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Childhood vaccination rates and the new school year

JUANA SUMMERS, HOST:

For kids, back to school means new school supplies, maybe some new clothes and going to the doctor's office to get up to date on shots. Increasingly, parents are leaving that last one - routine vaccinations - off the to-do list. The CDC says the vaccination rate among kindergartners is dropping. And according to Gallup, fewer Americans overall think childhood vaccinations are important. These trends help explain why measles, a disease that the U.S. eradicated with the vaccine 24 years ago, is now back with a vengeance. Joining me now to talk about it is Dr. Steven Furr. He's a family physician in Jackson, Ala., and the president of the American Academy of Family Physicians. Welcome.

STEVEN FURR: Thank you. Glad to be with you.

SUMMERS: Dr. Furr, if I can, I want to start by talking about the measles outbreaks that we have been seeing this year. The state of Oregon, for example, is facing its largest outbreak since 1991. And if I understand correctly, this disease was eradicated in the United States back in 2000. So help us understand. Why are measles cases surging in some states right now?

FURR: Yeah, the thing you have to realize, a lot of these viral illnesses are all different, but measles is very infectious. And about 94- to 95% of people have had to have a measles infection or be vaccinated to have herd immunity. So therefore, you only have to have 4- or 5% of people to not be immunized for an outbreak to occur. So most of these outbreaks - about 86% of them - have been patients who are unvaccinated, who their vaccination status is unknown.

And the problem with measles, they can get severely ill. Almost 60% of measles patients under 5 years of age get hospitalized. So generally, children get two measles vaccines. They get one when they're 12 months of age, and then they get another one usually before they go back to school. So it's so important that they get both of those vaccinations in.

SUMMERS: What do you think it is that's leading some of these parents to choose not to vaccinate their children? If I understand, most of these emerging cases of measles have been in people under 19. Is it that they've just perhaps forgotten how bad measles once was in this country?

FURR: Yeah. I think that's a great point because, you know, people in this generation have been very fortunate. They have not seen a lot of these diseases. So they really don't know what they're like. So when I was growing up, my grandmother had polio. So I knew what it was like. And she had a deformed leg because of that. When they offered me a polio vaccine, I didn't hesitate to get it.

So I think part of it - people don't realize how severe some of these infectious diseases can be, and so it's kind of out of sight, out of mind. And I think we take it for granted - even the flu. People say the flu is real common. It's been around a long time. But we forget how many people are hospitalized and die from the flu every year.

SUMMERS: Since the early days of the COVID-19 pandemic, there has been poll after poll after poll that shows that Americans' confidence in vaccines is waning, and there's a real-world effect here. Just one data point - the CDC reported late last year that the rate of immunization among kindergarteners is dropping. You're on the front lines here. What do you think is behind these trends?

FURR: I think it was a lot of disruption during COVID. Offices were often closed. They couldn't get into their family physician or their primary care physician. And now, I think part of that is in our health care system now. They might go to urgent care for some of their acute problems rather than going to their family physician's office or their pediatrician's office, so that those places - they don't think about immunization. So I think the biggest thing is to get families associated with their family physician, pediatrician, where they can talk about the immunizations, what they need and what really will protect them.

SUMMERS: You've mentioned a couple of reasons why people aren't getting vaccinated - the breakdown in well care for children, but also a lack of exposure to the effects of serious viral illnesses. I'm struggling to reconcile this for myself because, I mean, as a country, we have all just had the experience of living through a pandemic, where people were dying in huge numbers before there was a widely available vaccine. Do you have an explanation for how that didn't make a bigger difference in attitudes toward vaccination?

FURR: Yeah, I think you've got to realize when you look at the history of vaccinations, just like when COVID vaccine came out, and everybody was thinking the uptake was going to be 80, 90%. I knew that wasn't realistic 'cause we've been doing the flu vaccine for years, and we never got over 45% of people to get vaccinated. So there is a hesitancy about vaccine in many different communities. You know, you could go back to the fact that this came through - might have been sponsored by the government and got started - and you go back to the Tuskegee experiment. There's just some concern in communities.

But best way to get people immunized is to have their personal relationship with their family physician. And I can tell you the way I get most - so many people immunized is the spouse will be in with a husband, and he comes in. And I say, you want to get your flu shot? And he says yes. And then the spouse, I'll say do you want to get yours while you're here? And they'll say yes. So a lot of times it's just a matter of the physician asking them. And then when they ask and have concerns, then you can talk and address about those concerns. But some of it, I think, is just denial. Denial is a protective psychological defense we all have. And you'll think everybody else will get this, but I'll never get it.

SUMMERS: Some of the trends that we've been talking about in terms of childhood vaccination rates may be concerning to some listeners. So I want to ask you - as a physician, what brings you hope when you think about the role that you and your colleagues play in both keeping kids healthy, but also helping to prevent the spread of disease?

SUMMERS: Dr. Steven Furr is a family physician in Jackson, Ala., and he's also the president of the American Academy of Family Physicians. Dr. Furr, thank you.

FURR: Thank you. Great to talk with you. Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Kathryn Fink
Kathryn Fink is a producer with NPR's All Things Considered.
Juana Summers is a political correspondent for NPR covering race, justice and politics. She has covered politics since 2010 for publications including Politico, CNN and The Associated Press. She got her start in public radio at KBIA in Columbia, Mo., and also previously covered Congress for NPR.
Courtney Dorning has been a Senior Editor for NPR's All Things Considered since November 2018. In that role, she's the lead editor for the daily show. Dorning is responsible for newsmaker interviews, lead news segments and the small, quirky features that are a hallmark of the network's flagship afternoon magazine program.