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Advocate to vaccinate: moving away from the “politics” of vaccination

Pediatric Research volume 95, pages 1168–1171 (2024)Cite this article

In the 2 decades from 1994–2013, immunization of children prevented ~732,000 deaths, ~21 million hospitalizations and 320 million cases of disease worldwide.1 Routine immunization has led to virtually 100% reductions in diphtheria, Haemophilus influenza Type B, measles, mumps, rubella and polio.2 In the United States (US) alone, childhood vaccination, combined with widespread acceptance and effective delivery of immunizations, has contributed to exponential reductions in pediatric morbidity and mortality.3,4 Pneumococcal conjugate and rotavirus vaccines are credited with preventing up to 60,000 rotavirus-associated hospitalizations, 211,000 severe pneumococcal infections and 13,000 US deaths in the first decade of the 21st century.5,6,7

COVID vaccination is protective against infection, particularly against the need for mechanical ventilation, critical illness and death, with immunocompetent adult vaccine efficacy rates between 50–94%.8 COVID vaccination in pregnancy carries high rates of effectiveness against hospitalization and Emergency Department/Urgent Care use, irrespective of current predominate strains.9 Vaccine efficacy in the United States against COVID hospitalization during pregnancy ranges from 64–99% depending on circulating strain and has been associated with decreased rates of stillbirth.9,10,11 COVID hospitalization in infants ≤6 months is also reduced with maternal immunization.11,12

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Fig. 1: United States partisanship and state vaccination exemptions.
Fig. 2: United States partisanship and child vaccination rates for Diphtheria, Tetanus, Pertussis (Dtap), Influenza and Human Papilloma Virus.

Data availability

All data used in this paper is already publicly available from referenced sources.

References

  1. Whitney, C. G., Zhou, F., Singleton, J. & Schuchat, A., Centers for Disease Control and Prevention (CDC). Benefits from immunization during the vaccines for children program era - United States, 1994-2013. MMWR Morb. Mortal. Wkly Rep. 63, 352–355 (2014).

    PubMed  PubMed Central  Google Scholar 

  2. Talbird, S. E. et al. Impact of Routine Childhood Immunization in Reducing Vaccine-Preventable Diseases in the United States. Pediatrics 150, e2021056013 (2022).

    Article  PubMed  Google Scholar 

  3. Shah, S. Immunization Issues in Preterm Infants: Pertussis, Influenza, and Rotavirus. Neoreviews 15, e439–e448 (2014).

    Article  Google Scholar 

  4. Zhou, F. et al. Economic Evaluation of the Routine Childhood Immunization Program in the United, States, 2009. Pediatrics 133, 1–9 (2014).

    Article  Google Scholar 

  5. Centers for Disease Control and Prevention (CDC). Ten great public health achievements—United States, 2001-2010. MMWR Morb. Mortal. Wkly Rep. 60, 619–623 (2011).

    Google Scholar 

  6. Pilishvili, T. et al. Sustained reductions in invasive pneumococcal disease in the era of conjugate vaccine. J. Infect. Dis. 201, 32–41 (2010).

    Article  PubMed  Google Scholar 

  7. Tate, J. E., Cortese, M. M. & Payne, D. C. Uptake, impact, and effectiveness of rotavirus vaccination in the United States: review of the first 3 years of postlicensure data. Pediatr. Infect. Dis. J. 30, S56-60 (2011).

    Article  PubMed  Google Scholar 

  8. Centers for Disease Control and Prevention (CDC). COVID Data Tracker. Available at: https://covid.cdc.gov/covid-data-tracker/#vaccine-effectiveness. Accessed 12 December 23.

  9. Schrag, S. J. et al. Estimation of COVID-19 mRNA Vaccine Effectiveness Against Medically Attended COVID-19 in Pregnancy During Periods of Delta and Omicron Variant Predominance in the United States. JAMA Netw. Open 5, e2233273, (2022).

    Article  PubMed  PubMed Central  Google Scholar 

  10. Prasad, S. et al. Systematic review and meta-analysis of the effectiveness and perinatal outcomes of COVID-19 vaccination in pregnancy. Nat. Commun. 13, 2414 (2022).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Rand, C. M. & Olson-Chen, C. Maternal Vaccination and Vaccine Hesitancy. Pediatr. Clin. N. Am. 70, 259–269 (2023).

    Article  Google Scholar 

  12. Halasa, N. B. et al. Effectiveness of Maternal Vaccination with mRNA COVID-19 Vaccine During Pregnancy Against COVID-19–Associated Hospitalization in Infants Aged <6 Months — 17 States, July 2021–January 2022. MMWR Morb. Mortal. Wkly Rep. 71, 264–270 (2022).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Werchan D. et al. Effects of Prenatal Psychosocial Stress and COVID-19 Infection on Infant Attention and Socioemotional Development. Pediatr Res. https://doi.org/10.1038/s41390-023-02807-8 (2023). (In this issue).

  14. Albrecht, D. Vaccination, politics and COVID-19 impacts. BMC Public Health 22, 96 (2022).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Allcott, H. et al. Polarization and public health: Partisan differences in social distancing during the coronavirus pandemic. J. Public Econ. 191, 104254 (2020).

    Article  PubMed  PubMed Central  Google Scholar 

  16. Bolsen, T. & Palm, R. Politicization and COVID-19 vaccine resistance in the U.S. Prog. Mol. Biol. Transl. Sci. 188, 81–100 (2022).

    Article  PubMed  Google Scholar 

  17. Sallam, M. COVID-19 Vaccine Hesitancy Worldwide: A Concise Systematic Review of Vaccine Acceptance Rates. Vaccines 9, 160 (2021).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Ward M. 1 Million Deaths Was a Choice. Politico. 5/10/2022. Available at: https://www.politico.com/newsletters/politico-nightly/2022/05/10/1-million-deaths-was-a-choice-00031545. Accessed 15 December 23.

  19. Lazarus, J. V. et al. Revisiting COVID-19 vaccine hesitancy around the world using data from 23 countries in 2021. Nat. Commun. 13, 3801 (2022).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Wallace, J., Goldsmith-Pinkham, P. & Schwartz, J. L. Excess Death Rates for Republican and Democratic Registered Voters in Florida and Ohio During the COVID-19 Pandemic. JAMA Intern. Med. 183, 916–923 (2023).

    Article  PubMed  Google Scholar 

  21. Maxmen, A. How Lawmakers in Texas and Florida undermine Covid Vaccination Efforts. NBC News, November 7, 2023. Available at: https://www.nbcnews.com/health/health-news/lawmakers-texas-florida-undermine-covid-vaccination-efforts-rcna123866. Accessed 12 December 23.

  22. Texas Health and Human Services. COVID-19 Rider 40. Available at: https://www.dshs.texas.gov/immunization-unit/legislative-reports-immunizations-unit/covid-19-rider-40. Accessed 12 December 23.

  23. Relating to prohibiting a private employer from adopting or enforcing certain COVID-19 vaccine mandates; authorizing an administrative penalty. 11-10-23. Texas Senate Bill 7. 88th Legislature 3rd Session. Available at https://legiscan.com/TX/text/SB7/id/2847887. Accessed 17 December 23.

  24. Mello, M. M. et al. Effectiveness of vaccination mandates in improving uptake of COVID-19 vaccines in the USA. Lancet 400, 535–538 (2022).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Abraham, C., Garabedian, L. F., LeCates, R. F. & Galbraith, A. A. Vaccine Mandates and Influenza Vaccination During the Pandemic. Pediatrics 152, e2023061545 (2023).

    Article  PubMed  Google Scholar 

  26. Colgrove, J. & Lowin, A. A Tale of Two States; Mississippi, West Virginia, And Exemptions to Compulsory School Vaccination Laws. Health Aff. 35, 348–355 (2016).

    Article  Google Scholar 

  27. Kuznetsova, L., Cortassa, G. & Trilla, A. Effectiveness of Mandatory and Incentive-Based Routine Childhood Immunization Programs in Europe: A Systematic Review of the Literature. Vaccines 9, 1173 (2021).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Greyson, D., Vriesema-Magnuson, C. & Bettinger, J. A. Impact of school vaccination mandates on pediatric vaccination coverage: a systematic review. CMAJ Open 7, E524–E536 (2019).

    Article  PubMed  PubMed Central  Google Scholar 

  29. Bednarczyk, R. A., King, A. R., Lahijani, A. & Omer, S. B. Current landscape of nonmedical vaccination exemptions in the United States: impact of policy changes. Expert Rev. Vaccines 18, 175–190 (2019).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Wang, E., Clymer, J., Davis-Hayes, C. & Buttenheim, A. Nonmedical exemptions from school immunization requirements: a systematic review. Am. J. Public Health 104, e62–84 (2014).

    Article  PubMed  PubMed Central  Google Scholar 

  31. Blank, N. R., Caplan, A. L. & Constable, C. Exempting schoolchildren from immunizations: states with few barriers had highest rates of nonmedical exemptions. Health Aff. 32, 1282–90 (2013).

    Article  Google Scholar 

  32. Larson, H. J., Gakidou, E. & Murray, C. J. L. The Vaccine-Hesitant Moment. N. Engl. J. Med. 387, 58–65 (2022).

    Article  CAS  PubMed  Google Scholar 

  33. World Health Organization. Ten Threats to global health in 2019. Vaccine Hesitancy. Available at: https://www.who.int/news-room/spotlight/ten-threats-to-global-health-in-2019#:~:text=Vaccine%20hesitancy%20%E2%80%93%20the%20reluctance%20or,in%20tackling%20vaccine%2Dpreventable%20diseases. Accessed 12 December 23.

  34. United Nations Children’s Fund. The State of the World’s Children, 2023: For Every Child, Vaccination. Available at: https://www.unicef.org/reports/state-worlds-children-2023. Accessed 19 November 23.

  35. UNICEF. Measles cases in Europe and Central Asia Skyrocket by 3000 percent this year compared to last. Available at: https://www.unicef.org/press-releases/measles-cases-europe-and-central-asia-skyrocket-3000-cent-year-compared-last. Accessed 18 December 23.

  36. World Health Organization. Immunization Analysis and Insights. Available at: https://www.who.int/teams/immunization-vaccines-and-biologicals/immunization-analysis-and-insights/surveillance/monitoring/provisional-monthly-measles-and-rubella-data. Accessed 18 December 23.

  37. Higgins, D. M., Moss, A., Blackwell, S. & O’Leary, S. T. The COVID-19 Pandemic and Parental Attitudes Toward Routine Childhood Vaccines. Pediatrics 152, e2023062927 (2023).

    Article  PubMed  Google Scholar 

  38. Centers for Disease Control and Prevention. SchoolVax View. Vaccination Coverage and Exemptions among Kindergartners. Available at: https://www.cdc.gov/vaccines/imz-managers/coverage/schoolvaxview/data-reports/index.html. Accessed 17 December 23.

  39. Seither, R. et al. Coverage with Selected Vaccines and Exemption from School Vaccine Requirements Among Children in Kindergarten — United States, 2022–23 School Year. MMWR Morb. Mortal. Wkly Rep. 72, 1217–1224 (2023).

    Article  PubMed  PubMed Central  Google Scholar 

  40. Schrier K. HR 2862. Vaccine Awareness Campaign to Champion Immunization Nationally and Enhance Safety Act of 2019 or the VACCINES Act of 2019. Available at: https://www.congress.gov/bill/116th-congress/house-bill/2862. Accessed 12 November 23.

  41. Schrier K. HR 2347. Strengthening the Vaccines for Children Program Act of 2021. Available at: https://www.congress.gov/bill/117th-congress/house-bill/2347. Accessed 12 November 23.

  42. Congressional Budget Office. Cost Estimate. HR 2347, Strengthening the Vaccines for Children Program Act of 2021. Available at: https://www.cbo.gov/system/files/2022-02/hr2347.pdf. Accessed 13 November 23.

  43. National Vaccine Advisory Committee. Protecting the public’s health: critical functions of the Section 317 Immunization Program-a report of the National Vaccine Advisory Committee. Public Health Rep. 128, 78–95 (2013).

    Article  PubMed Central  Google Scholar 

  44. Jarris, P. & Dolen, V. Section 317 immunization program: protecting a national asset. Public Health Rep. 128, 96–8 (2013).

    Article  PubMed  PubMed Central  Google Scholar 

  45. 317 Coalition. Removing Barriers to Immunization. President’s Budget Request: Fiscal Year 2024. Available at: https://www.317coalition.org/president-s-budget-request. Accesssed 17 December 23.

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Author information

Authors and Affiliations

  1. Maria Fareri Children’s Hospital, New York Medical College, Valhalla, NY, USA

    Shetal Shah & Heather L. Brumberg

  2. Academic Pediatric Association, McLean, VA, USA

    Mona Patel & Maya Ragavan

  3. American Pediatric Society, The Woodlands, TX, USA

    David Keller & Lisa Chamberlain

  4. Association of Medical School Pediatric Department Chairs, McLean, VA, USA

    Tina Cheng & Ann Reed

  5. Society for Pediatric Research, The Woodlands, TX, USA

    Joyce Javier & Lois Lee

Authors
  1. Shetal Shah
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  2. Heather L. Brumberg
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On behalf of the Pediatric Public Policy Council

  • Mona Patel
  • , Maya Ragavan
  • , David Keller
  • , Lisa Chamberlain
  • , Tina Cheng
  • , Ann Reed
  • , Joyce Javier
  •  & Lois Lee

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SS wrote the manuscript and aggregated the data in this paper. HLB reviewed the paper and made critical revisions to the manuscript.

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Correspondence to Shetal Shah.

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Shah, S., Brumberg, H.L. & On behalf of the Pediatric Public Policy Council. Advocate to vaccinate: moving away from the “politics” of vaccination. Pediatr Res 95, 1168–1171 (2024). https://doi.org/10.1038/s41390-024-03043-4

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