Physicians seek to boost childhood vaccination rates

Doctors see all kinds of illness and ailments in any given year, but something they don’t see in their offices and emergency departments are cases of measles, mumps, tetanus, meningitis or polio.

Those diseases were once big health concerns decades ago, but the development and expansive distribution of immunizations for these illnesses have nearly eradicated them in modern society.

But they’re never really gone, and its why physicians continue to work to encourage parents to not only get their kids vaccinated but stick to the nationally recommended shot schedule.

In August, the U.S. Centers for Disease Control and Prevention released a new report, analyzing the impact of routine childhood immunizations in the nation since 1994. Their findings? Childhood vaccines have helped prevent hundreds of millions of illnesses, tens of millions of hospitalizations and more than one million deaths over the last 30 years.

The CDC looked at the impact of nine vaccines recommended for children: the DTaP vaccine against diphtheria, tetanus and pertussis (whooping cough); Haemophilus influenzae type B (Hib); poliovirus; measles, mumps and rubella; hepatitis A; hepatitis B; varicella (chicken pox); pneumococcal conjugate; and rotavirus. The CDC’s vaccine schedule recommends about a dozen different immunizations for children before they reach 18 months of age, with additional boosters administered up through age six.

For Dr. Thomas Gutwein, Allen County Health Commissioner and Parkview physician executive for emergency department and pre-hospital service lines, that’s a list of diseases that doctors rarely or never see in their practices or emergency rooms nowadays.

“The vaccines really are very, very effective and that’s the good part of the story,” Gutwein said. “In emergency medicine, these specific illnesses are very rare.”

The effectiveness of these routine vaccines not only protects individuals but also provides a secondary defense by building herd immunity in the population, which helps to protect people who haven’t been immunized or can’t be for medical reasons.

But physicians are raising alarms as vaccination rates have fallen off both locally and statewide since 2020.

Source: Indiana Department of Health

In 2020, the percentage of children who completed their recommended vaccine schedule before age three was 70.2% and had been increasing year over year. But then COVID-19 pandemic hit and vaccinations have fallen off sharply, hitting as low as 56.4% statewide before ticking up to 58.6% overall in 2024, according to the Indiana Department of Health.

As health commissioner, Gutwein is an advocate always looking for ways to boost community vaccine rates. In Allen County, about 64% of children under age three were on schedule with their vaccines in 2020, but like the state, that number dropped to under 60% before rebounding to 61.1% this year.

Regionally, most counties remain ahead of the state average, although most have seen rates dip since 2020. Locally, Huntington and Whitley counties lead the region at 72.2% and 72%, respectively, with Wabash, Wells, Noble and DeKalb counties all currently above 65%, according to Indiana Department of Health data. On the opposite end, Kosciusko County has seen a large drop-off from over 70% in 2020 to 54.6% this year, while LaGrange County is only 35.5% vaccinated – attributable to its large Amish population – but that county has also seen a significant drop from a rate just shy of 50% in 2020.

When children aren’t getting their shots on time, they’re missing part of their protection and fall back on the community’s herd immunity. But if overall vaccination rates continue to fall and that herd immunity weakens, it provides opportunities for diseases to re-emerge and spread, Gutwein said.

“You’re gambling,” Gutwein said of the risk represented by not vaccinating on time. “And the odds are good in your favor that you won’t get sick, but as a group or as a society, as a community, we actually help each other. It’s not just about the individual. It’s herd health, a community health issue.”

In the few years since 2020, physicians have been working to play catchup with parents and their children. The Allen County Health Department, for example, has helped provide additional funding to the Fort Wayne-based, low-cost Super Shot clinic and other programs directly marketed to parents to encourage vaccination and get back to those pre-pandemic marks.

Rates are starting to bounce back as kids who were young during the pandemic and might have missed shots are in or heading to public school and catching up with immunization requirements for attendance.

“It’s going to take everybody to get back on board. We’re doing a lot of catchup for kids going back to school, which is really beneficial,” Gutwein added.

When it comes to working with parents on vaccinations, Dr. Tony GiaQuinta, Parkview Physicians Group – Pediatrics, said most parents understand the benefits routine vaccines provide to their child’s long-term health.

“In my clinic I still see a very high level of confidence in immunizations, and it starts with us as providers, because patients go to their pediatrician and family care doctor because they trust them inherently,” GiaQuinta said. “I am able to speak with confidence that a vaccine is safe and a vaccine is effective and this is the most important, most powerful medicine in my medicine bag to keep their child healthy and thriving.”

The COVID-19 pandemic did, however, increase skepticism and hesitancy about vaccines in general, and GiaQuinta said some parents do have questions or want more information before choosing to vaccinate. GiaQuinta acknowledges that there is a ton of information available about vaccines – some good, some not – and parsing that as a layperson can be difficult. Listening to and responding to parent concerns is key, and GiaQuinta said that pediatricians and parents can bridge the gap by recognizing they share the same end goal – ensuring that those children grow up healthy and reach their full potential.

“I can tell a parent ‘I see how much you love and care for your child and want them to be healthy,’” GiaQuinta said. “From there I can talk about how immunizations, in my experience, are the best medicine to fulfill their goal. When it’s pitched that way and discussed that way it really becomes obvious to the parent this is the best way to keep their child healthy.”

Decades of success of the national vaccination effort may also be a factor that’s led to some complacency, Gutwein said, because people don’t regularly see the negative impact of the diseases vaccines are preventing.

“Because we’ve been so successful at eliminating these diseases, they haven’t seen friends or relatives that are suffering from these diseases,” Gutwein said. “If you don’t see it personally, having mumps or having a prolonged illness, then you’re not going to be as concerned about it.”

But these are serious diseases that can have serious, long-term consequences, GiaQuinta reminds. Diseases like tetanus cause extreme, debilitating muscle contractions; polio can lead to permanent paralysis; and meningitis can be fatal or lead to lifelong neurological impairment for those who survive.

If parents have questions or concerns, raise them with your pediatrician or primary care physician at your next well-child visit, GiaQuinta said, and your doctor will be able to share the details and reasoning behind the when and why those vaccines are suggested.

“I would recommend nothing less than the ideal schedule for my children and my patients,” GiaQuinta said. “The reason why it’s the ideal schedule is because this is the quickest way to get your child immunized in a safe effective manner.”