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Control and eradication of vaccine-preventable diseases rely on high levels of vaccination. For some infections, such as measles, this level needs to be above 95% to achieve herd immunity and protect children too young to be immunized. Recent studies have demonstrated that disease outbreaks overlap geographically with areas where parents refuse vaccines (NEJM JW Pediatr Adolesc Med Jun 26 2013).
Researchers examined health records from Kaiser Permanente of Northern California for more than 150,000 children born between 2000 and 2009 and followed until at least age 36 months. From 2002 to 2012, rates of underimmunization (child missed at least 1 recommended vaccine by age 36 months) increased annually by an average of 6%, peaking at 13% in 20…