Declines in vaccination rate could lead to millions of cases of preventable disease
May 22, 2025
Summary: Decreases in vaccination rates could lead to millions of cases of preventable disease and increases in complications and costs.
Source: Jian, et al JAMA April 24, 2025
Researchers in JAMA used a microsimulation model to project the likely number of measles, rubella, polio and diphtheria infections under different scenarios of community vaccination rates. They built their model on a state-by-state level, as vaccination rates vary widely among states. The results are sobering. Childhood vaccination rates have generally been on the way down, and the researchers report that measles became endemic (much like influenza and COVID-19) in 83% of their simulation models in an average of 21 years even with no further decline in vaccination rates. A decline in vaccination rates of 10% could lead to more than 11 million cases of measles over the 25 year projection period. A 25% decline in childhood vaccination rates was projected to lead to 100 cases of paralytic polio.
Source: Jian, et al JAMA April 24, 2025 for effectiveness rates and CDC FastStats 2021 for vaccination rates
Measles leads to hospitalization in 10-20% of cases, and leads to devastating neurologic complications in one of 1000 cases. Measles also leads to “immune amnesia,” and increases risk of death from other infections. Rubella leads to deafness, blindness, and sometimes severe cognitive impairments in 65% of babies of women who are infected from 0-16 weeks of pregnancy. Diphtheria leads to death in 10% of those who are unvaccinated. When we have vaccination rates over 95%, we have “herd immunity.” Each person who gets infected (from a foreign trip for instance) is unable to infect others. When vaccination rates fall, even those who are vaccinated can be infected, as vaccinations don’t induce immunity in all who receive them.
Here’s a link to an article in StatNews of reader memories of childhood diseases.
Here’s a link to a post from me on this topic.
Implications for employers
Pediatric vaccines are one of the few medical interventions that improve individual and population health AND lower health care costs.
Pediatric infectious diseases cause a large amount of productivity loss as parents stay home to care for their sick children; vaccinations decrease time away from work.
Employers can ask their carriers for reporting on pediatric vaccination rates, and educate members that childhood vaccinations are available without cost sharing.
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