What’s the Impact of Vaccine-Preventable Diseases in Colorado?

March 21, 2023

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Immunize Colorado and Children’s Hospital Colorado recently released a report detailing the impact of vaccine-preventable diseases (VPDs) in Colorado from 2020-2021. The report, which was prepared by researchers in the Department of Epidemiology at Children’s Colorado, reveals that in the two-year span over 327,000 adults and nearly 50,000 children visited a Colorado emergency department (ED) or were hospitalized from infection with a VPD. More, VPDs resulted in a combined $13 billion in healthcare charges. While the COVID-19 pandemic prevented many from staying up to date with vaccines, routine childhood vaccination rates continue to lag even as we return to more normal behaviors. Colorado ranks 32nd in the nation for the Centers for Disease Control’s (CDC) recommended 7-series vaccines by 24 months of age for children born in 2018. So what does this mean for Coloradans? We’ve broken down a few of the report’s key findings.

Which VPDs most impact Coloradans?

COVID-19 and influenza caused the most hospitalizations in both adults and children in 2020 and 2021. In those two years combined, there were over 420,000 hospitalizations and ED visits for both age groups due to VPDs. A majority of adult hospitalizations were due to COVID-19, followed by influenza, varicella, and pneumococcal disease. Childhood hospitalizations were dominated by infections from influenza, COVID-19, and pneumococcal disease. (The report does note that COVID-19 vaccines were not widely available in 2020 and thus COVID-19 was not considered a VPD at that time.) The report’s authors also recognize that while children do have a lower risk of severe disease from COVID-19 infection compared to adults, “since 2020, COVID has been a top ten cause of death among US children.” This stands in contrast to the myth that COVID-19 does not pose a risk to kids. 

VPDs also result in economic costs, which disproportionately impact those most underserved in our communities. For instance, the economic toll of VPDs for publicly insured and uninsured children is nearly double that for commercially insured children and more than double for publicly insured and uninsured adults. Hospitalizations and ED visit charges for publicly insured and uninsured Coloradans (adults and children) totaled over $5 billion in 2020 and $4 billion in 2021. The costs of VPDs are felt by hospitals and health insurance companies, and can trickle down to taxpayers. For individual families, these costs also include not only hospital bills, but lost wages due to time taken from work. 

HPV-related hospitalizations and emergency department visits are common in Colorado. Our HPV vaccination rates are low.

The report also highlights human papillomavirus (HPV)-related ED visits in Colorado adults. HPV can cause oropharyngeal, cervical, and anogenital cancers. HPV-related ED visits resulted in $80-95 million in charges for the two-year period. Statistically, four out of five people will develop HPV at some point in their lives, but the HPV vaccine can prevent 90% of HPV-related cancers. The HPV vaccine can be given as early as age nine but is recommended between ages 11 and 12 – when the immune response is the strongest. In Colorado, only 51% of 13-17-year olds have initiated their first dose of HPV vaccine and only 37% have completed the vaccine series, placing Coloradans far below the Healthy People 2030 goal of 80% HPV vaccine coverage. The Alliance for HPV Free Colorado has made public  HPV vaccine data in Colorado, which breaks vaccination coverage down by region and race/ethnicity and shows large disparities across the state.

HPV is transmitted through intimate skin-to-skin contact and can be spread unknowingly. Some are concerned that giving the HPV vaccine will increase sexual activity in teens and pre-teens and choose not to vaccinate their children. Data doesn’t support this claim. In fact, there is no association between HPV vaccination and increased sexual activity. HPV-related cancers affect both men and women so it’s important for both boys and girls to get vaccinated before they are ever exposed to the HPV virus. Again, the HPV vaccine prevents 90% of HPV-related cancers. HPV vaccination is truly important to ensuring health throughout the lifespan!

Colorado’s vaccination rates remain low while measles cases make national headlines. Vaccine-preventable diseases aren’t a thing of the past.

People may think that diseases like measles aren’t common anymore and so  we shouldn’t be concerned about vaccinating against them. The truth is that these diseases are still circulating, especially in certain parts of the world, and it doesn’t take a big gap in immunization coverage for them to spread. Measles is extremely contagious. In fact, a person infected with measles can infect 90% of the people they contact (CDC). A 95% MMR (measles, mumps, and rubella) immunization rate is needed to prevent the disease from spreading easily in a community. 

Measles cases have made national headlines in recent months in the United States. In February, nearly 20,000 people were exposed to measles at a religious gathering in Kentucky. This event is linked to an outbreak in Ohio during which 85 children were infected and 36 were hospitalized. In January, the CDC released data that showed at least 250,000 U.S. kindergartners are not protected against measles. According to the Colorado VPD report, our state ranks 32nd in the nation for children completing the CDC’s 7-series of routine vaccines by age two. Data from the Colorado Department of Public Health and Environment (CDPHE) show that in 2021 only 94.4% of Colorado students were fully vaccinated against measles. 

Certain groups are more at risk from measles infection. Children under five are more susceptible to complications, as are people who are unable to be vaccinated, such as infants and those who have conditions for which the MMR vaccine is contraindicated. These groups rely on others to be vaccinated so they can stay protected. Given lower-than-ideal immunization rates in Colorado and measles’ ability to spread quickly, one can see why vaccination is so important! 

Measles isn’t the only disease that poses a threat. Polio, which is considered eliminated in the U.S., made a reemergence last fall in Rockland County, New York when a case of paralytic polio was identified in one individual and wastewater samples indicated its transmission in New York City. Vaccine-preventable diseases aren’t common today thanks to the success of vaccines, but they can come back and spread easily, especially when vaccination rates are low. We have to continue vaccinations for ALL VPDs to ensure that they remain uncommon! 

Your choice to vaccinate is not just about you or your family.

Vaccine-preventable diseases are just that – preventable! The health and economic impacts of these diseases to ourselves and our families, to our communities, and to our healthcare system are harmful, but preventable through vaccines. Vaccines remain one of the greatest achievements in public health. We all have a role to play to keep our community healthy. Your choice to vaccinate has impacts far beyond yourself and your family. Alternatively, when you delay or choose not to vaccinate, you make a choice that allows for diseases to spread. Join us in keeping Colorado communities healthy. Ensure that you and those you love are up to date with routine immunizations and vaccinations for COVID-19 and flu!

Immunize Colorado was formed in 1991 in response to alarmingly low vaccination rates across the state. At the time, only about 50% of Colorado’s children were adequately vaccinated. A group of physicians and other concerned individuals came together to strategize how to protect Coloradans from vaccine-preventable diseases and increase vaccine uptake. Much work remains. You can donate or discover other ways to get involved in supporting our commitment to healthy Colorado communities today!

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