Mississippi, first in school-age vaccines, lags in immunization rates for teens, adults

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For years, the one bright spot on Mississippi’s otherwise bleak health care landscape has been its reputation as a leader in childhood immunizations. Last year, 99.6 percent of kindergartners were fully immunized, by far the highest rate in the country.

“In a state where there are not a lot of health care statistics that we brag about, it’s one of the things that we do really well,” Dr. Mary Currier, the former state health officer, told Mississippi Today last year.

The reason for the state’s success is a 40-year-old law that, unlike those in other states, has remained impenetrable to the loopholes requested by the anti-vaccine movement.

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High immunization rates are important in a state like Mississippi, which already has a less-healthy population, officials say.

But Mississippi’s reputation as a leader in immunizations masks a more complex reality—when it comes to young children, teenagers and adults, Mississippi lags far behind the national average, in some cases coming in dead-last, according to data from the Centers for Disease Control and Prevention in Atlanta.

“There are huge, huge gaps and we definitely want that to be part of the narrative,” said current State Health Officer Dr. Thomas Dobbs.

Mississippi is currently tied for 34th in early childhood immunizations, with just 72 percent of children under three receiving five vaccines on schedule. While the rate rises to nearly 100 percent in kindergarten, the numbers nearly flip by the time kids are in high school.

In overall vaccinations among teenagers, Mississippi comes in at 47th, ahead of just Kansas, South Carolina and Oklahoma, according to the CDC. And the state ranks dead last for HPV vaccinations among teenagers, with just over half of kids in that recommended age group receiving the vaccine.

Numbers don’t improve much in adulthood. Mississippi currently ranks 36 in vaccine coverage among adults, with just 35 percent of adults having the recommended pneumococcal, tetanus, diphtheria and shingles immunizations.

“It’s pretty dismal,” said Jill Gonzalez, a researcher with the online site Wallethub, which released a study of national vaccination rates last week.

And the vast majority of Mississippians of all ages avoid flu shots, which aren’t required for school age kids. Mississippi currently ranks 46th in influenza vaccinations, according to the CDC, with just 42 percent of Mississippians getting flu vaccines last year.

This, said Dobbs, is a serious problem with flu season around the corner. Mississippi has the second-highest flu-related death rate in the country. Hawaii is the only state where a more people per capita die from flu.

Dr. Thomas Dobbs, state health officer

“It’s the thing that we’re really, really bad at,” Dobbs said. “What happens is that if you look at people in Mississippi over 65, we’re actually really good. But there’s a perception that adults and children don’t need the vaccine as much as they do. We have a lot of deaths in that age group because people underestimate the risk.”

The problem with immunization numbers, according to Dobbs, is the same problem for Mississippians when it comes to other aspects of health care: access.

“With early childhood vaccines, part of it are the intrinsic social barriers in Mississippi—poverty, transportation—those play a big role. So if we’re ranked 20 from the bottom in immunizations when there’s no law mandating them, I’d argue that’s pretty good compared with other (areas of health care),” Dobbs said.

“But I think it’s also way deeper than that. I think it’s health culture in Mississippi … We don’t seek health care, we don’t embrace health services. Part of it’s a cultural thing, part’s an awareness thing and part is that people don’t think they’re at risk of dying of something like the flu.”

Ironically, high immunization rates are perhaps more important in a state like Mississippi, which already has a less-healthy population, according to Dobbs and Gonzalez.

“We’re paying the price in well being and lives and also in money,” Dobbs said.

He points to HPV, which causes cervical cancer and certain throat cancers. Increasing the immunization rate, he said, “could completely eliminate cervical cancer.”

But Dobbs and Gonzalez split on best way to address this problem. No states, Gonzales said, mandate vaccines outside of school entry. Instead, she points to states like Massachusetts, which have adopted an incentive program, rewarding families that comply with recommendations with gift cards and vouchers.

“Local authorities are really going to have to help this at a grass roots level and help from the ground up, rather than having states mandate this.”

Dobbs said he agrees that Mississippi is unlikely, in the current anti-vaccine climate, to add more immunization requirements to law, but he thinks increasing coverage depends on increasing awareness.

And he said that recent campaigns, launched by the Department of Health, have made a difference. Though he acknowledges the HPV immunization rate “still lags,” he said it’s gone up dramatically. The rate has most than tripled since 2008, when it was 16 percent among Mississippi teenagers. During that same time, the national rate almost doubled, from 35 percent to 68 percent.

“We’ve really got to double down as much as we can in this era of rapid news cycles and information overload. Sometimes information is hard to stick, but we need people to understand how important this is,” Dobbs said.