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Missoula Measures - Immunizations


Why this topic?

The increase in life expectancy during the 20th century is largely due to improvements in child survival; this increase is associated with reductions in infectious disease mortality, due largely to immunization. However, infectious diseases remain a major cause of illness, disability, and death. Immunization recommendations in the United States currently target 17 vaccine-preventable diseases across the lifespan. Healthy People 2020

People in the United States continue to get diseases that are vaccine preventable. Viral hepatitis, influenza, and tuberculosis (TB) remain among the leading causes of illness and death in the United States and account for substantial spending on the related consequences of infection. Healthy People 2020

Before widespread immunization in the United States, infectious disease killed or disabled thousands of children each year. Tens of thousands of cases of paralytic polio and an average of 450,000 measles cases were reported annually. CDC Childhood Immunization Facts  We have achieved dramatic success in turning those grim statistics around, but our very success can cause some of us to forget about the risk and become lax in immunizing our children.

Although Montana law requires full vaccination before kindergarten, many younger children are left at risk for a variety of reasons: lack of health care coverage, poverty, religious belief, lack of education of parents, or fear of unproven vaccine side effects. Immunization levels at age two reflect the status of the community’s commitment to provide accessible preventive health care to young children and families.

Vaccines are among the most cost-effective clinical preventive services and are a core component of any preventive services package. Childhood immunization programs provide a very high return on investment. For example, for each birth cohort vaccinated with the routine immunization schedule (this includes DTap, Td, Hib, Polio, MMR, Hep B, and varicella vaccines), society:

Despite progress, approximately 42,000 adults and 300 children in the United States die each year from vaccine-preventable diseases. Communities with pockets of unvaccinated and under-vaccinated populations are at increased risk for outbreaks of vaccine-preventable diseases.  Healthy People 2020

How are we doing?

We compare favorably to other larger Montana towns in making solid progress toward the Healthy People 2020 goals.

In 2009, of the 753 kindergarteners registered in Missoula Dist. 1 schools, only 2 were non-compliant for adequate immunizations, and 9 had no immunizations because of religious beliefs. However, "adequate immunization" rates for two-year-olds are more difficult to accurately assess.

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graph % of kids fully immunized by 35 months, 5 lowest states, Montana, US average, 7 highest states, Healthy People 2010 Goal

Healthy People 2020 Goals    
  Base Target
Kids age 19-35 months with recommended doses of standard immunizations * 68% 80%
Adults age 18-64 with seasonal influenza vaccine 25% 80%
Adults age 65+ with pneumococcal vaccine 60% 90%

* = DTaP, polio, MMR, Hib, hepatitis B, varicella, PCV


Related data

The Difference Immunization Makes

Along with traffic safety (seat belts) and not smoking, the childhood immunization program is listed by CDC as one of the top ten public health improvements from 1900 to 1999. Two of the many striking improvements that immunization has made in the lives of children are illustrated below:

(Pertussis is also known as Whooping Cough) 


Source: Epidemiology and Prevention of Vaccine-Preventable Diseases: The Pink Book, 6th Ed., January 2000, USDHHS/CDC.

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Brief background

What is 'Full Immunization'?

Children need 80% of their vaccinations in the first two years of life, which requires multiple doses of vaccine and about five visits to a health care provider. Full immunization by age two consists of required and/or recommended protection against: diptheria, tetanus, whooping cough, polio, meningitis, hepatitis B, measles, mumps, rubella, hib, and PCV.  Hepatitis A protection may be considered for older children.

Spreading infections

Missoula has one or more whooping cough (pertussis) cases almost every year. It is likely that a significant reservoir of pertussis-susceptible adults exists because of waning immunity years after vaccination. Adult cases are usually not recognized, but they can infect others. Of infants with pertussis, 70% need to be hospitalized. CDC Fact Sheet

A 1993 mumps case highlights the need for continuing vigilance. This person was not vaccinated and probably contracted the disease while out of the country. Missoula residents travel to many parts of the world, and Missoula hosts travelers from all over the globe. This increases the likelihood of the introduction of various vaccine-preventable diseases, which still occur at epidemic levels in many parts of the world. MCCHD, Infectious Diseases

And it’s not only communicable diseases from which youngsters need protection. In early 1998, a nine-day-old infant contracted neonatal tetanus, a severe, often fatal disease. The baby’s mother had never been immunized, so her baby didn’t receive any protection during pregnancy which usually protects the child for the few months until the vaccine series begins. MCCHD

Reaching every child by age two

One of the most important steps that anyone can take to improve timely vaccination is to foster public/private partnerships to support immunization efforts. Raising parents’ awareness about the need for timely immunizations, developing and coordinating immunization campaigns, and providing assistance with vaccine costs and/or transportation can increase access to immunization. MCCHD Many children are covered by health insurance policies which provide free vaccinations up to two years of age. Sliding fee scales for childhood vaccinations at the Missoula City-County Public Health Department are based on income and size of household, thus furthering accessibility by low income families.

Barriers to children's immunizations


Related Websites

Centers for Disease Control (CDC) - information on all aspects of immunizations

Missoula City-County Health Dept. Health Services Division

Links to health data, statistics and information from many national sources.


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