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Posted on: May 12, 2022

Clinician Advisory: Falling Immunization Coverage Among Children

May 12, 2022

Clinician Advisory: Falling Immunization Coverage Among Children

Call to Action for Reminding and Recalling Under-Immunized Patients

Requested action:

  • Please use reminders and recall messaging directed toward parents and guardians in order to get children back on track with being up-to-date for immunizations.
  • For technical assistance in childhood immunization, contact our Childhood Vaccine Program at 425-339-8625 or the Vaccine Preventable Disease program for clinical assistance at 425-530-7178


Today the Washington State Department of Health released a report showing marked decreases in administration of and coverage with routine childhood immunizations compared to already unsatisfactory pre-pandemic levels.

  • Declines in administration were most pronounced in older children, but impacts on coverage were greater in younger children.
  • Single-dose MMR coverage in 19-35 month-olds declined from 85% to 74% statewide, and two-dose MMR coverage in 4-6 year-olds declined from 71% to 62%. This is far below the 95% coverage that is needed to provide herd immunity against sustained measles transmission following an introduction into the community.  
  • As of December 2021, only 48% of Snohomish County 4-6 year-olds were fully vaccinated with all age appropriate antigens.   

Vaccine Administration and Coverage, Snohomish County, 2020-2021

Milestone Age Group

∆ in Doses Administered (%)1

Coverage2 (%)



∆ Jun 2020-

Dec 2021


Dec 2021

0-24 months





19-35 months





4-6 years





11-12 years





13-17 years





1compared to average of 2015-2019

2see page 5 of the report for age-specific coverage definitions


Health Officer’s Statement:

Coupled with our improved sanitation and general standard of living over the years, immunization against vaccine preventable diseases is the main difference between us now and the widespread illness, disability and death that was common among children a century ago. Most of us alive today were born after that transition occurred in the mid-20th century when blindness, deafness, developmental disability, and death from these conditions among children were common. Now these consequences are almost unheard of.  But we should not take this gift for granted or be overconfident about our current situation. 

Current low levels of coverage against vaccine preventable diseases like measles, mumps, rubella, whooping cough, meningitis and pneumonia leave our society and our children vulnerable to illness and disease transmission that can have devastating effects on individuals and the community. Part of our recovery from the COVID pandemic has to be each and every one of us making sure that our patients’ immunizations are complete and up to date as soon as possible. Don’t delay. Reach out to your under-immunized patients’ families right away and start working on getting our children up-to-date.  

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