Immunization: Trends and Challenges in Texas

Brief history and overview of immunization

photo of girl receiving vaccination

Immunizations are one of the public health successes of the 20th century. They have eradicated smallpox globally and polio in the United States and have drastically reduced measles, diphtheria, rubella, pertussis, and other diseases that can cause severe illness and death (Association of State and Territorial Health Officials [ASTHO], 2016).

An estimated 11,000 babies are born in the U.S. every day. Each of those infants should receive up to 19 doses of vaccine by age 18 months to be protected against 11 childhood diseases, according to the Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP).

Vaccines represent one of the most cost-effective clinical preventive services available. Each birth cohort immunized according to the ACIP schedule benefits society by:

  • Saving 33,000 lives.
  • Preventing 14 million cases of disease.
  • Reducing direct health-care costs by $9.9 billion.
  • Saving $33.4 billion in indirect costs (Office of Disease Prevention and Health Promotion, Healthy People 2020).

New vaccines are in development to address emerging issues, including Zika, and additional infectious diseases and agents, such as tuberculosis, HIV, and malaria—all of which can spread rapidly through international travel.

Vaccine hesitancy and refusal is growing among certain demographics and in specific geographic areas, creating greater vulnerability for individuals who are too young to be immunized or have health conditions that prevent them from being immunized.

Alert: Immunization Requirements

Texas Health Steps preventive medical checkups for children and adolescents from birth through 20 years include the requirement to screen the patient’s vaccine history and administer immunizations according to the ACIP schedule. Checkups are not considered complete unless all checkup components, including administration of immunizations, are performed. If an immunization is not administered – for example, if the child has a fever – the reason the immunization was not administered must be included in the medical record along with a plan to complete the requirement. Refer to the Resources for links to the current Texas Health Steps Periodicity Schedule, ACIP immunization schedule, and all other resources mentioned in this course.