A nurse readies an MMR vaccine at Sanford Children’s Hospital in Sioux Falls. (Joshua Haiar/South Dakota Searchlight)
Close to half of South Dakotans aren’t up-to-date on their flu shots or their hepatitis B vaccinations, new vaccine survey results released by the South Dakota Department of Health indicate.
About 63% aren’t up-to-date on their HPV vaccinations, which protect against most cases of cervical cancer, and 78% aren’t up-to-date on their pneumococcal vaccinations, which help protect against pneumococcal infections.
That’s “concerning” to Keith Hansen, president of the South Dakota State Medical Association. Vaccinations are “one of the most important developments in health” to keep people and communities healthy, he said.
As a reproductive endocrinology and infertility specialist, he is especially concerned with how vaccine-preventable diseases can affect pregnant women and newborn children.
“It’s really sad when someone isn’t vaccinated and then they come into the hospital because they caught a vaccine-preventable disease,” Hansen said. “Now they have some bad outcome that could have been prevented.”
The state Health Department conducted the survey to better understand vaccination behaviors, decision-making and awareness of the vaccine schedule. A U.S. Department of Health and Human Services grant funded the survey.
COVID pandemic influences some vaccine behavior
More than a quarter of survey respondents said the COVID-19 pandemic negatively impacted their views on vaccines. Those respondents also had lower vaccination rates for the flu and COVID, at 34% and 4%, respectively.

Among all survey respondents, 96% reported ever being vaccinated. About 98% of respondents with children reported that their child had received at least one vaccination.
About 96% of respondents said they get at least “some” vaccines recommended by their doctor, and nearly 93% of respondents said they follow the routine or a delayed vaccination schedule for their child.
Carmen Toft, director for South Dakota Families for Vaccines and board vice president of Immunize South Dakota, said the state should “celebrate” those positive statistics.
The goal, Toft said, is to reach vaccination rates above 95% to reach herd immunity, which is when the prevention of infectious diseases becomes most effective.
Tdap vaccinations remain high
While most vaccination rates in the survey are lower than Hansen or Toft prefer, up-to-date Tdap vaccination rates were highest among respondents at 78%. The vaccine protects against infections caused by diphtheria, tetanus and whooping cough.
Among respondents who said their vaccination views were negatively impacted by the COVID-19 pandemic, 75.5% of adult respondents were up to date on their Tdap vaccination.
That could be because the Centers for Disease Control and Prevention recommends adults get the Tdap booster every 10 years for adults, Toft said, rather than yearly like the flu. If vaccine hesitancy rises, Tdap vaccination rates could be impacted more slowly than more regularly recommended vaccines.
Hansen added that Tdap vaccinations are sometimes administered in response to injuries, such as cuts, to prevent tetanus. Also known as lockjaw, tetanus causes muscle contractions and can be life-threatening.
Conflicting information could lead to more vaccine hesitancy
The most common reasons respondents gave for not receiving vaccinations included hearing contradictory information — from doctors, social media, news outlets, government agencies and others — and believing a vaccine isn’t safe or isn’t needed.
Concern about vaccine safety was the most common reason respondents gave for choosing not to vaccinate a child, followed by the belief that it wasn’t needed and the prevalence of conflicting information about vaccines.

Toft said fast-spreading misinformation on social media is influencing public opinion. So is U.S. Secretary of Health and Human Services Secretary Robert F. Kennedy Jr.’s introduction of “fringe ideas” to inform policy changes, she said.
“It’s moved off of Facebook feeds and onto ‘CBS Mornings’,” Toft said, adding “the decisions seem more and more politicized, and that’ll only lead to more confusion.”
A CDC vaccine committee charged with setting national guidelines around vaccine policy voted on Friday to eliminate a 34-year-old recommendation that all newborn babies receive a hepatitis B vaccine. There was a 99% drop in serious infections among children between 1990 and 2019, which is attributed to the universal vaccination policy. Recommendations for adults and unvaccinated older children will remain unchanged.
The new recommendation mirrors COVID-19 guidelines changed by the same committee in September. The change at that time caused widespread confusion about the vaccine’s accessibility and if insurance companies would cover it.
“I think it’ll be a while before we see the long-lasting implications of some of these decisions they’re making,” Toft said of the committee’s decisions.
The recommendations play a key role in determining which vaccines insurance companies are willing to cover and how accessible those immunizations are to the public.
South Dakota’s survey results indicate that most people place their trust in local professionals rather than national entities: 84% of respondents said their preferred source of health information is their doctor or health professional. About 95% said they “somewhat” or “to a great extent” trust their doctor or health professional with vaccine information — more than pharmacists, the state Department of Health, or the CDC. Social media and news outlets were the lowest trusted sources among respondents.
Hansen hopes health professionals take note and choose to broach immunization discussions more often with patients. Toft agreed that health professionals are the best point of contact for vaccine education.
“When we talk to vaccine-hesitant parents, we’re like, ‘Yes, ask questions. I’d love to help you. I’d love to connect you with a provider who can answer your questions,’” Toft said. “We want you to have access to information to make the best decision for you and your family.”






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