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Vaccine rates are up, but so are refusals

by Maggie Fox /  / Updated 
Image: Amish Measles
Jacqueline Fletcher, director of family and community health services at the Knox County Health Department, prepares doses of the measles, mumps and rubella (MMR) vaccine Noah Addis / for NBC News file

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More U.S. kids are getting their full series of vaccines, but more and more parents are also refusing to immunize their children, new health insurance data shows.

The No. 1 vaccine refusal hotspot is in New York, a new report from the Blue Cross Blue Shield Association finds.

Vaccination rates are up 12 percent overall since 2013 among people covered by employer-provided health insurance, Blue Cross and Blue Shield reports. But the rate of vaccines refusal rose from 2.5 percent in 2010 to more than 4 percent in 2016, the insurance group found.

How can both of those things be true? It’s because most kids who missed vaccines missed them because they skipped regular doctor appointments, not because their parents deliberately declined to get them vaccinated, the company found.

“Missed well-child visits are a primary driver of under-vaccinated children,” the report reads.

Related: Minnesota measles outbreak fueled by vaccine skeptics

The childhood vaccine schedule is complicated and means for multiple pediatrician or clinic visits by the time a child is 3.

Kids need several doses of these vaccines: hepatitis B; rotavirus; diphtheria, tetanus and pertissus (whooping cough); Haemophilus influenza B; pneumococcal; polio; meales, mumps and rubella; chickenpox; and hepatitis A.

Kids who don’t get the full series of vaccines are susceptible to infection and can spread infections. Schools and daycares can refuse to admit unvaccinated and undervaccinated children, and states regulate admission due to vaccination status, but there are no laws in the U.S. forcing vaccination.

Blue Cross and Blue Shield looked at the records of kids born in 2010 and followed them to the age of 3 in 2013, and then looked at records of kids born in 2013, who turned 3 in 2016.

They found 69 percent of kids were fully vaccinated in 2013, compared to 77 percent in 2016.

That’s still not good enough, said Dr. Trent Haywood, chief medical officer for the Blue Cross Blue Shield Association.

Related: Vaccine debate vexes Vermont village

“We think it should be closer to the 80 percent mark, and really, above 90 percent, ” Haywood said. “One of the things we want to do is raise attention to that issue.”

Blue Cross Blue Shield is trying to edge the numbers up, in part by reminding pediatricians and family practice doctors when the data show all their patients are not fully vaccinated on time. The clinic or office can then contact patients and remind them to come in. This simple outreach works, studies have shown.

“First and foremost what we are in the business of doing is providing access to care," Haywood said.

He said insurance companies save money if kids get vaccinated, because it is far cheaper to pay for a vaccine than it is to treat a child with measles, pneumonia or diphtheria. “It’s always more effective and more affordable if you do the right thing on the front end,” he said.

Why so many more refusals? “We are not certain as to why that went up,” he said.

But vaccine deniers have become much more active as social media gives them an easy way to voice their opinions without contradiction from experts.

The survey shows where the hotspots are of vaccine deniers. Claims submitted to insurance companies can be coded to show if a parent gave a non-medical reason for refusing to vaccinate a child.

“Medical claims coded with a parental vaccine refusal climbed from 2.5 percent for children born in 2010 to 4.2 percent for children born in 2013,” Blue Cross Blue Shield said.

Related: Most kids who died of flu weren't vaccinated

“Refusal rates were highest in the states of New York at 8.4 percent, Washington at 7.0 percent, Oregon at 6.8 percent, New Jersey at 6.5 percent and Arizona at 6.4 percent.”

Several areas around New York City had especially high rates of vaccine refusals.

“The three metropolitan statistical areas with the highest refusal rates are all in New York. They include Nassau-Suffolk at 14.2 percent, Dutchess County at 10.3 percent and New York-Newark at 10.1 percent. The county with the highest refusal rate was Richmond County (Staten Island) in New York at 25.6 percent,” the company said.

The findings only apply to people with Blue Cross Blue Shield insurance. About 60 percent of Americans get their health insurance through employer-sponsored coverage.

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