Childhood vaccination in 21st century faces multiple challenges that threaten success

May 4 2009

"Childhood vaccination represents one of the most successful public health interventions ever," write Matthew M. Davis, M.D., M.A.P.P., of the University of Michigan, Ann Arbor, and Samir S. Shah, M.D., M.S.C.E., of The Children's Hospital of Philadelphia, in an editorial in the May issue of Archives of Pediatrics & Adolescent Medicine, a theme issue on vaccines. "Diseases that once killed thousands of children each year have been virtually eliminated."

"Nevertheless, childhood vaccination in the 21st century faces multiple challenges that threaten its success," write Dr. Davis and Dr. Shah, both members of the Archives editorial board. For example, a skeptical public questions the safety of vaccines, vaccine shortages lead to delayed immunization and low vaccination rates among adults leave the children they care for vulnerable to preventable diseases.

"These challenges demand innovative responses from the generation of researchers and policymakers now engaged in work regarding vaccines around the globe," they continue. "In this issue of the Archives, authors present many compelling ideas and research findings that set the stage for the next phase of efforts designed to protect children and their families through the use of safe and effective vaccines."

Articles published in the issue find that:

• A social marketing strategy may be useful in battling negative public perceptions about vaccines
• Pediatricians could play a greater role in immunizing adults who have contact with young children
• In times of vaccine shortages, pediatric practices with systems to track high-risk children may help ensure they receive needed immunizations first
• Accelerating the dosing schedules of some vaccines appears to increase immunization rates and also may reduce disease burden
• Strategies for introducing new vaccines-especially those with cultural sensitivities, such as the human papillomavirus (HPV) vaccine-should address community concerns through effective communication, appropriate delivery and targeted advocacy
• Although progress has been made in addressing disparities in vaccine-preventable diseases among American Indian and Alaskan Native children, sustained routine vaccination will be necessary to maintain that progress

"Vaccine-preventable diseases still result in significant morbidity and other societal costs," Dr. Davis and Dr. Shah conclude. "As research for new and more effective vaccines continues, medical personnel must optimize the way they use existing vaccines. The articles included in this issue of the Archives highlight novel strategies for improving the uptake and effectiveness of currently available vaccines."