April 18, 2023

Too many Philly kids are missing routine vaccines, putting us all at risk. Here’s how to keep our city safe. | Expert Opinion

by Ezekiel J. Emanuel and Matthew Guido, For The Inquirer

Philadelphia has a problem with routine childhood vaccines: Nearly one in five public school students is not fully vaccinated, with immunization rates falling for two straight years.

While Philadelphia’s kindergarten vaccination rates remain slightly above the national average and above cities such as Washington, D.C., and Houston, the city should not be complacent. If we can’t turn around this trend and boost childhood vaccination rates, the city risks those rates slipping even further, which can open the door for deadly outbreaks. Young children are already facing high rates of transmissible illnesses such as respiratory syncytial virus (RSV) and the flu as many return to socializing after being relatively sheltered during the pandemic; adding another virus to the mix could be disastrous.

What’s more, Philadelphia has an opportunity to make itself a national exemplar in this area. Wouldn’t it be great to be known for having the nation’s most effective, citywide public vaccination effort that protects our children and reflects well on our health systems, School District, and city government?

But we’re not there.

Last year, only 82.2% of kindergarteners in Philly public schools had all five mandatory childhood vaccinations: polio, measles-mumps-rubella (MMR), diphtheria-tetanus-pertussis (DTaP), hepatitis B, and chicken pox. This is down significantly from 89.9% during the 2019-20 school year. Over this period, the kindergarten MMR rate dropped below measles’ herd immunity threshold (95%), increasing the possibility of measles outbreaks in schools. What’s more, one in five babies born in Philadelphia likely has no immunity against measles because their mothers lack protective antibodies that can be passed in the womb, leaving them vulnerable until getting their first vaccine dose at 12 months.

Even more worrisome are the enormous neighborhood disparities in vaccinations. For instance, citywide, 90% of children under 5 have received all required doses of the polio vaccine, but in some neighborhoods of South Philadelphia, the number is less than 60%. This is well below polio’s herd immunity threshold (80%).

The city’s drop in routine immunizations is neither inevitable nor irreversible.

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