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Decline in vaccination rates for children worries western Minnesota public health director

West Central Tribune - 3/16/2023


— The COVID-19 pandemic may be winding down, but infectious diseases are likely to remain in the forefront for public health agencies for years to come.

A decline in immunization rates among young children has

Countryside Public Health

Director Liz Auch concerned about the likelihood of seeing a rise in infectious diseases, she told the

Yellow Medicine County Board

of Commissioners on Tuesday.

"I think the next 10 years we need to work really hard to just understand where we are with infectious diseases, and what that means," Auch told the commissioners. "That is work I think public health has to do."

Auch cited her concerns as she provided the agency's annual report. The public health agency serves the counties of

Yellow Medicine


Big Stone




Lac qui Parle




The agency plays an important role in those counties by providing immunizations to children, and services for expectant and new mothers and their families.

Auch emphasized that she is not reporting a rise in infectious diseases for which immunizations are provided in the five counties. She pointed out that nationally there has been a rise in reported cases of measles and pertussis (also known as whooping cough). Vaccinations can provide protection against both of the highly contagious diseases.

The decline in immunization rates is statewide and local. Among the five counties served by Countryside Public Health, Yellow Medicine County reported the highest vaccination rate — at 75% among children ages 0 — 2 years last year. That is the percentage of children immunized according to a Centers for Disease Control protocol for protection against a variety of infectious diseases, ranging from chickenpox and diphtheria to polio and measles.

Statewide, the vaccination rate among that age group has declined to 63.3%. When Auch began her career in public health 23 years ago, the statewide vaccination rate for that age group was at about 80%, she told the commissioners.

She attributes some of the decline to a change in public perceptions. "We can see the thought process of where people are with immunizations, and how they feel about immunizations is changing a bit," said Auch.

She also believes the pandemic has played a role in the decrease as well. During the pandemic, her staff has been unable to conduct the face-to-face meetings and evaluations with new mothers participating in the Special Supplemental Nutrition Program for Women, Infant and Children, as well as with others involved in other public health services. Face-to-face outreach visits by staff declined from 1,887 in 2019 to just 23 in 2021 and 69 in 2022.

The in-person visits were replaced by telephone calls. Conversations over the telephone are not as effective in providing education about the importance of immunizations, Auch explained.

On the positive side, the pandemic led Countryside to play a bigger role in providing vaccinations against COVID-19. It expanded its vaccination clinic times to include evenings and lunch hours to improve accessibility.

The director said the public health emergency that has restricted in-person outreach work is expected to end May 11. Once it is lifted, she said the agency will be conducting in-person meetings with WIC participants twice a year, instead of four times as was the case pre-pandemic.

Her goal for the agency going forward is to place a greater emphasis on the importance of educating the public and understanding the reluctance by some to be immunized. The agency will need to be more flexible, she said. She hears from parents who are hesitant to fully vaccinate their children, and ask instead what are the most important vaccinations.

Public health workers will need to inform parents about the side effects and complications that accompany a decision not to protect against each of the childhood diseases.

The workers must also accept that some parents will not fully vaccinate their children. "If we dig our heels in and don't work with families, that is not going to work either," she explained.

The WIC program — which provides supplemental foods, health care referrals and nutrition education — is one avenue through which Countryside Public Health is able to work with many young families and provide health information. In Yellow Medicine County, the agency provides WIC vouchers to more than 1,000 participants each month. In December, that represented more than $67,000 in spending at in-county grocery stores.


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