医生们试图提高儿童疫苗接种率

医生在任何一年都会看到各种各样的疾病和小病，但他们 don’t 在他们的办公室和急诊科看到麻疹病例, mumps, tetanus, 脑膜炎或小儿麻痹症.

这些疾病在几十年前曾是严重的健康问题, but the development and expansive distribution of immunizations for these illnesses have nearly eradicated them in modern society.

但它们从未真正消失, and its why physicians continue to work to encourage parents to not only get their kids vaccinated but stick to the nationally recommended shot schedule.

In August, the U.S. 疾病控制和预防中心 发布了一份新报告，分析了常规儿童免疫接种的影响 从1994年开始. Their findings? 儿童疫苗帮助预防了数亿种疾病, tens of millions of hospitalizations and more than one million deaths over the last 30 years.

The CDC looked at the impact of nine vaccines recommended for children: the DTaP vaccine against diphtheria, tetanus and pertussis (whooping cough); Haemophilus influenzae type B (Hib); poliovirus; measles, mumps and rubella; hepatitis A; hepatitis B; varicella (chicken pox); pneumococcal conjugate; and rotavirus. The CDC’s vaccine schedule recommends about a dozen different immunizations for children before they reach 18 months of age, 在六岁之前还会注射额外的助推剂.

For Dr. Thomas Gutwein, Allen County Health Commissioner and Parkview physician executive for emergency department and pre-hospital service lines, that’s a list of diseases that doctors rarely or never see in their practices or emergency rooms nowadays.

“The vaccines really are very, very effective and that’s the good part of the story,” Gutwein said. “在急诊医学中，这些特殊疾病非常罕见.”

The effectiveness of these routine vaccines not only protects individuals but also provides a secondary defense by building herd immunity in the population, which helps to protect people who haven’t been immunized or can’t be for medical reasons.

But physicians are raising alarms as vaccination rates have fallen off both locally and statewide since 2020.

资料来源:印第安纳州卫生部

In 2020, the percentage of children who completed their recommended vaccine schedule before age three was 70.2%，并且逐年增长. But then COVID-19 pandemic hit and vaccinations have fallen off sharply, hitting as low as 56.在全州范围内为4%，然后上升到58%.根据印第安纳州卫生部的数据，到2024年，这一比例将达到6%.

作为卫生专员, Gutwein一直在寻找提高社区疫苗接种率的方法. In Allen County, 到2020年，约64%的3岁以下儿童按计划接种了疫苗, 但是就像国家一样, 这一数字在反弹至61%之前曾降至60%以下.1% this year.

Regionally, 大多数县仍高于州平均水平, 尽管自2020年以来，大多数国家的利率都有所下降. 在当地，亨廷顿和惠特利县以72分领先.2% and 72%, respectively, with Wabash, Wells, Noble和DeKalb县目前都在65%以上, 根据印第安纳州卫生部的数据. On the opposite end, Kosciusko County has seen a large drop-off from over 70% in 2020 to 54.今年是6%，而拉格朗日县只有35%.5% vaccinated – attributable to its large Amish population – but that county has also seen a significant drop from a rate just shy of 50% in 2020.

当孩子们没有按时注射疫苗时, they’re missing part of their protection and fall back on the community’s herd immunity. 但如果整体疫苗接种率继续下降，群体免疫力就会减弱, 它为疾病的再次出现和传播提供了机会, Gutwein said.

“你是在赌博，”Gutwein在谈到不按时接种疫苗所代表的风险时说. “而且你不会生病的几率很大, 而是作为一个群体或一个社会, as a community, 我们实际上是互相帮助的. 这不仅仅是个人的问题. 这是群体健康，是社区健康问题.”

在2020年之后的几年里, 医生们一直在努力追赶父母和他们的孩子. 艾伦县卫生局, for example, 为总部位于韦恩堡的, low-cost Super Shot clinic and other programs directly marketed to parents to encourage vaccination and get back to those pre-pandemic marks.

Rates are starting to bounce back as kids who were young during the pandemic and might have missed shots are in or heading to public school and catching up with immunization requirements for attendance.

“这需要每个人都回到船上. 我们为孩子们返校做了很多功课, 这是非常有益的,” Gutwein added.

当谈到与父母一起接种疫苗时，Dr. Tony GiaQuinta, 侨福医生小组-儿科, said most parents understand the benefits routine vaccines provide to their child’s long-term health.

“在我的诊所里，我仍然看到人们对免疫接种非常有信心, 这要从我们作为供应商开始, because patients go to their pediatrician and family care doctor because they trust them inherently,” GiaQuinta said. “I am able to speak with confidence that a vaccine is safe and a vaccine is effective and this is the most important, 我药袋里最强大的药能让他们的孩子健康成长.”

COVID-19大流行, however, 增加对疫苗的怀疑和犹豫, and GiaQuinta said some parents do have questions or want more information before choosing to vaccinate. GiaQuinta acknowledges that there is a ton of information available about vaccines – some good, 有些则不然——作为一个外行人，分析这些信息可能会很困难. 倾听和回应父母的担忧是关键, and GiaQuinta said that pediatricians and parents can bridge the gap by recognizing they share the same end goal – ensuring that those children grow up healthy and reach their full potential.

“I can tell a parent ‘I see how much you love and care for your child and want them to be healthy,’” GiaQuinta said. “从那里我可以谈谈如何免疫, in my experience, 是实现他们目标的最佳药物吗. When it’s pitched that way and discussed that way it really becomes obvious to the parent this is the best way to keep their child healthy.”

Decades of success of the national vaccination effort may also be a factor that’s led to some complacency, Gutwein said, because people don’t regularly see the negative impact of the diseases vaccines are preventing.

“因为我们在消除这些疾病方面非常成功, 他们没有见过患有这些疾病的朋友或亲戚,” Gutwein said. “如果你不亲自去看的话, 患腮腺炎或长期患病, 那么你就不会那么在意它了.”

But these are serious diseases that can have serious, long-term consequences, GiaQuinta reminds. 像破伤风这样的疾病会导致极端的, debilitating muscle contractions; polio can lead to permanent paralysis; and meningitis can be fatal or lead to lifelong neurological impairment for those who survive.

如果家长有疑问或担忧, raise them with your pediatrician or primary care physician at your next well-child visit, GiaQuinta said, and your doctor will be able to share the details and reasoning behind the when and why those vaccines are suggested.

“I would recommend nothing less than the ideal schedule for my children and my patients,” GiaQuinta said. “The reason why it’s the ideal schedule is because this is the quickest way to get your child immunized in a safe effective manner.”