Health Departments See Reduced Demand For Vaccinations

While high exemption rates remain a concern, officials believe more families are receiving vaccines in primary care settings rather than at county clinics before school starts


August 21, 2013 – Getting kids ready for school means getting them vaccinated – and county health departments throughout the Portland metro area are hosting walk-in clinics and supporting schools and primary health providers to make certain they have stores of vaccines.

“We work with providers on quality assurance, on how to stock vaccines, make sure they have vaccines that are age appropriate, how to store it so it's effective,” said Marny Storey, interim public health director in Clark County. “That's kind of the hidden piece.”

Clinics throughout Clark County started hosting free vaccination clinics at various locations at the beginning of this month, with one more happening next month and a final clinic in September, where Multnomah County offers vaccinations on an ongoing basis at administration costs listed on the county's website. In Clackamas County, immunizations are offered for free, by appointment, at its clinics, and Washington County offers vaccines at its three clinic sites, as well as technical assistance making sure children in the area are up to date.

“The interesting thing is that – and I've been doing this for many many years, over 20 years – with Oregon Health Plan and the children's insurance program, year after year we see our demand diminishing. Providers and options and access have improved for the general public,” said Dana Lord, Clackamas County's interim public health director. “The only kids who end up needing these immunizations before school are from out of state or out of the country. The schools have done a wonderful job of getting children ready.”

Washington County community health nurse Kim Nguyen said its schools typically don't run any special clinics, but schools do contact her with information about which children are not up to date on their vaccines and may need to be seen in a community health clinic.

“We do encourage them to go to their primary care providers. We don't really do any special clinics,” Nguyen said.

The reduced demand for vaccines administered by county health clinics is an issue apart from the high rate of religious or philosophical exemption in western Oregon and Washington, Lord said. While higher than the national average, it seems to have leveled off somewhat in the past few years, Lord said, partly because the law doesn't require families to get vaccinations (or provide proof of exemption) until February.

“Our concern from the public health perspective is that we do have a great herd immunity rate.

I think it's important because we can only keep that herd immunity when the majority of the population agrees that that is a good thing to do,” Lord said.

Nguyen said she's aware of a handful of providers in Washington County who are offering families an alternative vaccine schedule – which, like philosophical abstentions, are sometimes recommended by the movement that links certain childhood vaccinations with autism, a link that has been debunked by multiple studies.

Storey said officials recommend ensuring children are vaccinated against pertussis – which reached pandemic proportions last year – and, while influenza shots are not required for school admission, she advises children receive those as well.

“Making sure children are up to date on vaccines before sending them back to school is one of the most important things parents can do, not only for their own child but for their classmates and friends and the whole community,” Storey said.

Image for this story by Sanofi Pasteur (CC BY-NC-ND 2.0) via Flickr.

Christen McCurdy can be reached at [email protected].

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