polio vaccine (OPV) at 12 - 18 months; or 3 shots of IPV at 2 and 4 months and 12 - 18 months; or 3 doses of OPV at 2 and 4 months and 12 - 18 months.

  Measles/mumps/rubella (MMR):
  One vaccination - at 12 - 15 months.

  Chickenpox:
  One vaccination - at 12 - 18 months.

  Hepatitis B:
  Three vaccinations - at 0 - 2 months, 1 - 4 months, and 6 - 18 months.

  H. influenza type b (Hib):
  Four vaccinations - at 2, 4, 6, and 12 - 15 months. One type of the Hib vaccine requires only three doses at 2, 4, and 12 - 15 months.

• Because of changes and improvements in the vaccine schedule, parents/caregivers should talk to their health care providers about the most recent recommendations.
  
  
• Catch-up vaccinations can be given if the child did not get the vaccinations at the recommended times. But delays in starting immunization result in a delay in the child's protection against these dangerous diseases.
  
  
• In most cases, multiple vaccines can be given without increasing the risk of adverse effects or decreasing the effectiveness of the vaccines.
  
  

Contact Information:
National Immunization Program
Centers for Disease Control and Prevention
1600 Clifton Road, NE
Mailstop E-52
Atlanta, Georgia 30333

National Immunization Information Hotline
1-800-232-2522 English
1-800-232-0233 Spanish