Vaccination rates for Alabama’s youngest residents have dropped dramatically since the COVID-19 pandemic. And this is especially true when it comes to the polio vaccine.
The state’s infants and young children are not meeting thresholds needed to fight nearly eradicated diseases, like measles, according to data from the Centers for Disease Control and Prevention and the Alabama Department of Public Health.
“Every time vaccination rates decline, it creates the possibility that these diseases will re-emerge in the population,” said Wes Stubblefield, a pediatrician and physician at ADPH.
Statewide, the vaccination rate for children ages 19 to 47 months plunged from about 71% in October 2021 to just 65% last November, the last date for which monthly data was available from ADPH. That’s about 13,700 more unvaccinated toddlers in the state than just two years ago.
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The federal data covers different ages but paints a similar picture of growing rejection of vaccination in Alabama. Only 65.5% of 35-month-old children born in 2021 have received all recommended vaccines. This is down from 82.5% for children born in 2017.
Recommended routine immunizations include hepatitis, polio, measles, chickenpox, diphtheria, tetanus and pertussis, pneumococcal disease, and Haemophilus influenzae.
No vaccination has seen adoption fall faster or in more regions than the IPV vaccine, which prevents polio. This round of vaccines fell more than any other in just over half of Alabama’s counties and had the largest overall decline in the state.
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Children are supposed to complete their first round of vaccines by age 47 months, although additional booster shots are planned for children ages 4 to 6.
“I’m probably one of the last doctors still practicing in Alabama who has seen a real case of measles,” said Karen Landers, pediatrician and ADPH chief medical officer. “These children suffered terribly from these illnesses. Some of them are dead and we don’t see him anymore.
She said she wants to see the state reach a 95% total vaccination rate.
But Alabama is not alone in moving in the opposite direction, as many states are seeing declines. Alabama now ranks 10th in the nation in fully vaccinated rate of children born in 2021.
And vaccination rates vary widely from state to state. Some Alabama counties have seen declines of more than 20 points in vaccination rates for specific types of shots in recent years.
In two Alabama counties, Barbour and Blount, fewer than half of toddlers were considered up-to-date on their vaccinations.
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“We feel very distant from these diseases because we have eradicated them,” Landers added. “But they can come back, and they can come back with a vengeance if we don’t use the tools we have, such as vaccines,” she said.
Last year, doctors warned of declining measles, mumps and rubella vaccination rates in the state, saying rates were too low to prevent outbreaks. For example, the threshold for achieving herd immunity against measles is 95%. But Alabama’s vaccination rate for children under 4 was only 77%.
“We are nervous, very nervous, about having a measles outbreak across the country,” David Kimberlin, co-director of UAB and the Division of Pediatric Infectious Diseases in Children, said during a press conference last February. “We have feared a resurgence of vaccine-preventable diseases for some time now. »
In 2024, ADPH reported two cases of rubella. Each year, fewer than 10 cases of illness are reported on average in the United States, according to the CDC.
Alabama also experienced a whooping cough outbreak last fall, with elementary and middle schools and college campuses reporting cases. There have been a total of 263 confirmed cases of the virus in 2024, according to ADPH, compared to just 41 in 2023.
“Believe in science”
Prices for seven routine vaccinations – four of which are required to attend school – decreased between January 2021 and November 2024.
This shift comes in the years since the rollout of COVID-19 vaccines and the ensuing public fight over vaccines and mandates during the pandemic.
President Donald Trump’s nominee for Health and Human Services secretary, Robert F. Kennedy Jr., is known for his vaccine skepticism, although he told lawmakers Tuesday that he would not remove no vaccine.
According to Politico, Kennedy has convinced some Republican senators that he has reconsidered his previous beliefs that the measles vaccine can cause autism and the polio vaccine can be more deadly than the disease, and is now “pro-safety vaccination”.
Alabama Republican Sen. Tommy Tuberville, who in December indicated support for Kennedy’s skepticism, calling his position a “breath of fresh air,” told reporters this week: “I’m not aware of all of this” when asked again if he had any concerns. on Kennedy’s past criticism of vaccines.
Doctors have expressed concern about the impact Kennedy could have on already declining vaccination rates if he is confirmed to lead the agency.
“As pediatricians,” the American Academy of Pediatrics said in a statement after Trump’s nomination of Kennedy, “we firmly believe that the most effective way for HHS to ensure the future health of our nation is to protect and support the health of our children: ensuring that science continues to underpin all decision-making, policies and programs.
In just over half of Alabama’s counties, all types of vaccines have declined. The polio vaccine has seen the fastest decline in more than half.
The first two doses of the DTap and Hib vaccines are administered at the same time as the polio vaccination: at two months, then again at four months. Those numbers have each declined by 5 percentage points over the past few years in Alabama, but polio has fallen by 8 points.
“We must stick to what we know and believe in the established science, which shows the safety of vaccines and that vaccinating our children is the best way to keep our children healthy, our communities, our state, our country healthy. overall good health,” said Brittney Anderson, a family physician in Demopolis, a town west of Montgomery in the Black Belt.
“Vaccines are safe”
One bright spot was the Black Belt region. This area, which runs the length of the state in a crescent from south of Tuscaloosa to south of Auburn, was home to some of the lowest vaccination rates in the state in 2021.
(Don’t you see the map? Click here.)
Three Black Belt counties were below 50% in 2021: Dallas, Perry and Russell. But while the state as a whole saw a decline, these three counties increased significantly, seeing double-digit increases in toddler vaccination rates. Perry and Dallas counties lead the state in increasing vaccination rates, with increases of 17.1 and 16.6 percentage points, respectively.
Anderson, a Black Belt family physician, said area doctors have built strong relationships with their patients.
“There is a level of trust that probably makes patients and parents of those patients more likely to believe their doctors when they tell them that vaccines are safe,” Anderson said.
She said she regularly talks with parents about vaccines, adding that part of her job as a doctor is to educate patients about their health. According to Anderson, the best thing you can do in the face of hesitation is to answer all of a parent’s questions.
“One of the things I ask of our parents is that they trust our training and experience. If you don’t trust me when I say your child should get these vaccines, then will you trust me if I tell you? Does your child have an ear infection or a stomach virus?
