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Policy Brief: Immunization Rates among Children in Washington State

Dani Woodley
Western Washington University

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Immunization Rates Among Children in Washington State
Summary:
As a nurse on the pediatric floor in an acute care setting, it is difficult to see or
hear, about children having to be hospitalized for exposure to illnesses that can be
prevented with simple vaccinations. In our state we have many citizens who are unable to
obtain immunizations due to being too young, immune-compromised, or unable related to
medical reasons. Herd immunity is a term that has at one time, reduced cases of
preventable infectious diseases, though now, there is an increase in prevalence of diseases
such as Measles, Whooping cough, and Hepatitis in our country. To achieve herd
immunity to protect our unimmunized, we must attain at least a 90% immunization rate.
In 2015, Washington State reports only 67% of toddlers who were fully vaccinated by age
3 (WA State Department of Health [DoH], 2015). The DoH (2015) reports that the state
and national goal is that 90 percent of children will each receive individual childhood
vaccine. Washington State is nowhere near these immunization goals. The Healthcare and
Wellness Committee must eliminate the loophole that allows parents to opt out of
vaccinating their children for personal or philosophical beliefs.
Background:
To aide in eliminating preventable infectious diseases in our state, we must
become stricter with our compliance of vaccinating younger populations. Healthy People
2020 (2016) goals for immunization and infectious diseases are rooted in research on
clinical and community activities and services for the preventing and treating infectious
diseases. To help improve the immunization rates in Washington State, costs of all
recommended immunizations up until age 18 are covered. Also, if individuals cant
afford the office visit or administration fees of those vaccines, patients can request to
have them waived (WA State Department of Health, 2015). Healthy People 2020 (2016)
points out that immunizations are one of the most cost-effective preventative measures in
place. Every birth cohort that is vaccinated at 90% with the routine immunization
schedule will:

Save 33,000 lives.

Prevent 14 million cases of disease.

Reduces direct health care costs by $9.9 billion.

Saves $33.4 billion in indirect costs.

Research is finding that vaccination rates among children associated with nonmedical exemption rates are at higher risk for increased diseases (Centers for Disease
Control, 2015). Reasons for non-medical exemptions include philosophical
exemptions, which cluster geographically, making some communities at a greater risk for
outbreaks of vaccine preventable diseases. In February of 2015, this committee approved
HB 2009 for a second reading, which would eliminate the personal belief or
philosophical exemption as it pertains to immunization coverage (Washington State
Legislature, 2016). This is as far as the bill has gone; it has been stuck in its second
reading for over a year.
Recommendation:
It is crucial for the safety of unimmunized citizens in Washington State that the
Healthcare and Wellness Committee continue to process HB 2009. Vaccination
exemptions must be stricter to decrease vaccine preventable diseases. Additional
recommendations to increase immunization rates include:
o Partner with and increase the budget available to the Washington State
Department of Health, Prevention & Community Health division to
purchase vaccinations for uninsured or underinsured individuals.
o Support this division to arrange in school vaccination clinics so they
are available to children on the spot to make vaccinations more

accessible.
The CDC (2015) emphasizes that in addition to state vaccination
requirements, stronger health care practices such as having more in-depth
discussions with hesitant parents and establishing vaccination as the default
are strategies to improve vaccination coverage rates

Support state clinics to get vaccination data to the healthcare providers to aid
them in achieving their vaccination goals, and educate providers on the right
vaccinations at the right time.
References

Centers for Disease Control and Prevention. (2015, April). Improving vaccination
coverage fact sheet. Retrieved from http://www.cdc.gov/vaccines/imz
managers/laws/downloads/Improving-Vax-Coverage-Factsheet.pdf
Healthy People 2020. (2016, February). Immunizations and infectious diseases. Retrieved
from http://www.healthypeople.gov/2020/topics-objectives/topic/immunizationand-infectious-diseases
Washington State Department of Health. (2015, August). Vaccine rates leave Washington
toddlers at risk for preventable diseases. Retrieved from
http://www.doh.wa.gov/Newsroom/2015NewsReleases/15160ChildhoodImmuniz
ationDataNewsRelease
Washington State Department of Health. (2015, January). Measles. Retrieved from
http://www.doh.wa.gov/Portals/1/Documents/5100/420-014-Fact-Measles.pdf
Washington State Legislature. (2016, February). House bill 2009: Concerning
immunizations & school-aged children. Retrieved from
http://app.leg.wa.gov/billinfo/summary.aspx?bill=2009&year=2015