Annual Vaccine-Preventable Diseases in Colorado's Children Report Now Available

Date: Monday, February 4, 2019

Feb 04 2019

New Report Shows High Cost of Vaccine-Preventable Disease, Highlights Opportunities to Improve Immunization Rates

Economic burden of vaccine-preventable disease in Colorado children totaled $55.5 million in 2017

AURORA, Colo.— In 2017, Colorado ranked 23rd among U.S. states for childhood immunizations, with 29 percent of children under-immunized at 36 months of age. Over 9,400 Colorado children were treated for vaccine-preventable diseases in a hospital or emergency department, resulting in $55.5 million in charges. That’s according to an independent report released today by Children’s Hospital Colorado (Children’s Colorado) and the Colorado Children’s Immunization Coalition (CCIC). The report, Vaccine-Preventable Diseases in Colorado’s Children, also finds that the prevalence of free-or-reduced lunch eligible students and Medicaid enrollment are indicators of high immunization rates at the local level.

Prepared by pediatricians and researchers from the Department of Epidemiology at Children’s Colorado, the report provides an analysis of the state of health of Colorado’s children based on the most recent National Immunization Survey conducted by the Centers for Disease Control and Prevention, Colorado Hospital Association inpatient and emergency department data and Colorado Department of Public Health and Environment data. The first of three anticipated reports, the February installment of the Vaccine-Preventable Diseases in Colorado’s Children report examines 2017 data on vaccine-preventable diseases in Colorado, highlights the latest updates involving measles in our and other states, and underscores opportunities to decrease barriers to vaccination and improve rates. Findings show that, despite incremental improvement, there remain significant gaps in protection for Colorado’s children.

Key findings from the report include:

Hospitalizations and emergency department visits due to vaccine-preventable disease result in high costs to parents, businesses and taxpayers.

  • Hospital and emergency department (ED) charges to treat children in Colorado for vaccine-preventable diseases totaled more than $55 million in 2017. Actual costs, considering costs of doctors’ office visits, medication, lost wages and decreased productivity, are much higher. [Table 1]
  • In 2017, 558 Colorado children were hospitalized with vaccine-preventable diseases; there were three deaths among these children.
  • Influenza (flu) alone accounted for 460 hospitalizations and 8,656 ED visits among Colorado children in 2017, resulting in more than $42 million in charges.
  • The second most common vaccine-preventable disease to lead to hospitalization was pneumococcal disease, with a total of close to $10 million in charges. The second most common vaccine-preventable cause of ED visits among children in Colorado was varicella (chickenpox), with $1 million in charges.

The highest burden of vaccine-preventable illness falls on young children.

  • Among children in Colorado who were hospitalized for vaccine-preventable diseases, 53 percent were under five years of age. [Figure 3a]

Vaccination coverage for young children improved overall from 2013-2017, but a significant percentage of Colorado children are inadequately protected against vaccine-preventable diseases.

  • Colorado ranks 23rd among US states for early childhood vaccination with 71 percent of children ages 19-35 months up to date on all vaccines. This is well below the Healthy People 2020 goal of 95 percent for each vaccine. [Figure 1] 
  • In 2017, 29 percent of children ages 19-35 months were missing one or more routine vaccines. Rates of non-compliance (not being up to date on recommended vaccines) were highest among children 3-19 months. [Figure 2]
  • MMR (Measles-Mumps-Rubella) vaccination coverage remains well below the 95 percent required to protect a population or community against outbreaks of measles at 87 percent.
  • More than 25 percent of all 7-month-old infants in Colorado are still behind in vaccinations to prevent tetanus, diphtheria, pertussis (DTaP) and pneumococcal disease (PCV).

Low levels of community protection due to inadequate vaccination rates leave many vulnerable children at risk of serious infectious diseases, such as measles.

  • On Jan. 15, public health officials reported an adult in Denver tested positive for measles resulting in an extensive investigation. As of January 2019, the U.S. is experiencing measles outbreaks in Oregon, Washington and New York, with the outbreak in New York having grown to more than 200 cases.
  • Even when a vaccine-preventable disease exposure does not result in transmission, the cost of investigation and prevention can be high. Tri-County Health Department officials estimated the costs of responding to two separate measles cases in 2016 and 2017 to be $18,000 and $49,000 respectively.

Local-level immunization data shows insurance status is an indicator for immunization coverage.

  • School districts with more students enrolled in Medicaid or with more students eligible for free-or-reduced lunch were more likely to have ≥95 percent of their K-12 students up to date with the school-required immunizations. [Map 2]
  • In contrast, higher prevalence of student mobility (those who begin and finish the school year in different districts) and private insurance were indicators for lower immunization rates among K-12 students.
  • County-level data illustrates opportunities to increase Medicaid enrollment and thereby increase immunization rates, particularly in the southwest corner of the state where there are higher numbers of children who are eligible but not enrolled in Medicaid. These counties also have lower immunization rates compared with the rest of the state. [Map 1]

“Vaccines are the best way to safely and effectively prevent many dangerous infectious diseases. When families vaccinate, they protect their children and our communities against preventable illness. Improving vaccination rates will help to prevent unnecessary personal and economic costs, hospitalizations and even death. I encourage all Coloradans to know their family’s vaccination status and to talk with their doctors about vaccines,” said Dr. Jessica Cataldi, report author and pediatrician at Children’s Hospital Colorado and Assistant Professor of Pediatric Infectious Diseases at the University of Colorado School of Medicine.

“While Colorado parents who refuse or delay vaccination for their children are a concern for our state’s health, another concern are the parents who face barriers to vaccination, including gaps in insurance coverage, transportation and the ability to take time off from work,” said Stephanie Wasserman, executive director of the Colorado Children’s Immunization Coalition. 

“To ensure the health of all our children, it’s imperative that Colorado lawmakers dedicate enhanced funding, capacity and resources to support our health services infrastructure and make vaccines more accessible to Colorado families.”

Access the full Vaccine-Preventable Diseases in Colorado’s Children Report.

About the Colorado Children’s Immunization Coalition:
The Colorado Children’s Immunization Coalition (CCIC) is a statewide, independent 501(c)(3) nonprofit. Its mission is to strategically mobilize diverse partners and families to advance children’s health through immunizations. CCIC does not accept funding from vaccine manufacturers or distributors. To learn more, visit and connect with CCIC on Facebook and Twitter

About Children’s Hospital Colorado Children’s Hospital Colorado (Children’s Colorado) has defined and delivered pediatric health care excellence for more than 100 years. Founded in 1908, Children’s Colorado is a leading pediatric network entirely devoted to the health and well-being of children. Continually acknowledged as one of the nation’s top ten Best Children’s Hospitals by U.S. News & World Report and Parents magazine, Children’s Colorado is known for both its nationally and internationally recognized medical, research, education and advocacy programs, as well as comprehensive everyday care for kids throughout Colorado and surrounding states. Children’s Colorado also is recognized for excellence in nursing from the American Nurses Credentialing Centers and has been designated a Magnet® hospital since 2005. The hospital’s family-centered, collaborative approach combines the nation’s top pediatric doctors, nurses and researchers to pioneer new approaches to pediatric medicine. With urgent, emergency and specialty care locations throughout Metro Denver and Southern Colorado, including its campus on the Anschutz Medical Campus, Children’s Colorado provides a full spectrum of pediatric specialties. For more information, visit and connect with Children’s Colorado on Facebook, Twitter and Pinterest.

Media contact: Meredith Preece
Office: 720.777.1798 Mobile: 608.295.3475