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 43rd 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.