Because of COVID-19, children are out of school, being kept away from day care and missing out on extracurricular activities. One unintended consequence of the pandemic is that children are also missing important doctor visits and vital vaccinations. In the months since COVID-19 was first reported in the U.S., there has been a sharp decline in the number of kids receiving routine childhood vaccines, and the decreasing numbers have experts concerned.
A May report by the Centers for Disease Control and Prevention (CDC) shows that from mid-March to mid-April, U.S. doctors who participate in the federally funded Vaccines for Children program ordered about 2.5 million fewer doses of all routine non-influenza vaccines and 250,000 fewer doses of measles-containing vaccines compared to the same period in 2019.
Some state health departments have noted the local impacts of the downward trend:
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In Washington state, 30% fewer children were vaccinated in March and 40% fewer children were vaccinated in April compared to the previous year.
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In a May 11 advisory, the Massachusetts health department said vaccine orders are down 60% in the state.
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The state of Minnesota is reporting a 70% drop in doses of the measles vaccine given in the state compared to this time last year.
The dwindling vaccination rates have prompted guidance from the American Academy of Pediatrics (AAP) urging parents not to skip routine vaccine appointments. The AAP press release states that in-person medical visits should occur whenever possible and are necessary for vital services, which include immunizations.
Delaying vaccination may not seem like a big deal if the decision is only temporary, but experts warn that missed doses of vaccines can have major repercussions, especially for young children. While many parents are rightfully concerned about exposure to COVID-19, it’s important to remember that missed vaccines can leave children vulnerable to exposure to a number of other illnesses, like measles, diphtheria, rubella or even chicken pox. And many of these vaccine-preventable diseases can cause widespread outbreaks.
“Sometimes because of vaccinations being so successful, people have not really seen these diseases,” says Dr. Ashlesha Kaushik, a pediatric infectious disease specialist at UnityPoint Health in Sergeant Bluff, Iowa. “But we did get a big resurgence of measles just last year, so there’s really a risk these diseases can come back if we just stop vaccinating.”
In the midst of the COVID-19 pandemic, Kaushik tells Care.com the last thing medical professionals want is an outbreak of another infectious disease. “Measles can put so many children at risk, especially immunocompromised children,” she explains. “Same for the chicken pox, same for diphtheria. All of these diseases are so devastating, and if you see the worst complications, it is heartbreaking … This pandemic has left us scarred enough. So many people have died. You don’t want another crisis with another virus or big bacteria coming back.”
Experts also warn that vaccine schedules are carefully timed and studied to give children the best possible protection from illness, and delaying scheduled doses can affect kids’ future immunity. “The most critical vaccines are the 2-, 4-, 6- and 12-month vaccines,” says Dr. Amy Baxter, a pediatric emergency medicine specialist and pain researcher based in Atlanta, “and the reason for that is because the immune response is learning to see those diseases, and it needs frequent reminders.”
Baxter tells Care.com all of the vaccines for kids under 2 years old are “exquisitely timed to maximize the immune response while minimizing the amount of viral material that is introduced.” Disrupting the recommended vaccination schedule leaves kids vulnerable and can have a lasting impact on kids’ health.
“Vaccines are school for the immune system,” Baxter explains. “If you give a lesson to a student and then don’t remind them and come back a few years later, they’re not going to remember the lesson. In the same way, your immune system needs to be reminded really frequently of these illnesses in those first 6 months to be able to have good immune memory later on.”
Parents may be understandably concerned about exposing themselves or their children to COVID-19 by heading to the pediatrician’s office, but Kaushik says doctors are doing everything they can to minimize the risks.
The current AAP guidelines for care providers call for:
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Prioritizing in-person care for newborns.
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Offering tele-health services when possible.
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Scheduling well-visits and sick visits at different times of day.
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Socially distancing patients in the waiting room, or even seeing well patients at different facilities when possible.
In addition to these guidelines, Kaushik says some doctors are asking vulnerable patients to wait in their cars, encouraging the use of hand sanitizer, implementing the use masks for those over age 2 and prioritizing cleanliness above and beyond the normal procedures.
“The big thing that parents should realize is that pediatricians are very much up and running,” says Kaushik. “The pediatric offices are open, and the doctors are in and ready to cater to their patients. Parents can always call ahead of time, and they can rest assured that pediatric offices are following the AAP’s advice. They are really putting safeguards in place and doing everything they can to protect their patients.”
Kaushik continues, “”Parents need to be listening to their pediatrician’s advice and also the public health professionals’ advice because they are the ones who have read the scientific evidence. Vaccines have been such a safe and effective means of preventing infection. These are the best tools we have.”