Ohio, the Last Stronghold State, Starts Requiring Vaccines for Preschoolers

Less than 62 percent of Ohio children 19 to 35 months old have all the vaccines recommended by the federal Centers for Disease Control and Prevention. Can the state's new day-care and preschool vaccine law make a difference?
by | August 24, 2015 AT 3:10 PM

By Misti Crane

Ohio toddlers are among some of the worst-protected against vaccine-preventable illnesses, and pediatricians and public-health leaders are hopeful that Ohio's new day-care and preschool vaccine law will make a difference.

The law, like the state's school-age vaccine requirement, gives parents a simple way to opt out if they object to vaccines or their child has an allergy or other medical reason to forgo a shot.

Even with that allowance, most kids in Ohio historically have caught up on their vaccines by kindergarten, when the school vaccine law kicks in, said Dr. Mary DiOrio, medical director at the Ohio Department of Health. The new law for children who go to day care or preschool has the potential to increase vaccine coverage among those kids even earlier, keeping them from spreading illnesses to one another and to family members, including vulnerable infant siblings and the elderly, DiOrio said.

The most-recent data available show that in 2013, less than 62 percent of Ohio children 19 to 35 months old had all the vaccines recommended by the federal Centers for Disease Control and Prevention. More Ohio toddlers -- 86 percent -- had the vaccine for measles, mumps and rubella than any other vaccine. The lowest coverage was for hepatitis A; fewer than half of the children had that vaccine.

The only states with worse coverage were Arkansas and Nevada. The national average was more than 70 percent.

"We know by the time kids enter into school, a lot of them get up-to-date with their vaccine requirements," said Dr. William Cotton, medical director of the primary-care network at Nationwide Children's Hospital. "We hope this does the same thing. We'll have to see how it plays out," he said.

About half the children in day care attend small, unregulated day cares that aren't subject to the law, he said.

Before passage of the requirement, Ohio was the only state without a vaccine-coverage law for children in day care or preschool. But before the law, most providers required proof of vaccination history under rules made by the Ohio Department of Job and Family Services, said Karen Lampe, a board member of the Ohio Association of Childcare Providers who runs day-care centers in Dayton.

Still, DiOrio said she thinks the law will have an impact on Ohio's toddler vaccine-coverage rates.

Cotton said a lot of children stop seeing doctors for regular checkups when they are no longer babies, and some families take their children for medical care only when they are sick, leading to gaps in vaccine coverage.

"Some are going to urgent care when they're sick, and they aren't getting any primary care," he said. "And not all physicians are up-to-date and aggressive with immunizations."

Cotton said he and others have talked about the potential to tighten Ohio's law to reduce the number of parents opting out of vaccine requirements, and they have looked at similar legislation elsewhere that mandates a conversation with a public-health professional before an exemption is granted.

Jose Rodriguez, spokesman for Columbus Public Health, stressed the importance of vaccinating children in the interest of the health of the community, including those kids who cannot be vaccinated for medical reasons.

Illness spreads quickly in buildings with a lot of children, and there's great opportunity at day-care centers and preschools to prevent or slow the spread of disease, including whooping cough and measles, he said.

(c)2015 The Columbus Dispatch