ATLANTA – The growing list of childhood vaccinations reads like an alphabet soup: Hib, HepA, HepB, IPV, PCV, MCV4, DTaP, Tdap, varicella and influenza.
Parents dragging their kids to the doctor’s office for those required school shots can expect to hear about more vaccines and, if they’re uninsured, new expenses.
Twenty years ago, it cost $75 to $100 to immunize a child with the four available vaccines. Today, 12 are generally recommended for kids and adolescents, at a private-sector cost of about $1,250.
And the government is expected to recommend a 13th vaccine for girls – a shot that protects against cervical cancer. It costs about $360 for the three-dose series, potentially raising the per-child vaccination bill to more than $1,600.
“The good news is we can now prevent so many diseases. The bad news is it’s gotten more complicated,” said Dr. Anne Schuchat, who directs immunization programs for the U.S. Centers for Disease Control and Prevention.
Although vaccinations are routinely covered by health insurance, some worry that government funding for shots for the poor and uninsured will not keep up with demand.
Another challenge: Outbreaks of mumps, whooping cough and other infections that can be prevented with vaccines have shown that immunized people can still catch the disease. So more booster shots are needed.
Of the nearly 4,900 people who caught the mumps during an outbreak in the Midwest this year, hundreds had received both recommended doses of mumps vaccine, CDC officials said.
Doctors have been giving childhood pertussis – or whooping cough – vaccinations for decades. So some were surprised by reports of vaccinated children coming down with the illness in middle school and high school.
“We’ve learned the whooping cough vaccine we thought was going to last forever wears off by the time they reach adolescence,” said Dr. Carol Baker, a Houston-based pediatrician who serves on the Advisory Committee on Immunization Practices, a panel that helps set national vaccination guidelines.
After a new tetanus-diphtheria-pertussis vaccine came out last year, the committee recommended a dose for children when they are 11 or 12 to give them better protection into early adulthood. A bacterial meningitis vaccine also was recommended for that age group.
A shortage of the new meningitis shot led the vaccine panel to suspend its call for 11- to 12-year-olds to get it. So currently, the shot is recommended only for students entering high school and college.
The vaccine’s manufacturer, Sanofi Pasteur, is building a new plant in Pennsylvania that is expected to bolster production in 2008, a company spokeswoman said.
Doctors are worried about other vaccine supply problems, too.
In February 2004, when there was a shortage of a vaccine against pneumococcal pneumonia, federal officials asked doctors to put off the fourth recommended dose for young children. CDC officials lifted the suspension seven months later.
Then there’s the flu. The government has been broadening flu shot recommendations to cover more children. This year the CDC added 2- to 5-year-olds to a list that already included children ages 6 months to 23 months.
Flu shot shortages in past autumns make doctors wonder whether they will be able to vaccinate so many children.
Vaccines will be covered for children on Medicaid and other people in need who qualify. A bigger problem is children who don’t qualify for the federal coverage and who have inadequate health insurance. Many states already aren’t getting enough money to pay for shots for those kids, even without adding the human papillomavirus vaccine for girls.
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