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Mass., Boston top vaccination compliance lists

WASHINGTON - Massachusetts led all states, and Boston topped all major cities nationwide in the percentage of young children who received disease-fighting vaccinations last year, according to figures released yesterday by the Centers for Disease Control and Prevention.

For children ages 19 to 35 months, Massachusetts recorded 83.6 percent coverage for all six vaccines, well above the national average of 77 percent. Nevada had the least coverage, at 59.5 percent.

In Boston, 81.4 percent of children from 19 to 35 months were given the entire series of vaccines, ahead of New York City's 72 percent, Los Angeles County's 78.5 percent, and Chicago's 77.3 percent. The lowest coverage was Detroit's 65.2 percent.

John Auerbach, commissioner of the Massachusetts Department of Public Health, said the Commonwealth's high immunization rates stem from a public health commitment that children receive the shots and doses to prevent diseases ranging from measles to hepatitis B.

"We have made it a priority to focus attention on prevention of illness for children," Auerbach said. "And we have found that promoting a system of universal vaccines is an effective prevention activity."

This year, the state budgeted roughly $49 million for vaccine coverage, an increase of about $12 million from last year. Most of the extra money will go toward a goal of universal coverage of vaccines against rotavirus for children, which causes severe diarrhea, and meningitis for adolescents.

Auerbach also said the Bay State is "fortunate in that we have an excellent system of primary care delivery" in clinics, doctors' offices, and a network of community health centers.

Massachusetts has 50 independent community health centers, including 25 in Boston, that provide pediatric services.

Bolstered by the city's network of hospitals, the neighborhood clinics emphasize to parents the importance of getting their children all their vaccinations on time, said Dr. Anita Barry, director of communicable disease control at the Boston Public Health Commission.

"We work with the centers closely to make sure people are aware of when they should get vaccines," Barry said. "We try to make sure walk-in immunization services are as available . . . and we also want to have linguistic and cultural expertise. If you are, say, a Chinese linguistic family, we could send them to the South Cove Community Health Center in Chinatown."

Nevertheless, a critical part of the city's vaccination coverage plan - a computerized system that allowed doctors and nurses to see a child's vaccination record - went off-line this year because the federal funds used to run it dried up. The program, which had been operating for 13 years, had cost roughly $100,000 each year.

"If we don't get more funding later, it's going to be interesting to see what will happen in the next couple of surveys, whether our [immunization] coverage will drop," she said. The immunization package for children includes six vaccines that prevent 10 serious diseases, several of which flourished in the United States a half-century ago.

The CDC-recommended series consists of four doses of vaccines against diphtheria, tetanus, and pertussis; three doses of polio vaccine; inoculations against measles, mumps and rubella; three doses of a vaccine to prevent haemophilus influenzae type B, or Hib; three doses of hepatitis B vaccine; and one or more doses of vaccines against chickenpox.

The immunizations begin with infants and continue through a child's second birthday.

Massachusetts, Connecticut, and Rhode Island have ranked near the top in the country in immunization rates of children for the past five years.

CDC officials said they were pleased that the country as a whole is moving toward its goal of having 80 percent of the nation's children immunized by 2010.

"Thanks to this high level of coverage, and due to the good work of immunization providers and the commitment from parents, the diseases that these vaccinations prevent are at very low rates in this country," said Dr. Melinda Wharton, deputy director of the CDC's National Center for Immunizations and Respiratory Diseases.

The national rate of childhood immunizations represented a slight increase from the 76.1 percent coverage in 2005, but was a significant jump from the national rate of about 65 percent in 2002. But Wharton said the percentage of children from low-income and African-American families continued to lag. She said that the percentage of immunized black children is lower than that of white children because the poverty rate is higher among black families.

The CDC estimates showed that African-American children and children from families living below the poverty line both had immunization rates at about 74 percent, more than 3 percentage points lower than the national average.

The CDC also documented major increases in the percentages of specific vaccine coverage.

For instance, the percentage of children receiving three doses of pneumococcal conjugate vaccine since 2005 increased about 4 percent to 87 percent last year; for those receiving four doses of the vaccine, 68.4 percent received it last year, compared with 53.7 percent in 2005.

For the first time, the CDC also estimated the percentage of 13- to 17-year-old children receiving recommended vaccine coverage. It found that coverage was low for two vaccines that were recommended only two years ago: MCV4, or meningococcal conjugate vaccine, at 12 percent; and Tdap, or tentanus, reduced diphtheria, and acellular pertussis vaccine, at 11 percent.

Wharton said no information was available on the coverage of another recently recommended vaccine, human papillomavirus, or HPV. The vaccine, given to women in three shots over six months, helps prevent cervical cancer and other diseases.

She said since the vaccine was licensed in June 2006, it is now available in all 50 states and the manufacturer reports distribution of 7.5 million doses around the country.

"For a new vaccine, that's quite a number of doses," Wharton said.

John Donnelly can be reached at donnelly@globe.com

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