Delaware Faces Immunization Challenges Head-on.

This article explores the recent history of under immunized vaccine preventable diseases, along with recent outbreaks and how the Delaware Division of Public Health has responded to each. Delaware's vaccination efforts for children have achieved high coverage rates for all of the vaccine preventable diseases, leading to low incidences rates in the state. The main reason for these high rates is the law for mandated immunization for children entering kindergarten. As children age out of primary school, vaccination uptake declines. HPV vaccination rates are a prime example, as even though Delaware's rates as compared to the National average are better, they fail to meet Healthy People 2020 standards of 80% vaccinated. To get to the heart of an under immunized population, a study to determine where the lower vaccinated rates are, along with the surveillance rates to cross match the results must be undertaken. It is understood that for communities where vaccination rates are lower, risk for disease is greater, with several recent outbreaks corroborating this. A pertussis outbreak in the Delaware Amish community was managed by the State with education and outreach in the community, with mixed results. Hepatitis A is an epidemic in a number of states, and Delaware has taken steps to try to protect our vulnerable population, using outreach, education and vaccination clinics to prevent the outbreak from occurring locally. While work continues, resources will need to be continually applied to ensure that vulnerable populations have the means to access the services needed. DPH continuously monitors State vaccine coverage level data and disease outbreaks within and outside Delaware's borders and has implemented the above-mentioned public health initiatives to promote immunization awareness and address community health concerns.