Average completion rates for routine childhood and adolescent vaccinations in Michigan decreased from 2017 to 2023, according to a study published in Pediatrics in August. The study, which analyzed data from the Michigan Care Improvement Registry, compared completion rates across all Michigan counties.
In an email to The Michigan Daily, Dr. Kao-Ping Chua, senior author of the study, wrote that researchers focused on a seven-vaccine series for children and a six-vaccine series for adolescents, and found that completion rates for both decreased over the six-year period.
“We found that the percentage of children aged 19-35 months who had received their recommended routine vaccinations dropped nine percentage points, from 76% to 67%,” Chua wrote. “The percentage of teenagers aged 13-17 years who had received their recommended routine vaccinations dropped six percentage points, from 81% to 75%.”
Abram Wagner, assistant professor in the School of Public Health, studies vaccine hesitancy. In an interview with The Daily, Wagner said these findings are concerning to public health experts.
“Vaccination is one of the most cost-effective methods we have for improving the health of children, pregnant women and older adults,” Wagner said. “So it is disheartening when vaccination rates are falling, because that just means — as a state — that we’re more susceptible to outbreaks and to disease and to death.”
Even though scientific research has shown that vaccines are safe and effective, childhood vaccination rates have been falling across the United States. Wagner said a variety of factors contributed to this decline, including the spread of misinformation about the COVID-19 vaccine and debunked claims linking vaccines and autism.
“Since the ’90s, there’s been a bit more of a mobilized presence of what we now call vaccine hesitancy among parents,” Wagner said. “Then there was the rise of social media, like Facebook and Twitter, in the early 2010s, so more people were having an easier time finding others who had anti-vaccine feelings or sentiments.”
The study also found that the Michigan counties with the greatest decline in vaccination rates had lower median incomes and a higher uninsured population. The effect of urban or rural status was also analyzed, but was not found to have a consistent effect. According to Chua, this disparity could be related to a lack of access to care.
“Counties with lower income and higher uninsurance typically have fewer health care providers and greater barriers to health care access,” Chua wrote. “The additional barriers to health care access during the COVID-19 pandemic due to social distancing measures may have particularly impeded the receipt of immunizations in these counties.”
In addition, the study examined adolescent completion rates of the human papillomavirus vaccination. Since the first HPV vaccine was approved in 2006, the percentage of adolescents receiving the vaccine has gradually increased. The study found that while HPV vaccination rates in Michigan did increase from 2017 to 2023, this increase was smaller than that predicted by the trends in vaccination rates prior to the COVID-19 pandemic.
Rackham student Mengdi Ji is in the Epidemiological Science doctoral program and studies vaccination. In an interview with The Daily, Ji said one obstacle to increasing HPV vaccination is stigma.
“There are lots of myths around HPV vaccination,” Ji said. “Lots of parents may think, ‘oh, I got my children vaccinated, they may have early sex or risky sexual behavior.’”
Research has not found an association between HPV vaccination and risky sexual behavior. As with the general childhood and adolescent vaccination rates, there were disparities in vaccination rates based on county characteristics. The increase in HPV vaccination completion was smallest in counties with low median incomes and high rates of uninsured individuals.
In the U.S., vaccines are an increasingly politically polarized topic. Secretary of Health and Human Services Robert F. Kennedy Jr. has spread false claims about vaccine safety and efficacy, and fired all 17 members of the Advisory Committee on Immunization Practices in June.
These events have led to concern among public health experts, including Wagner. He said people have forgotten the serious effects of diseases like measles and polio because vaccines previously eliminated these diseases in the US. However, the Centers for Disease Control and Prevention reported 1,431 confirmed cases of Measles so far this year – a dramatic increase from years prior.
“We’re trying to protect against some really deadly diseases, and we just don’t have those kinds of experiences anymore,” Wagner said. “But unfortunately, we might be able to have those experiences more in the future as vaccine rates decline. But I do not think that we have an environment where there’s a lot of trust in the media, so I’m worried that if there was an outbreak of a bad vaccine-preventable disease that causes a lot of disability, people won’t believe the media reporting on it.”
Daily Staff Reporter Nadia Taeckens can be reached at taeckens@umich.edu.
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