New York

Study details county differences in childhood vaccination rates


A recent study shows early childhood vaccination rates gradually increasing in New York but still failing in many counties to reach the state’s target for 2-year-olds.

The nonprofit New York State Health Foundation notes that in the 57 counties outside New York City in 2020, 64.5% of children ages 24-35 months had received all seven recommended vaccines by their second birthday against diseases such as chickenpox, measles and mumps. 

The vaccination rate is up from 59.4% in 2018, but falls short of the 70% goal set by the state’s Prevention Agenda 2019-2024.

The study, “Getting a Fair Shot: Progress and Disparities in Early Childhood Vaccination in New York State,” found significant variation from county to county.

Within the Capital Region and eastern Mohawk Valley, vaccination rates ranged from 81.3% in Warren County to 58.5% in Montgomery County.

The split was even wider for the rest of the state, from a low of 42.1% in Rockland County to a high of 82.2% in Livingston County.

“Unfortunately, we did not dig into any of the numbers to get a better understanding of that. That would be a great next study,” said Mark Zezza, one of the study’s authors and the director of policy and research for the foundation.

“There’s so many different factors that come into play,” he continued, reeling of a list that includes religious beliefs and cultural norms, access to health care providers, local prevalence of electronic health data systems, and the extent of preschool and daycare programs in the area.

The degree and the effectiveness of outreach by local school districts and departments of public health also are critical, Zezza said.

The 2020 rates of full vaccination among 2-year-olds in local counties: 

  • Albany 64.6%
  • Fulton 60.3%
  • Montgomery 58.5%
  • Rensselaer 73.7%
  • Saratoga 78.0%
  • Schenectady 72.7%
  • Schoharie 70.8%

Statewide, there also is variation by race and ethnicity:

  • All groups: 64.5%
  • Asian 67.4%
  • Black 62.0%
  • Hispanic 64.7%
  • White 69.4%

Claire Proffitt, supervising public health nurse for Schenectady County Public Health Services, said the county has had a long-running effort to increase early childhood vaccination and reduce disparity among various communities.

It received a state grant to train providers on ways to encourage higher rates of vaccination. Key among them: Presentation. 

She said, nurses and doctors are taught to say something along the lines, “Billy is due for his MMR shot today,” rather than asking, “Do we want to do the chickenpox vaccine today?” 

“We do a lot with motivational interviewing, helping providers be strong with that skill,” Proffitt said.

This practice over the years has built relationships within the community that paid off amid the COVID pandemic, she said. For a long time, Schenectady County had the highest adult COVID vaccination rate in the state, and still is highest north of New York City.

At the same time, Public Health Services has learned to allay concerns people have about vaccines and counter misinformation they have heard.

“We worked to really be able to adapt our message really quickly,” Proffitt said.

Zezza said it’s too soon to say if the state’s early childhood vaccination rate will increase further in 2021, with all the attention paid to adults getting the COVID vaccine.

“But it does seem like good news that in 2020, despite having the pandemic, the pediatric rate actually improved a little bit,” he said. “That offers a little bit of optimism.”

The study reviewed the percentage of 24-month-olds in each county who had received all seven vaccinations in the Early Childhood Series: DTaP, HepB, HiB, IPV, MMR, PCV and Varicella. 

HiB and PCV are not mandatory for school attendance, only daycare or pre-K attendance, according to the state Department of Health.

The Centers for Disease Control reports that 97% of New York children have received the five mandatory shots by the time they enter kindergarten, which may indicate some children are getting vaccinated later than their second birthday.

Zezza said the public health community believes earlier is better.

“The longer kids wait, the more they’re at risk and the longer potentially they might put kids around them at risk,” he said.

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