Childhood vaccination represents one of the most successful public health interventions ever. Diseases that once killed thousands of children each year have been virtually eliminated.1 Immunization with the basic series of childhood vaccines is widely considered one of the most cost-effective options available to medical personnel.2
Nevertheless, childhood vaccination in the 21st century faces multiple challenges that threaten its success. An increasingly skeptical public questions whether vaccines are safe enough, leading to underimmunization of large segments of the population in some regions. Periodic vaccine shortages necessitate prioritizing vaccines for the highest-risk populations, leading to delayed immunization of many young children. Waning immunity and low vaccination rates among adults leave the most vulnerable children underprotected against some vaccine-preventable diseases, leading to communitywide outbreaks of infections such as pertussis. Lastly, newly recommended vaccines for adolescents are targeted to a population renowned for low health care use rates.
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