Fewer Minnesota toddlers are getting scheduled shots for major diseases, a new report says, because of declining health insurance coverage and rising parental skepticism about immunizations.
The report by Children's Hospitals and Clinics of Minnesota cited federal data showing a decline in the childhood immunization rate from 80.5 percent in 2007 - when the state ranked seventh nationally - to 76.9 percent in 2009.
"Any drop, even 1 percentage point, will get our attention," said Patricia Stinchfield, an immunization specialist at Children's. "What is 1 percentage point in Minnesota? 4,000 kids. That's 150 classrooms of kids that are not vaccinated."
The report concludes that Minnesota's childhood immunization rate fell to 20th among states in 2009. A Star Tribune review of the data, which comes from an annual federal survey of families, showed Minnesota at 16th. Neither is entirely accurate because the survey has a wide margin of error.
Most public health leaders in Minnesota are nonetheless concerned. Executives at Children's issued the report to "turn the conversation" away from fears that vaccines can increase risks of autism and other disorders, and toward their proven safety and effectiveness. The report also highlights federal subsidies and other programs that make shots free for low-income families.
Stinchfield called the autism link "the most notable myth,'' one that persists even though studies linking certain vaccines to autism have been repeatedly discredited.
While autism rumors have circulated widely, parents' familiarity with basic childhood illnesses has declined, experts said.
"Parents are just not aware of how important it is that their children get vaccinated," said Barbara Ottis, an immunization specialist at Park Nicollet in St. Louis Park. "They don't even know about these diseases for the most part."
Ottis coaches doctors and nurses on addressing parents' concerns and trains them to discuss vaccinations, even if parents refused them during prior visits. Park Nicollet saw its own immunization rate drop between 2008 and 2009, according to Minnesota Community Measurement, a separate data source, which confirmed the trend in the federal survey.
Minnesota is typically a national leader in vaccination rates, and reported a high rate of H1N1 flu shots during the 2009-2010 pandemic.
Health officials suspect the declining rate of childhood immunizations reflects the declining rate of insured families. Uninsured families are less likely to see doctors at all, which makes them less likely to learn about the availability of free immunizations.
To be up to date, children by age 3 should have received four doses of vaccine against diphtheria, tetanus and pertussis (DTaP); three doses against polio; one dose against measles, mumps and rubella; three doses against Haemophilus influenzae type b (Hib); three doses against hepatitis B; and one dose against the virus that causes chickenpox.
Health officials still take these diseases seriously. The Minnesota Department of Health announced a measles case last week. The state reported five Hib cases in 2008, including one death and three cases among unvaccinated children, and 1,000 cases of whooping cough (pertussis) in each of the last three years.
Another reason for Minnesota's declining childhood immunization rate was a shortage of Hib vaccine from 2007 to 2009. Many Minnesota clinics pre-ordered the vaccine from the manufacturer that caused the shortage, said Kris Ehresmann, director of infectious diseases for the state Health Department. The shortage might have caused families to delay all vaccinations or not receive the Hib shots their children needed to be up to date.
Ehresmann said it's unclear whether Minnesota is seeing a sustained drop in immunizations, in part because of the Hib vaccine shortage and the federal survey's margin of error. But she agreed with the need to be vigilant as new families emerge that haven't heard the vaccine message yet.
"Because we have a new birth cohort every year -- 67,000 to 70,000 kids born in Minnesota every year," she said, "we can't be complacent."
Jeremy Olson • 612-673-7744