Policy Brief, Volume 1, Issue 4, February 25, 2022

Let Us not Forget The Importance of Public Health and School Immunization Programs

The Covid-19 pandemic has claimed 5.7 million lives worldwide and has become the deadliest disease event in American history. Sadly, the United States has been less successful in managing the pandemic than the world’s other economically developed countries. The U.S has higher case ratesmore deaths and lower vaccination rates. Since Dec. 1, 2021, the share of Americans who have died from the coronavirus is 63 percent higher than other large, wealthy nations. A cross-country study in The Lancet attempted to determine the reasons why there were differences in Covid cases, deaths and vaccination levels in 177 different nations including the U.S. One useful finding among many was that higher levels of “trust in government and between individuals” resulted in lower infection rates and higher vaccine coverage.

It was expected that Utah would perform well during the pandemic because it has the youngest median age (31.4) in the United States and is the 5th healthiest state in the nation according to recent rankings. These factors directly contributed to Utah having the 4th lowest death rate in the nation as of February 8th (134.7). However, as of this same date, Utah had a Covid case rate of 29,006 per 100,000 population, the 4th highest, and a full vaccination rate of 64%, the 21st lowest.

The Importance of Public Health

In spite of the remarkable historical achievements, the pandemic has had the unanticipated effect of discrediting public health in the U.S. In many states, including Utah, the traditional role of public health has been challenged and laws have been enacted to “rein in public health officials.” And personal attacks on our public health workers has been worrisome. It is important not to forget that public health has had a significant impact on the well-being of every single American. Public health has been credited with adding 25 years to the life expectancy of people living in the U.S. in the 20th century. This remarkable achievement occurred because of vaccine programs that eliminated or controlled infectious diseases; improvements in maternal and child health; reductions in the use of tobacco; improved food safety; and, improved management of drinking and waste water.

Vaccination against Childhood Infectious Diseases

The development of safe and effective vaccinations against serious and deadly diseases has been “one of the foremost scientific advances of the 21st century.” We are concerned, however, that vaccine hesitancy in the U.S and in Utah during the pandemic will cause us to forget the significant impact that vaccinations have had on our well-being today. In the 19th century, viruses were ever-present but poorly understood and exacted an enormous toll on the population as hundreds of thousands were infected and tens of thousands died. About one-fifth of children died before reaching age 5, many from infectious diseases such as smallpox, diphtheria, polio, mumps and rubella that are now preventable with vaccines. However, of these, only smallpox has been officially eradicated. The others are still with us. In the past, school vaccinations have been an extremely important agent for achieving our highly vaccinated population. And, schools must continue to play a significant role in the future if we are to maintain and improve on our past accomplishments. Unfortunately, clouds are on the horizon. Trends in vaccination levels appear to be declining in Utah, and legislators in some states are questioning school vaccination requirements.

Utah’s Childhood Immunization Rates

In the school year 2009-10 Utah’s immunization rate for kindergarten children was 97.7%, the 6th highest in the U.S. In previous years Utah had also ranked high. By the school year 2018-19, however the rate had steadily declined to 92.8%, and our rank had dropped to 23rd. In the most recent reporting year, the Utah rate increased to 96%, but the comparative rank was the same at 23rd. The one-year increase is encouraging; however, concern continues that the previous nine-year trend could be indicative of the future.

Conclusions

Prevention of disease is far preferable to getting sick. It is therefore critically important that Utah develop a sound strategy to strengthen public health and establish a relationship of trust between government, public health professionals, and our citizens. We must also create a plan to eliminate confusion about vaccines and their essential importance to the health of our citizens. This includes strengthening support for the immunization of children against infectious diseases.