Childhood Immunizations Get Big Boost in NJ

Andrew Kitchenman | April 24, 2013 | Health Care
Rate tops national average but advocates stress need for more residents, both children and adults, to get their shots

For the first time in years, New Jersey is above the national average for the percentage of children who have received immunizations, but health advocates are still concerned about two trends.

Parents worried about possible harmful effects are asking for shots to be spread over a longer period of time and there are more requests for religious exemptions, health experts say.

State officials are marking National Infant Immunization Week by emphasizing the importance of babies receiving their shots and urging parents to have their children vaccinated.

Of New Jersey residents between 18 and 35 months old, 79.6 percent have had the full set of recommended vaccines, compared with the national average of 77 percent.

The state had fallen below the national average in recent years.

“With a great deal of collective efforts in the past five years, the state seems to have turned around distressingly falling immunization rates and is now climbing above the national average to more acceptable rates,” said Dr. Lawrence Frenkel, co-chairman of the New Jersey Immunization Network, which is dedicated to increasing immunization rates.

Frenkel said an electronic registry of all new childhood immunizations, the New Jersey Immunization Information System, is helping. While the system has been in place since 1997, the state began requiring online reporting in 2012.

While many healthcare providers have expressed frustration with having to implement the online reporting, Frenkel said providers have been begun to embrace it in recent months.

Timely reporting of vaccinations can help state officials target public awareness efforts to areas with low immunization rates, doctors said. In addition, state officials have cite the benefits of having complete and accurate records, managing vaccine inventories and helping parents remember when immunizations are due or late (

“Most pediatricians understand the public health benefits as well the benefits to the parent and the patient,” Frenkel said of the immunization registry, which can be incorporated into patients’ electronic health records. More than 2 million children under 7 years old have had at least two vaccine doses recorded in the information system.

Dr. Margaret Fisher, Frenkel’s network co-chairwoman, said “lots of good things are happening,” to increase the immunization rate, but there’s room for improvement. Both Fisher and Frenkel are pediatric infectious-disease specialists.

Fisher said a recent trend of parents asking for vaccinations to be spread out – known as alternate immunization schedules — is harmful. She said that there is no scientific evidence to support prolonging the immunization process, such as spreading four vaccines over four visits to a doctor, rather than having all four shots at once.

“While I’m not totally opposed to alternate immunization schedules, the problem is that they’re untested and they often leave children unprotected,” Fisher said. “There’s clearly no evidence for that and in fact it’s giving the child more episodes of pain because you’re separating the doses.”

Dr. Drew Harris, chairman of the New Jersey Public Health Institute, noted another issue of increasing concern – more parents have been citing religious beliefs as a reason why their children should be exempt from immunizations. The number of religious exemptions rose from 2,105 in 2008 to 6,204 in 2011, according to statistics tracked by Harris.

“The explanation for the increase in the number of religious exemptions is likely the result of the weakening of the religious exemption requirements,” Harris said, citing a 2008 opinion by the state attorney general’s office that doctors should not question parents when they claim the religious exemption.

Harris added: “There doesn’t seem to be a significant increase in religiosity in New Jersey that would explain it.”

State Department of Health spokeswoman Donna Leusner described the 1.3 percent of state schoolchildren who have religious exemptions as “very small.”

Fisher added that it’s also important for teenagers and adults to be immunized.

“One of the ways to protect infants sometimes is to immunize their parents and their grandparents,” said Fisher, citing pertussis – or whooping cough – as a particularly virulent and resurgent disease that adult immunizations can help prevent. She credited state officials with understanding the importance of the issue.

Leusner said in an email that state officials recommend that everyone be immunized.

“Vaccines are the safest and most effective tool we have for preventing vaccine-preventable diseases—they protect both the people who receive them and those with whom they come in contact,” she wrote.

Harris added that in a tightly interconnected world, the possibility of infectious diseases spreading quickly is a strong reason for immunizations. ”There’s always going to be something that nature’s going to throw at us and we have to be ready for it,” Harris said.

State Health Commissioner Mary E. O’Dowd highlighted the importance of immunizations during an event at the Monmouth County Health Department in Freehold on Monday.

“Every parent wants what’s best for their children,” O’Dowd said. “Giving babies the recommended immunizations by age 2 is the best way to protect them from childhood diseases like whooping cough and measles.”

For those who are uninsured or underinsured, Monmouth County provides regularly scheduled vaccinations for children, according to Michael Meddis, the county public health coordinator.

“There’s been a lot of controversy and misinformation about vaccines that get posted on the Internet,” Meddis said, saying scientific studies have debunked theories about potential harm caused by vaccines.

Meddis added that it’s important for doctors to inform parents about the dangers of going without immunizations.

“A lot of parents haven’t even seen these diseases, they don’t realize how serious they are,” Meddis said, noting the irony that the very success of immunizations has reduced parents’ awareness of their importance. He recalled the impression that witnessing the effects of polio on children had on his generation growing up in the 1950s.

Anytime the country allows immunization levels to drop, “we’re going to see kids die – we constantly need to reinforce the importance of having your child immunized in a timely manner, in accordance with the schedule” recommended by health authorities, he said.