The Colorado Health Institute (CHI) has launched online vaccine equity maps that identify populations and communities disproportionally impacted by the COVID-19 pandemic and track vaccination progress across the state. The data show that in many of the state’s more vulnerable areas, vaccination rates are far behind the state average. The data also show, promisingly, that in much of the San Luis Valley and in other communities with lower incomes, more than a third of adults have been vaccinated. The maps were created to support Colorado’s vaccine equity efforts, led by Immunize Colorado and the Colorado Vaccine Equity Taskforce. The data is also supporting Together We Protect, Colorado’s COVID-19 Vaccine Equity Fund, as it prioritizes funding for vaccine equity efforts across the state.

In 2019, healthcare charges to treat vaccine-preventable diseases (VPDs) like measles, flu and whooping cough in Colorado adults and children reached $1.1 billion. That was before COVID-19 emerged. The same year, vaccine-preventable diseases were the culprit in over 14,000 hospitalizations and emergency department (ED) visits in children, and over 20,000 in adults. That’s according to a new independent report jointly released today by Children’s Hospital Colorado (Children’s Colorado) and Immunize Colorado.

The Vaccine-Preventable Diseases Report, prepared by researchers in the Department of Epidemiology at Children’s Colorado, examines CDC National Immunization Survey data and 2019 Colorado Hospital Association inpatient and emergency department data to determine the health and economic burdens resulting from VPDs in Colorado. According to the report, the economic toll of VPDs is highest for publicly insured and uninsured children and adults, with hospitalizations and ED visit charges for these groups totaling over $900 million in 2019.

The report also finds that only 64% of Colorado’s children born in 2017 were fully vaccinated by age two, ranking our state 43^rd in the nation. By age 35 months, the rate bumps up slightly to 78%—still well below national goals. This likely explains why, for children, ED visit and hospitalization rates for VPDs (excluding influenza) are highest during the first three years of life when on-time vaccination rates are lowest. As the report notes, “under-vaccination early in life leaves children vulnerable to serious diseases.”

In 2020, Colorado’s already-low childhood vaccination rates dropped further when the COVID-19 pandemic hit. Compared to the number of doses delivered January to March 15, doses delivered after March 15 to May were 31% lower for children 0-2 years, 78% lower for 3-9 years, and 82% lower for 10-17 years of age. Although vaccination rates have improved since this initial drop, they have not returned to pre-pandemic levels.

“The consequences of this period of under-vaccination may only become clear as pandemic mitigation measures ease up over the next year; low rates could leave children vulnerable to diseases like measles when they head back to in-person learning and when people start traveling more,” said Dr. Jessica Cataldi, the report’s main author and infectious diseases pediatrician at Children’s Hospital Colorado.

In fact, a March 2021 Immunize Colorado analysis of data from the 2019-20 school year shows nearly 45,000 Colorado students would potentially need to be excluded from school for up to 21 days in the case of a measles outbreak because they’ve either claimed a vaccine exemption (26,830 students) or have an incomplete or missing MMR vaccination record on file (17,834). With the decline in routine vaccination rates, it’s likely the number of potential exclusions jumped even higher during the 2020-21 school year.

As preparation for the next school year begins, getting Colorado’s kids back on track with vaccinations will be critical—especially as they return to in-person learning. Any progress made to bring rates back up could be further delayed if COVID-19 vaccine(s) get approved for children and teens and they’re unable to receive other recommended vaccines like meningococcal and Tdap before heading back to school. Currently, CDC recommends that other vaccines shouldn’t be given within 2 weeks of the COVID-19 vaccine.

“That’s why it’s critical for health care providers to create opportunities for vaccination catch-up now and help get kids back on track,” said Dr. Cataldi. “We can’t risk additional disease outbreaks.”

To mitigate this risk in 2021 and beyond, child health care providers can prioritize scheduling well-child visits and vaccine appointments for their patients – and parents can call their child’s provider to schedule them – this spring, before the inevitable back-to-school rush.

Immunize Colorado has been awarded a grant in the amount of $15,000 from DaVita Kidney care to help expand the critical capacity of the Colorado Vaccine Equity Taskforce and its work to ensure everyone, regardless of race, ethnicity, ability or any other factor, has the information they need to make an informed decision about the COVID-19 vaccine for themselves and their family. This funding will allow Immunize Colorado to dedicate staff capacity, media and communications support, asset development, training and expert-led education opportunities to this important project—all with the goal to help build community trust in the COVID-19 vaccine for communities of color, people living with disabilities, LGBTQ+ individuals and people living on low incomes, as well as to reduce barriers to receiving the COVID-19 vaccine for these populations.

Many vaccines are currently being tested as a tool to combat the COVID-19 pandemic. A new fact sheet developed by Immunize Colorado explains the key differences and similarities between the three vaccines approved for Emergency Use Authorization (EUA) by the Food and Drug Administration (FDA) in the U.S. as of March 15, 2021: the Pfizer vaccine, the Moderna vaccine, and the Johnson & Johnson (Janssen) vaccine. The fact sheet describes how each kind of vaccine (mRNA and viral vector) works in the body to build immunity, explains the differences in dosing, and highlights all three vaccines’ ability to prevent nearly 100% of COVID-19 hospitalizations and deaths. 

Eight Colorado foundations have created a unique partnership focused on funding on- the-ground efforts to connect Coloradans who live daily without access to critical services and opportunities due to race and/or their socioeconomic status with access to COVID-19 vaccines and information.

Together We Protect, Colorado’s COVID-19 Vaccine Equity Fund, is focused specifically on supporting organizations working in communities disproportionally impacted by COVID-19 to ensure that people of color and those who face systemic barriers have the most appropriate and accessible information about the COVID-19 vaccine and can access the vaccine through opportunities that consider barriers such as technology, language, transportation and lack of health insurance.

Together We Protect will provide grants ranging from $10,000 – $100,000 to support Colorado community-based organizations, working in partnership with state-contracted vaccine providers, to provide culturally relevant and localized outreach, information and support to ensure communities who face systemic barriers have access to the COVID-19 vaccine.

“We know that our communities have been the hardest hit by the pandemic both in hospitalizations and deaths,” said Dr. Oswaldo Grenardo, a family physician and tri-chair of the Colorado Vaccine Equity Taskforce. “But we also know that by deploying strategic resources to help our communities get the information and access they need, we can focus on equity, not just expediency, in the distribution of vaccines across our state.”

Together We Protect is a partnership of Immunize Colorado and the Colorado Vaccine Equity Taskforce, which will provide on-the-ground technical assistance and support to community-based organization grantees, and these Colorado foundations:

• Caring for Colorado Foundation
• Colorado Health Foundation
• Community First Foundation
• Delta Dental of Colorado Foundation
• Denver Foundation
• Latino Community Foundation of Colorado
• Next50 Initiative
• Rose Community Foundation

The COVID-19 pandemic has affected every community in Colorado, but some populations have been impacted significantly more than others. Black, Latino, and Native Americans have all experienced rates of infection, hospitalization, and death that far exceed their proportion of the population. Access to COVID-19 vaccines and vaccination rates for both COVID-19 and other vaccines in these communities lag well behind those for White Coloradans.

“As people begin to receive the COVID-19 vaccine, we know that people and communities of color are being left behind. It is absolutely essential that we make equity a central part of our state’s vaccine response,” said Linda Reiner, President and CEO, Caring for Colorado Foundation, which is coordinating the fund. “Together We Protect makes it possible for foundations in our state to work in partnership with community organizations to address persistent barriers to immunization including people’s mistrust in the vaccine due to historic mistreatment of people of color in the health care system, and systemic barriers including language, transportation, and digital access.”

“It is clear that we need a more robust and strategic approach to ensuring that every Coloradan, no matter where they live or who they are, has the opportunity to get vaccinated,” said Stephanie Wasserman, executive director of Immunize Colorado. “This funding will help create those opportunities by connecting trusted, local community organizations with the resources needed to directly remove barriers and improve access to COVID-19 vaccine information and services for those they serve.”

For media inquiries, please contact:

• Michele Ames, 303.817.5510, michele@micheleamesconsulting.com 
• Christie McElhinney, 303.881.0124, christie@tscstrategies.com