Nancy Lugo: Ignoring immunizations increases risks

Nancy  Rudner

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Something risky is happening. Bad microbes lurk, ready to attack and cause devastating infections when our defenses are down, especially among children. With unprecedented breakthroughs in immunizations in the past 60 years, we have been close to eradicating many destructive childhood infections. Immunizations have almost knocked out deaths from polio, mumps, measles, rubella, rotavirus, whooping cough, and invasive H. influenza in the U.S.

Unfortunately, our success yields the seeds of vulnerability. Now that these diseases are rare and the threat of infections seems distant, more children forego immunizations. Ten years ago, 96 to 98 percent of kindergarteners in Orange and Seminole counties started school with all their shots. Now the coverage rates have dropped to 93 to 94 percent. In other words, in every classroom, on average two kids are not fully protected against these life threatening diseases and can spread infections to others. Only three out of four Orange and Seminole 2 year olds are up-to-date with their shots – one of the lowest rates in the state. So far this year, at least 539 children and adults in the U.S. were sick with measles, the most since 1994. These infections have spread in schools, restaurants, stores, neighborhoods, buses and trains.

The declining rates are the result of difficulty getting vaccinations and immunization skeptics. With one out of every nine children in Florida not insured, many families have a hard time getting health care for their children. Since Florida legislators opted to not accept the $51 billion in federal aid to expand Medicaid to cover more working families, too many children forego checkups and vaccinations. The federal program Vaccines for Children pays for vaccines given in a private office or clinic for the uninsured who can’t pay for them, but too few doctors and nurse practitioners accept children without any insurance. Health department budgets have also been slashed. The health department is not always a realistic option.

In contrast, immunization skeptics forego immunizations by choice. Some parents who have not seen the diseases fear of vaccine complications more than the diseases the vaccines are designed to prevent. If enough other children are immunized, their unimmunized child’s risk of getting the disease is not as strong and they enjoy the benefits of other people having their children immunized. But if enough people refuse the vaccines, the group protection is lost and the infections have a chance to spread. Some people have weak immunity in spite of immunizations; they don’t make enough antibodies. When most other people are immunized, the infections cannot spread from one person to another, so even the child with a poor response to the vaccine or the person with an immunity disorder is less likely to be ill. When more people refuse to be vaccinated, more people are vulnerable. We are turning back the clock on progress against these diseases.

We – as a community, as a school, as a county, as a state – are in this together. We all benefit each time someone is immunized. We are all at risk each time someone is not.

You can see the clusters of outbreaks across the world in the Council on Foreign Relations interactive map of preventable diseases at While we are seeing a local drop in immunization rates, 85 percent of children worldwide received immunizations last year, up from 60 percent in the 1990s. At the same time, the death toll among children under age 5 dropped nearly in half, from 12.6 million to 6.6 million. Great challenges remain, as lack of vaccines, remote areas, rough roads, war, and miscommunication disrupt immunization efforts. Recently in Nigeria and Pakistan, health workers immunizing children were killed.

Who says health care is not political?

We are one world. Infections can travel from far away lands to our community in a day. Will we lose the progress we have made in protecting the next generation from vaccine preventable diseases? It’s up to each one of us.

Nancy Rudner Lugo is a nurse coach and health advocate for Send her your questions at