Meningococcal Vaccine: Protection, Risk, Schedule
Childhood Vaccination Rates In Berks Following National Downward Trend
A quarter-century ago, measles was essentially eradicated in the U.S.
In 2000, health officials declared the highly infectious disease had been eliminated. High vaccination rates and other public health measures were credited for the victory.
But things have been changing.
Starting in the wake of the COVID-19 pandemic, measles has been making a bit of a comeback. So far this year, the U.S. Has seen 301 confirmed cases across 15 states, including a child in Montgomery County.
Health officials are sounding an alarm, saying that decreasing vaccination rates among children has put the country at risk of a measles revival as well as outbreaks of other, preventable childhood disease.
According to the U.S. Centers for Disease Control, after holding steady above 95% for a decade, the percentage of kindergarten-aged children who have received a measles, mumps and rubella (MMR) vaccination has dipped over the past few years.
That vaccination coverage for kindergartners has dropped from 95.2% in the 2019-20 school year to 92.7% in 2023-24. In 14 states, the rates is below 90%.
Health experts say a vaccination rate of 95% is critical to achieve herd immunity, where the number of protected people in a community is high enough to keep a disease from spreading to those not protected.
Local health experts say Berks County, while not performing as badly as some parts of the country, is mirroring national downward trends in vaccination rates. And that, they say, is concerning.
The Berks situationAccording to state data, kindergartners across Pennsylvania were vaccinated against measles, mumps and rubella at a rate of 94% for the 2023-24 school year, just below the 95% threshold.
Other vaccination rates for polio, varicella and chicken pox, Hepatis B, diphtheria and pertussis were similar, ranging 93.2% to 95.3%.
All of the rates were down from where they were five years ago.
The story is similar in Berks, though slightly better.
The rate for MMR vaccinations for kindergartners was 95.1%, according to state data, down from 96.9% in 2020-21.
Other vaccinations have seen similar dips. Polio vaccinations for kindergartners have dropped from 97.1% to 94.6%. Hepatitis B vaccinations have dropped from 98.1% to 95.8%. Varicella vaccinations have dropped from 96.6% to 94.5%.
"They have been dipping some," Dr. Jessica Ericson, staff physician for pediatric infectious disease at Penn State Health St. Joseph hospital, said of countywide vaccination rates. "Our rates aren't as bad as some places, our bottom line numbers are still pretty good, but our rates have been falling."
Why are rates falling?Dr. Olubunmi Ojikutu, chair of pediatrics at Reading Hospital, said the slide in vaccination rates can be traced to COVID-19.
"The steep decline started after the COVID-19 pandemic when the collective focus was on measures to preserve life and health from COVID infection," she said. "Many children ended up behind on their vaccine schedule."
Dr. Olubunmi Ojikutu, chair of the department of pediatrics at Reading Hospital (Courtesy of Reading Hospital) Ojikutu also said the the number of parents obtaining religious or philosophical exemptions for their children seem to be causing the drop, as medical exemptions have stayed fairly steady.
Ericson said the reasons parents have for not vaccinating their children vary but noted a growing trend of people — exacerbated by the pandemic — losing trust in medical experts.
"There has been an ongoing wearing away of trust in science and in the good intentions of doctors and pediatricians and scientists and public health officials," she said. "I think that is something COVID has made worse, this lack of trust."
That has led some parents to be wary of the safety of vaccinations, despite evidence to the contrary.
"Some families are concerned about safety even though vaccines are the most tested group of medications in terms of having to demonstrate their safety before being used," Ericson said.
Ericson said she has heard from parents who are refusing to vaccinate their children simply because public schools require them (unless an exemption is obtained).
"And some say they've never even heard of the diseases they protect against," Ericson added. "They disagree that they're important or that their kids are at risk."
Ojikutu said health care workers are trying their best to inform parents about the safety of vaccinations and counter misinformation that may be causing hesitancy.
"Health care providers are listening, answering parents' questions and sharing accurate information and resources and working hard to reassure parents about the safety of vaccines and how they keep each child and the community safe," she said.
Why are vaccines important?To Ericson, the importance of vaccines is simple to understand.
"The diseases that we bother to make vaccines for are ones that kill children, often in really terrible ways over a long time," she said. "As our immunization rates decrease, that means more children are at risk of getting these illnesses."
Dr. Jessica Ericson, staff physician for pediatric infectious disease at Penn St. Health St. Joseph hospital (Penn State Health St. Joseph) Ojikutu said recent events have shown just how important vaccinations are.
"To anyone who was waiting to see if these vaccines were still necessary, as you see with this current measles outbreak, vaccines are still valuable and necessary," she said. "Now is the time to schedule an appointment with the health care provider you trust to address your concerns.
"The best treatment we have for your child and the community is prevention through vaccination. When we partner together, we can keep these devastating diseases out of our lives, our homes, our schools, our sports teams, our gyms, our restaurants, our places of worship, our places of work, our favorite hangout spots and our neighborhoods."
Ericson agreed, saying she doesn't want parents to wait too long and suffer devastating consequences.
She said that often when she's caring for a critically ill child the parents talk about what they could have done differently, what they missed that could have prevented their child from being so sick.
"Most of the time the answer is that they did everything they could," she said. "That same conversation is really different and heartbreaking to have when there's a highly effective, highly safe vaccine that would have prevented that child's illness."
The measles, mumps rubella vaccine is among the shots considered crucial to a keeping children in a community healthy. (Getty Images)Former US Surgeon General: America Is Getting A Crash Course In Herd Immunity
Editor's note: Dr. Jerome Adams, who served as US surgeon general in the first Trump administration, is a distinguished professor in pharmacy practice and public health at Purdue University.
CNN —
The ongoing measles outbreak has reached three states and serves as a stark reminder of the vital role that herd immunity plays in safeguarding our communities. Originating in Gaines County, Texas, the outbreak has now resulted in 321 reported cases, with 38 hospitalizations and two deaths, including a school-age child who was unvaccinated.
The initial epicenter within a Texas Mennonite community highlights how declining vaccination rates can lead to rapid disease transmission. While some may believe that abstaining from vaccination keeps them healthier or more resistant to diseases, the reality is that their "immunity" has, until now, been borrowed from their vaccinated neighbors. This collective shield, known as herd immunity, is not automatic or enduring; it has been built over decades through high vaccination rates.
Unfortunately, this protection is now eroding due to rising vaccine skepticism.
Herd immunity works by ensuring that a high enough portion of the population is vaccinated so that highly contagious diseases like measles can't find a vulnerable "host" to spread to. This strategy protects those who cannot receive vaccines for medical reasons — and even those who refuse them for personal beliefs. However, as vaccine skepticism grows, many who have unwittingly benefited from herd immunity in the past are now at greater risk — ironically, from themselves.
A significant driver of current skepticism has been Robert F. Kennedy Jr. And the nonprofit organization he led, Children's Health Defense, which has spread vaccine mistrust and misinformation for years.
Ironically — or perhaps inevitably — now that Kennedy is secretary of the US Department of Health and Human Services, he faces the largest measles outbreak in Texas and the first child death from measles in over 20 years. Recently, at President Donald Trump's first Cabinet meeting, Kennedy acknowledged the death but seemed to dismiss the outbreak as "not unusual," drawing widespread criticism.
Now, as the outbreak spirals, he has reversed course, declaring measles a top HHS priority. In a subsequent Fox News op-ed, Kennedy wrote, "Measles outbreak is a call to action for all of us," emphasizing how vaccinations contribute to community immunity. This marked a dramatic shift from his past rhetoric, as he is now being forced to confront the consequences of the very skepticism he helped foster.
This moment is critical for both Kennedy and the nation. As I have previously stated, his tenure will not be defined by his work on nutrition or chronic disease (no matter how commendable) but by how he responds to an inexorably increasing number of vaccine-preventable disease outbreaks.
As Kennedy himself has acknowledged, the resurgence of measles "must serve as a wake-up call." The disease was declared eliminated in the US in 2000, thanks to decades of high vaccination rates. But since then, growing vaccine hesitancy, driven in part by disinformation campaigns, has led to declining immunization rates and renewed outbreaks. The US Centers for Disease Control and Prevention reports that in some communities, childhood vaccination rates have dropped below the 95% threshold needed to maintain herd immunity. The result? Vulnerable populations — including infants, immunocompromised individuals and those who opt out of vaccines — are now at greater risk than ever before.
The tragic death of a child should in and of itself be enough to remind us of the serious implications of measles outbreaks. Although it's true, as Kennedy points out, that most individuals who contract measles will not die from it, we also cannot overlook the alarming reality that 1 in 10 confirmed cases during this outbreak has required hospitalization. This statistic underscores the fact that even non-fatal cases can lead to severe health complications, including pneumonia, encephalitis, pregnancy-related issues and potential lifelong health challenges.
However, what makes measles particularly dangerous is its extreme contagiousness; many experts describe it as the most contagious virus known. It spreads through airborne particles and can linger in the air for hours. In an unvaccinated community, one infected person can spread measles to up to 90% of those around them. This is why even small declines in vaccination rates can lead to major outbreaks, with hospitalizations and deaths to follow. The Texas situation is proof that when herd immunity erodes, it's not a matter of if, but when, these outbreaks will follow.
The challenge for Kennedy is not just responding to this particular outbreak but reversing the tide of vaccine skepticism that has grown, in part, because of his own past activism. A true leader must be willing to acknowledge mistakes — even if unintended — and correct course. If he is serious about tackling measles, Kennedy must take concrete steps to promote vaccine uptake, even in areas and times when there isn't an active outbreak. Such measures include launching aggressive public education campaigns, ensuring vaccine access, and working with state and local officials to restore trust in immunization programs. And like his predecessors, he must consistently and unequivocally state his commitment to vaccines.
Ultimately, both Kennedy and much of unvaccinated America are receiving a crash course on the topic of herd immunity. The ability of a minority to remain unvaccinated has always depended on the decisions of a vast majority to protect them. Now, as we confront more outbreaks, one lesson is clear: Community immunity is not just a personal choice, it is a collective responsibility. Kennedy's legacy will be defined not by what he has said in the past but by what he does now. He will be remembered either as the vaccine skeptic who turned vaccine champion or as the man at the helm of HHS when America made measles great again. For the sake of our public health, and our children, we should all hope it's the former, not the latter.
Lancaster County Seventh Graders Below Herd Immunity For Whooping Cough
Lancaster County is exposed as whooping cough deaths nationwide hit a seven-year high last year and cases locally surged.
The elevated exposure for a whooping cough outbreak here is due to the fact that vaccination levels among seventh graders are below what is generally considered necessary to stop uncontrolled spread, a level commonly known as herd immunity.
Herd immunity "is like a community's invisible shield" against contagious, vaccine-preventable diseases, said Dr. Banku Jairath, a pediatrician at Penn State Health Children's Hospital. Herd immunity is especially helpful when it comes to protecting vulnerable groups from disease, and preventing larger outbreaks, she said. Whooping cough can be especially dangerous for young children and babies.
For herd immunity to work, the vaccination rates need to stay high, Jairath said.
To achieve herd immunity against pertussis, also known as whooping cough, 90% to 94% of the population must be immune, according to Jairath.
But among Lancaster County's seventh graders, vaccination levels are below 90%. That's according to 2023-2024 data from the Pennsylvania Department of Health, which tracks vaccination rates for public, private and homeschooled students in kindergarten, seventh grade and 12th grade.
Pertussis cases up locallyLast year saw more cases of whooping cough in Lancaster County than the two prior years. In 2022, there were less than five cases of pertussis, while there were 42 in 2023 and 48 as of Sept. 14, 2024, as LNPLancasterOnline reported last fall. On Sept. 4, the state Department of Health put out an alert warning that cases could rise as students return to school.
Ten deaths nationwide were attributed to whooping cough in 2024, according to provisional data from the Centers for Disease Control and Prevention, which would be the most since 2017 with 13. Six times more cases were reported nationwide in 2024 compared to 2023, with last year's total just short of 35,500. While pertussis cases were low during and after the pandemic — likely the result of measures such as masking and remote learning — they are beginning to return to more typical levels, the CDC said.
A bacterial respiratory infection, pertussis can cause illness lasting for weeks or months, state health department spokesperson Neil Ruhland told LNPLancasterOnline last fall. Early symptoms are mild cough, stuffy nose and low-grade fever, Ruhland said, while later symptoms can include a cough with a high pitched "whoop" sound. The coughing may also lead to vomiting.
The whooping sound that gives the illness its name comes about when the person takes a breath after a coughing fit, WellSpan Family & Pediatric Medicine pediatrician Dr. Vinitha Moopen said in September. Not everyone with pertussis will have this symptom.
For newborns — who usually don't cough when they have pertussis — the illness can lead to episodes where breathing stops, Moopen said. Pertussis can also be dangerous for immunocompromised people and those with asthma, Ruhland said.
Vaccination is the best way of preventing pertussis, Moopen said. But protection from childhood vaccinations wanes over time, and the Tdap vaccine can be given at 11 or 12 years old to boost that protection, Ruhland said. Adults have the option of getting a Tdap booster every 10 years.
What are local vaccination rates?For Tdap and Td — one of which protects against tetanus, diphtheria and pertussis while the other protects against tetanus and diphtheria — 84.1% of Lancaster County seventh graders were vaccinated. The state's data does not differentiate between Tdap and Td, but according to Pennsylvania law, Tdap is the one required for students entering seventh grade.
For DTaP — a vaccine for diphtheria, tetanus and pertussis that the CDC recommends for children under 7 years — 88.6% of Lancaster County seventh graders were vaccinated. The data does not differentiate between the DTaP, DTP and DT vaccines, though DT is no longer available in the US, according to the CDC.
Jairath said these numbers are "on the lower side," putting seventh graders at risk for pertussis. But she noted that the community's immunity levels are what matters, not the levels for specific age groups — while 12-year-olds can handle pertussis, problems arise when young children and older adults get severe symptoms from the illness.
During the peak of the COVID-19 pandemic, vaccine numbers in general decreased a bit, Jairath said. Some missed vaccines during that time were because of missed well child visits, not because of a desire to avoid vaccines.
An LNPLancasterOnline analysis found that Lancaster County's rates for nearly all required childhood vaccines have decreased from the 2018-2019 school year to the 2023-2024 school year. Pertussis vaccines are among the ones that decreased, though seventh grade rates of those and all other shots recovered a bit between 2022-2023 and 2023-2024. Twelfth grade Tdap/Td vaccination rates also recovered slightly between 2021-2022 and 2023-2024, according to the data.
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