Trust in CDC and childhood vaccination decline in St. Louis

ST. LOUIS — Public trust in the U.S. Centers for Disease Control and Prevention (CDC) has dropped sharply among St. Louis adults, even as childhood vaccination rates in the city fall to levels that health experts say leave communities vulnerable to outbreaks.

A new poll from iHeard St. Louis, a public health monitoring program at Washington University’s School of Public Health, shows a sharp decline in confidence in the CDC in the last three months. The survey was conducted in early September, and it found that only 56% of St. Louis adults believe the CDC is prepared to respond to flu outbreaks, down from 71% back in June.  Trust in the CDC’s vaccine recommendations also declined from 59% to 50%.

This loss of trust could be coming at a significant time. A six-month data investigation by NBC News, conducted with Stanford University researchers, found that much of the U.S. does not have the protection needed to stop the spread of deadly diseases, and that St. Louis serves as an example of the problems that communities face across the country.

The investigation points to the fact that for more than fifty years, vaccines have had excellent success in getting rid of some of the most lethal and devastating illnesses in children, saving many lives and giving us a “golden age” of public health, but now the vast majority of U.S. counties are experiencing declines in childhood immunizations. The trend has pushed many communities below the “herd immunity” threshold for measles, considered the most contagious virus known to humans.

The city of St. Louis is among the hardest hit. The rate of kindergartners in the city starting school with all state-required vaccines has plunged from 91.6% in 2010 to just 75.9% last school year, according to the analysis. 

Measles, mumps and rubella (MMR) vaccination rates dropped even lower, from nearly 90% to 74%. That’s below even Gaines County, Texas, where a measles outbreak killed three people this year.

The findings tell us that at the same time St. Louisans are losing confidence in the nation’s leading public health agency, vaccine coverage in schools is also withering away. Public health experts say the two factors feed each other, with declining trust fueling hesitancy and low vaccination rates reinforcing skepticism.

NBC’s reporting shows exemptions for school-required vaccines, whether for medical or religious reasons, have more than doubled in over half of U.S. counties. Exemption rates in St. Louis schools rose more than 10x since 2010.

The Washington University survey and the NBC/Stanford analysis both suggest that unless trust in public health institutions can be rebuilt, St. Louis may be on the front lines of a national backslide.