Vaccine-preventable diseases

The success of vaccines means we don’t see vaccine-preventable diseases as often as in the past, but some diseases are still common in the United States. We have to maintain high vaccination rates to ensure protection from these serious diseases.

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What is vaccination coverage and why is it important?

Vaccination coverage is the estimated percent of people who have received specific vaccines. Health departments all over the United States monitor vaccination coverage to understand how well communities are protected from vaccine-preventable diseases. Vaccination coverage information is used to identify areas and groups with lower vaccination coverage so public health departments, health care partners, and schools can take action to help improve vaccination coverage and protect everyone from vaccine-preventable diseases. You can find national and state data on vaccination coverage for vaccines across the lifespan by visiting CDC’s VaxView.

Massachusetts providers reporting immunization data to the Massachusetts Immunization Information System (MIIS) can access their own vaccination coverage report through the registry. Visit the ContactMIIS website for information on running these types of reports.

Vaccine-preventable diseases reported in Massachusetts

Some diseases that are prevented by vaccines, like pertussis (whooping cough) and chickenpox, remain common in the United States. On the other hand, other diseases are no longer common in this country because of vaccines. However, if we stopped vaccinating, even the few cases we have in the United States could very quickly become tens or hundreds of thousands of cases.

The Vaccine-Preventable Diseases 10-Year Morbidity Report, below, gives an overview of incidence of vaccine-preventable disease in Massachusetts.

Vaccine-Preventable Diseases Reported in Massachusetts, 2009 - 20191

Disease

2009

2010

2011

2012

2013

2014

2015

2016

2017

2018

2019 YTD

Measles2

2

3

24

0

1

8

0

1

0

2

2

Mumps2

15

9

4

6

71

5

6

258

192

44

35

Rubella2

1

0

0

1

0

0

0

0

1

0

0

Meningococcal

14

8

14

6

11

11

12

11

11

21

8

Pertussis

361

296

280

653

348

298

253

198

383

258

79
Hib3 < 5 1 1 0 2 1 1 0 1 2 1 0
Hepatitis A 70 50 40 43 46 43 35 64 53 371 125

Hepatitis B (acute)

43

42

68

61

42

36

34

32

52

48

12

Tetanus

0

0

0

0

0

0

0

0

0

0

0
Diphtheria 0 0 0 0 0 0 0 0 0 0 0
Polio 0 0 0 0 0 0 0 0 0 0 0
Pneumococcal Disease < 5 81 72 40 51 24 27 20 31 21 26 13
Varicella2 1415 770 606 627 475 469 356 290 382 291 158

1 YTD data are preliminary as of June 25 2019.

2 Measles, Mumps, Rubella, and Varicella numbers include confirmed and probable cases to better reflect disease burden. All other diseases include confirmed cases only.

3 Haemophilus influenzae type B

Childhood and adolescent immunization rates

The most recent National Immunization Survey showed Massachusetts had some of the highest vaccination rates in the country. In fact, Massachusetts ranks number one in the country for 19-35 month olds vaccinated with MMR vaccine, DTaP vaccine, and the combined series of 7 vaccines recommended for children before they turn age 2.  See the tables below for the NIS child and teen rates.

National Immunization Survey, Vaccines Routinely Recommended During Childhood

Estimated Vaccination Coverage among Children Aged 19 – 35 Months, 2017

Vaccine

MA

US

≥ 4 DTaP1

93%

83%

≥ 3 Polio1

96%

93%

≥ 1 MMR1

98%

91%

≥ 3 Hib (full series)

89%

81%

≥ 3 Hep B1

93%

91%

Hep B birth dose

75%

74%

≥ 1 varicella1

98%

91%

≥ 4 PCV

92%

82%

≥ 2 Hep A

57%

60%

Rotavirus

80%

73%

4:3:1:4:3:12

83%

73%

4:3:1:4:3:1:43

82%

70%

1 Required for child care/preschool entry in Massachusetts.

2 ≥ 4 DTaP, ≥ 3 polio, ≥ 1 MMR, ≥ 3 Hib (full series), ≥ 3 HepB, and ≥1 varicella

3 ≥ 4 DTaP, ≥ 3 polio, ≥ 1 MMR, ≥ 3 Hib (full series), ≥ 3 HepB, ≥ 1 varicella, and ≥ 4+ PCV

Estimated Vaccination Coverage among Adolescents Aged 13 – 17 Years, Adolescent Catch-Up Vaccines, 2017

Vaccine

MA

US

≥ 2 MMR1

98%

92%

≥ 3 Hep B1

95%

92%

≥ 1 varicella

97%

96%

≥ 2 varicella1

93%

89%

Immunity to varicella1,2

94%

90%

1 Required for school entry in Massachusetts. A provider-certified history of chickenpox also meets the requirement for varicella for school entry.

2 History of disease or ≥ 2 doses of varicella vaccine.

Vaccines Routinely Recommended for Adolescents, 2017

 

MA

US

≥ 1 Td or Tdap

98%

91%

≥ 1 Tdap1

96%

89%

≥ 1 meningococcal 2

94%

85%

≥ 1 HPV2

82%

66%

HPV series completion 2,3

66%

49%

Females

≥ 1 HPV2 85% 69%

≥ 2 HPV2

73%

58%

≥ 3 HPV2

53%

44%

HPV series completion2,3

67%

53%

Males

 

 

≥ 1 HPV2 79% 63%

≥ 2 HPV2

65%

49%

≥ 3 HPV2

53%

35%

HPV series completion2,3

64%

44%

1 Required for school entry in Massachusetts.
2 Not required for school entry. Meningococcal (MenACWY) vaccine is required for students in residential schools.
3 Includes those with ≥ 3 doses, and those with 2 doses when the first HPV vaccine dose was initiated prior to age 15 years and there was at least five months minus four days between the first and second dose as specified by Clinical Decision Support for Immunization (CDSi)

Adult immunization rates

While overall Massachusetts is doing well on childhood immunization rates, the same is not the case for adult immunizations rates. Unfortunately, far too few adults are receiving the recommended vaccines, leaving themselves and their loved ones vulnerable to serious diseases.

2017 Immunization Estimates for Massachusetts Adults, Non-Influenza Vaccine Estimates

 

MA

Ever had Tdap, > 18 y/o

40%

Hep B series, > 18 y/o

37%

Ever had Zoster, > 60 y/o

46%

Ever had Pneumonia shot, > 65 y/o

76%

Ever had 1+ dose HPV females, 18-26 y/o

70%

Ever had 3+ doses HPV females, 18-26 y/o*

Ever had 1+ dose HPV males,  18-26 y/o

41%

Ever had 3+ doses HPV males, 18-26 y/o*

† Insufficient data
*Of those that had received 1 dose of HPV
Source: Massachusetts Behavioral Risk Factor Surveillance System (BRFSS)

The Massachusetts Adult Immunization Coalition (MAIC) is a collaborative partnership dedicated to increasing adult immunization through education, networking, and sharing innovative and best practices. There are currently over 200 members representing local and state public health organizations, community health centers, health insurance plans, pharmacies, physicians, vaccine manufacturers, long-term-care and senior service organizations, consumer advocacy groups, hospitals, home health, and college health services.

The Coalition meets quarterly to discuss and strategize around issues such as targeted approaches to increase adult immunization rates in the Commonwealth of Massachusetts; the supply of publicly and privately purchased vaccine; immunization activities; surveillance of vaccine-preventable diseases; analysis of the flu season; and planning for a potential influenza pandemic.

Influenza rates

CDC estimates annual influenza (flu) vaccination coverage for the United States by utilizing data from several nationally representative surveys: the Behavioral Risk Factor Surveillance System(BRFSS), the National Health Interview Survey (NHIS), and the National Immunization Survey-Flu. (NIS-Flu). Internet panel surveys of adultshealth care personnel, and pregnant women are also used. Visit the FluVaxView page for vaccination coverage estimates, reports, interactive figures, and data tables related to flu.

The below table demonstrates Massachusetts flu immunization rates (DOC) compared to the United States flu immunization rates for the 2016-2017 season. While higher than the national average, flu immunization rates for the 2016-2017 season were at 50% in Massachusetts, meaning that only half of the population received the annual vaccine that can prevent serious illness, hospitalizations, and even death. Visit the Flu Website for more guidance on the flu and flu vaccine.

2017-18 Influenza Immunization Estimates

 

MA

US

Everyone ≥ 6 mos

50%

42%

Children 6 mos – 17 years

74%

58%

  • Children 6 mos – 4 years

76%

68%

  • Children 5 – 12 years

74%

60%

  • Children 13 – 17 years

72%

47%

Adults ≥ 18 yrs

44%

37%

  • Adults 18 – 64 yrs

40%

31%

  • Adults 18 – 64 yrs, High Risk*

46%

39%

  • Adults 18 – 49 yrs, High Risk*

42%

31%

  • Adults 18 – 49 yrs

37%

27%

  • Adults 50 – 64 yrs

46%

40%

  • Adults > 65 yrs

58%

60%

*Persons with asthma, diabetes, or heart disease

Massachusetts healthcare provider resources

The School Immunizations page reviews Massachusetts specific rates based on vaccines required for school entry and provides insight into the vaccine coverage in communities across the state. Since immunization rates are not uniform across the state, school immunization data highlight areas that may be more susceptible to vaccine-preventable diseases.

The Massachusetts Chapter of American Academy of Pediatrics Immunization Initiative is a collaborative effort to fully immunize children and adolescents in Massachusetts against vaccine preventable diseases. The membership includes physicians and nurses, MDPH Immunization Program officials, and representatives from organizations interested in improving immunization practices and immunization rates in communities across Massachusetts.

There is also a statewide initiative to increase HPV vaccination rates to decrease HPV-related cancer. For more information on HPV vaccine, visit the HPV Vaccine is Cancer Prevention website.

Healthcare professionals can use this MDPH HPV Information Sheet | (DOC) for background information on HPV vaccination rates and HPV-associated cancers, located on this page: HPV Vaccine is Cancer Prevention. There is also a statewide initiative to increase HPV vaccination rates to decrease HPV-related cancer. 

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