Since the COVID-19 pandemic, rates of childhood vaccination have fallen—and as a result, infections of previously rarely seen diseases like measles are starting to emerge. In Texas, a measles outbreak has infected over 250 people so far, and caused the death of a child—the first death from the disease in a decade. In Washington, an outbreak of whooping cough has resulted in the first death in the state from the disease since 2011.
Nearly all of the recent cases of vaccine-preventable disease have occurred in people who had not received the recommended doses of vaccine. In fact, of the children under the age of five who contracted measles in 2023, 99 percent had not received the two recommended doses of the measles vaccine.
Why are vaccination rates falling?
There have always been vaccine-hesitant people, but during the COVID-19 pandemic, misinformation and disinformation about the COVID vaccine was ubiquitous on social media. Many people were scared, unsure of what to believe, and uncertain how to sort out the facts from the myths. For many, this COVID vaccine hesitancy grew into a more general apprehension about all vaccines.
There were also the factors of COVID lockdown and the unfolding outbreak, and the difficulty and reluctance a lot of families felt at that time about taking their children to the doctor or pharmacy for routine vaccinations. The CDC reports that fewer children born in 2020 and 2021 received their childhood immunizations than kids born in 2018 or 2019.
Why are vaccinations so important?
Vaccines don’t only protect the person who is vaccinated—they also contribute to higher immunity rates in the general population which protects those who are unable to receive some vaccines, like pregnant people, infants, and immunocompromised people.
In order to prevent an outbreak of an infectious, vaccine-preventable disease like measles or mumps, 95 percent of the population must be fully vaccinated. Childhood vaccination rates for measles, mumps and rubella have now dropped below this 95 percent threshold, putting at risk those who are unable to get vaccinated, along with adults who received their vaccines long enough ago that their immunity is no longer as effective.
Young school-agers, particularly kindergarteners, are the core transmission group for infectious, vaccine-preventable diseases like measles, mumps and rubella, so it’s critical for children to get their vaccines on the recommended schedule to ensure their immunity by the time they reach school age.
What are the recommended childhood vaccines?
Pediatricians recommend a standard childhood immunization schedule for most children. These routine vaccines protect from several different infectious diseases, and some need additional doses to achieve maximum efficacy.
Here are some of the most common vaccine-preventable childhood diseases—
Whooping cough (pertussis)
The diphtheria, tetanus, and acellular pertussis vaccine, or DTaP, protects against whooping cough. There were over 32,000 cases of whooping cough in 2024—the highest number in a decade. Whooping cough (pertussis) is a highly contagious respiratory illness that causes persistent, uncontrollable coughing. Severe cases of whooping cough can lead to pneumonia, brain damage, and even death in vulnerable populations like infants.
The DTaP vaccine schedule consists of five doses, given at 2 months, 4 months, 6 months, 15 to 18 months, and 4 to 6 years. Additional booster shots are recommended at age 11, and then every 10 years. It is also recommended that pregnant people receive an additional dose of the vaccine between 27 and 36 weeks of gestation to protect their babies.
Measles
Measles is a disease caused by an extremely contagious airborne virus. It initially infects the respiratory system, and then quickly spreads to the rest of the body, causing a high fever and a rash which starts as small white dots in the mouth before turning into a rash of red spots all over the body.
Complications from measles infection include pneumonia, encephalitis, blindness, and a severely depleted immune system. Death from measles is very rare in highly vaccinated populations, but worldwide, over 10 million people were infected in 2023 and over 100,000 people died from measles.
The transmissibility of this disease cannot be understated. Measles is around 12 times more contagious than influenza, and twice as contagious as COVID-19 and chickenpox. Particularly vulnerable groups include children under five and pregnant people.
Mumps
Mumps is a contagious disease that leads to severe swelling in the salivary glands which causes puffy cheeks and tenderness and swelling of the jaw. Most children recover from the illness within several weeks, but severe cases can lead to complications such as meningitis, pancreatitis, and permanent hearing loss.
The disease is highly preventable with vaccination. The mumps vaccine is given as a combination vaccine to protect against measles, mumps and rubella. This vaccine is recommended at between 12 and 15 months of age, followed by a second dose between the ages of 4 and 6.
Rubella
Rubella, also known as the German measles, is an infectious illness characterized by a distinctive red rash which starts as a pink rash on the face and then spreads all over the body. It is a milder infection than measles, but still very contagious and preventable with two doses of the measles, mumps, and rubella vaccine.
Polio
Decades ago, polio was one of the most feared illnesses in industrialized countries like the United States, but high vaccination rates have virtually eradicated the disease from many parts of the world. There are still small outbreaks in areas with low vaccination rates, however, so continuing to vaccinate against polio remains crucial to maintaining immunity. Polio is a virus that mainly affects nerves in the spinal cord or brain stem, and can lead to muscle pain, weakness, and even paralysis.
What are the side effects of vaccines?
Any vaccine can cause side effects, most of which are mild and temporary. Many common vaccines work by introducing a small amount of a virus into the body to teach the immune system how to identify and protect against that virus. This process causes a minor immune response which can lead to mild cold symptoms, headache, swelling and redness at the injection site, and a low fever.
As with any medication, a severe allergic reaction is a remote possibility. Parents should look out for warning signs such as a fever over 105 degrees or seizure. The benefits of vaccination, however, greatly outweigh the small risk of an adverse reaction.
Keeping kids up to date on all of the recommended vaccines can not only help keep them safe from infectious disease, but also helps protect vulnerable people in the community as well as the general population. Check in with your pediatrician to make sure your child is up to date on their immunizations.
