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Vaccinations of children have plummeted during COVID-19 pandemic, CDC finds

“Parents should talk to their children’s doctors and work together to make sure that their children are up to date on their vaccines,” stressed Dr. Malini DeSilva, one of the report’s co-authors and a Minnesota pediatrician.

MMR vaccine
REUTERS/Rebecca Naden
It’s possible we could start seeing outbreaks of childhood diseases in the midst of the COVID-19 pandemic.
The number of vaccines administered to children has dropped precipitously in the United States during the COVID-19 pandemic, according to a report released Friday by the Centers for Disease Control and Prevention (CDC).

The decline appears to have rebounded somewhat among children under the age of 2 years, but it has left millions of children of all ages at increased risk for developing measles, meningitis, pertussis (whooping cough) and other vaccine-preventable diseases, health officials warn.

That risk will grow as states continue to relax their social distancing requirements.

“Parents should talk to their children’s doctors and work together to make sure that their children are up to date on their vaccines,” stressed Dr. Malini DeSilva, one of the report’s co-authors, in a phone interview with MinnPost. DeSilva is a Minnesota pediatrician and a research associate at the HealthPartners Institute in Bloomington.

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The American Academy of Pediatrics (AAP) described the report as “incredibly worrisome.”

“Immunizing infants, children and adolescents is important, and should not be delayed,” said Dr. Sally Goza, president of the AAP, in a released statement.

“I’m also concerned that children who have missed vaccines have also missed other health care that occurs during those visits, including physical exams, developmental screenings, and other important care that should not be delayed,” she added.

How the report was done

The report’s authors analyzed data from two sources: the Vaccines for Children Program (VFC), a national program that provides vaccines to publicly insured and uninsured children aged 18 and under in the U.S. at no cost (about half of all children in the country), and the Vaccine Safety Datalink, a collaborative project between the CDC and eight large health care organizations, including HealthPartners.

Dr. Malini DeSilva
Dr. Malini DeSilva
From the VFC data, the researchers pulled out the number of doses of non-influenza vaccines that were ordered through that program from Jan. 7 through April 21, 2019, and from Jan. 6 through April 19, 2020. When they compared the ordered doses for those two periods, they found a sharp decline after March 13 of this year, when President Trump declared a national emergency.

Close to 3 million fewer doses of childhood vaccines were ordered after that date compared to the previous year, said DeSilva.

Using the Vaccine Safety Datalink data for those same January-April dates, the researchers then looked at the number of measles-containing vaccine doses that were administered to children at the eight health care organizations. They found that the number of a doses administered in 2020 dropped steeply — by about half — after March 13.

The decline was smaller among children under the age of 2 years than among older ones, however, and it also rebounded sooner.

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“That suggests that the strategies that were put into place to try to prioritize and do outreach to families to get young children in for their well-child checks and vaccines are working,” said DeSilva.

Those efforts included directly contacting families about overdue vaccinations and changing the “workflow” in clinics and doctors’ offices to ensure minimum contact between patients.

Such efforts are now under way to reach the families of older children, said DeSilva.

What parents should do

Parents are understandably worried about exposing their children to COVID-19 by bringing them in for a well-child visit with their pediatrician, DeSilva acknowledges. But health care systems have implemented new procedures to keep children and their families safe, she added. These include separate respiratory clinics for patients with potential COVID-19 symptoms, revised check-in policies to eliminate time spent in a waiting room (or even, in some cases, administering the vaccine to children in cars) and rigorous cleaning procedures.

“Parents should talk with their children’s doctor about what protocols their doctor’s practice has put into place to provide additional protection for families when they’re coming in for these well-child checkups,” said DeSilva.

Weekly changes in Vaccines for Children Program provider orders* and Vaccine Safety Datalink doses administered for routine pediatric vaccines — United States, January 6–April 19, 2020
* VFC data represent the difference in cumulative doses of VFC-funded noninfluenza and measles-containing vaccines ordered by health care providers at weekly intervals between Jan 7–Apr 21, 2019, and Jan 6–Apr 19, 2020.

Delaying childhood vaccinations has serious health implications, she added.

“Catch up for those vaccinations often takes time, and with these continued delays we’re worried about herd immunity and vaccine coverage for the population,” DeSilva said.

It’s possible we could start seeing outbreaks of childhood diseases in the midst of the COVID-19 pandemic.

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“As social distancing restrictions begin to lift around the country and people begin to circulate, children and teens who are not vaccinated will be at higher risk for contracting a disease that could be prevented by a vaccine,” said Goza.

“While we wait for scientists and doctors to develop a vaccine for coronavirus, let’s work together to protect our children in every way that we can, today,” she added.

FMI:  The CDC report was published online in the agency’s Morbidity and Mortality Weekly Report, where it can be read in full.