by Michael Lyle, Nevada Current
A decline in “vaccine confidence” has contributed to a decrease in child immunization rates, Nevada health officials warned state lawmakers on Monday.
Vaccine rates among adults, which includes Covid and flu shots for the current season, are also only a fraction of the national average, health officials said at the Interim Committee on Health and Human Services.
“Vaccine confidence took a major hit through the pandemic,” Kristy Zigenis, the immunization program manager for the Nevada Department of Health and Human Services. “It’s going to take a lot to get us back on the right track.”
Medical providers recommend infants get a 7-vaccine series, which includes the Measles, mumps, rubella (MMR) shot and the vaccine for Diphtheria-Tetanus-Pertussis (DTaP), before 24 months.
But the number of children getting recommended vaccines in Nevada has decreased 3.3% since 2019, Zigenis said.
Officials were unable to compare state data to national trends since country-wide data is only available through 2020.
The decrease in immunization comes as the U.S. has seen an uptick in diseases like the measles despite the availability of vaccines. National health experts attribute the decline to misinformation.
As the number of children getting immunized has gone down in the state, Zigenis said there has been an increase in religious exemptions for school attendance. Medical exemptions have stayed about the same.
Public and charter schools saw 3.5% exemption rates in the 2021 to 2022 school year and private schools had 5.4% rate the same year, she said.
That grew to 4.9% in public schools and 8.2% in private schools in the 2022 to 2023 school year.
According to the Centers of Disease Control and Prevention, “any exemption rate nationally is about 3%,” Zigenis said. The national rate is not a precise comparison because it doesn’t include more recent years.
Health officials didn’t offer any explanation why Nevada exemption rates are higher than the nation’s. Lawmakers didn’t ask.
Non-medical exemptions
During public comment, Leann McAllister, the executive director for the Nevada chapter of the American Academy of Pediatrics, encouraged lawmakers to consider eliminating religious exemptions.
“Immunization requirements for child care and school attendance are an effective means of protecting people from vaccine-preventable diseases both by direct protection from the vaccine and indirect protection from communal immunity,” she said.
She added that while “legitimately medical exemptions to immunization requirements are important, non-medical exemptions to immunization requirements are problematic.”
Republican state Sen. Robin Titus, who is a physician, said eliminating religious exemption would send the public the wrong message. Instead, she said it’s up to health care providers to educate the public to regain trust.
“When the government comes in and says ‘the heck with that we’re just going to pass a law and make you do it’ it’s giving the wrong message,” she said.
Officials from the Department of Health and Human Services outlined policy proposals implemented in other states to expand access to vaccines and education efforts for those who seek exemptions for students.
Vermont, Oregon and Utah require parents to go through an extended process when seeking a religious exemption, Zigenis said.
She added that includes completing an online educational course before the exemption is implemented.
“We aren’t making a policy recommendation, just providing an overview of what other states do,” said Julia Peek, the deputy administrator for the Division of Public and Behavioral Health within the department.
Peek agreed with Titus that there should be additional efforts to regain trust, and training on how health providers talk with vaccine-hesitant patients.
‘Lots of room to grow’
Lawmakers in 2023 passed Assembly Bill 147, which allows dentists, dental hygienists and other previously unauthorized health care providers to administer vaccines.
Democratic state Sen. Fabian Doñate, who chairs the Interim Health and Human Services Committee, questioned whether lawmakers should expand the scope of the policy to also allow school nurses to give vaccines.
It’s not just children lagging in vaccine rates.
Zigenis said only 10.4% of Nevadans over 18 who are eligible for the most recent Covid-19 vaccine or booster have received one.
“The national comparison is at 22.6% so lots of room to grow,” she said.
Zigenis noted when Covid-19 went “to the commercial market there were some hiccups with the rollout and supply constraints.”
During the initial roll out of the vaccination, costs were paid for by the federal government rather than through a person’s insurance. When that changed in 2023, some people showed up to appointments and were told they would have to pay out of pocket.
The rate of Nevada adults getting vaccinated for the flu is also less than half the national average.
“We are coming to the tail end of the flu season and 21.6% of those 18 have received a dose of the 2023-2024 flu vaccine,” Zigenis told the committee, noting the national average is nearly 43%.
The new RSV vaccine, which is recommended for adults over 60 years old, has also seen low rates in Nevada. The state rate is 12.5% while the national rate is 23.6%.
With data showing pharmacies in the state are the “key source for adult vaccinations,” Zigenis said officials are working with pharmacists to ensure they encourage more vaccinations.
“If someone comes in for a flu vaccine but they can get an RSV vaccine we want to make sure it’s being offered,” she said.
