When it comes to making sure the disease-preventing power of vaccinations is being fully realized, there's always a new challenge needing to be met.

So says Amy Pisani of Waterford, executive director of a national nonprofit group, Every Child By Two, that works to increase immunization rates in the United States and abroad.

"Our job is never done," said Pisani.

Pisani, 44, has been the organization's executive director since 1996, leading it in education campaigns aimed at parents and health care professionals, working on federal vaccine policy and weighing in when states consider new vaccination legislation.

Though Every Child By Two is based in Washington, D.C., Pisani works out of an office on Cottrell Street in Mystic, a move she made six years ago with the approval of the board of directors so she and her husband Derek and their two children could be near their families. As executive director, her job includes building alliances with lawmakers as well as other heath and child advocacy groups, and educating the public through various websites, newsletters, a blog and Facebook page. One of the organization's largest campaigns, called "Vaccinate Your Baby," has as its spokeswoman actress Amanda Peet delivering messages about vaccine safety and the importance of following the recommended schedules for vaccinating children.

Every Child By Two, Pisani explains, was founded in 1991 by former First Lady Rosalynn Carter and Betty Bumpers, former first lady of Arkansas, after a measles epidemic killed 150 people, among them many young children. Even now, with U.S. immunization rates for five of the main vaccines at 90 percent and the worst of the wave of misinformation calling vaccine safety into question successfully quelled, there are still messages the public needs to hear about the importance of keeping up-to-date on immunizations, Pisani said.

"We all need to get whooping cough and flu vaccines, not just for our own health," she said, referring to the focus of recent campaigns by her organization.

Cases of pertussis - commonly called whooping cough because of the sound infected children make when they try to catch their breath between coughs - began resurging in 2010, and was declared an epidemic in several states. Last year, the highly contagious illness reached epidemic levels in Washington state, and reached high levels in neighboring New York State as well as Wisconsin.

"We've lost babies to pertussis," Pisani said. "It's heartbreaking."

In up to 83 percent of these cases, the child was infected by a family member, usually a parent, who was not up-to-date on the pertussis vaccine and boosters.

To be fully protected against whooping cough, children need five doses over six years of the DTaP vaccine, which protects against tetanus, diphtheria and pertussis. By age 11 or 12, the vaccine wears off, and a booster is needed, and adults should get a booster every 10 years. Women who are pregnant or considering pregnancy are also encouraged to get a booster.

Raising rates of immunization against the flu, for children, pregnant woman and adults alike, is another goal, Pisani said. According to the Centers for Disease Control, about 55 percent of children and 40 percent of adults received the flu vaccine in 2012. Too many people, Pisani said, are reluctant to get a vaccination that has to be readministered every year, often arguing that they don't need it because they never get the flu.

"But they probably get it and don't get sick with it and give it to somebody else," she said. "We have a long way to go with influenza."

She also recalls her own experience as a mother, recalling how one of her children had to be hospitalized with a serious case of the flu. At the time, there was no flu vaccine available for children in that age group. Since then, vaccine has been developed for infants and every other group.

In recent years, Every Child By Two has also broadened its efforts, working with United Nations groups to increase vaccination rates in developing countries. For about $20 worth of vaccines, Pisani said, a child can be protected against many of the most dangerous illnesses, from polio to measles to rubella, a bargain compared to the costs of medicines and treatments.

A few years ago, she recalled, Pisani and her four-person staff were directing much of the organization's resources toward combating what she calls "rumors and falsified data" that linked the use of a preservative containing mercury in vaccines to autism, and caused many parents to doubt the safety of all vaccines. The claims, though shown to have "no scientific merit," she said, led to a reformulation of the MMR (measles, mumps, rubella) vaccine to eliminate the use of the preservative. It was, she said, an unnecessary change that raised the cost of the vaccine, and the episode still leaves some with doubts.

"The trouble is, every new parent hears about the rumors, and we have to tell them all over again," she said. "It's been a massive undertaking to get people to trust vaccines again."

For information on Every Child By Two and its various campaigns, visit:

• www.ecbt.org

• www.vaccinateyourbaby.org

• www.shotofprevention.com

• Facebook@Vaccinate Your Baby

• Twitter - EveryChildBy2