Recently The Centers for Disease Control and Prevention (CDC) released the 2021 immunization schedules for children and adults, which included guidance on the COVID-19 vaccine for those who are at least 16 years old. Along with the COVID-19 vaccine, the CDC still recommends that patients stay up to date with routine immunizations protecting against the flu, pneumonia, shingles, tetanus, meningitis and other vaccine-preventable diseases.
However, in guidance regarding the COVID-19 vaccines currently in the market (Moderna and Pfizer as of late February 2021), the CDC advises against receiving any other vaccines both two weeks before the two-dose COVID series begins and two weeks after it is complete. For most patients, this means there will be at least a six-week to eight-week window of time during which their other recommended immunizations will be on hold.
This limited time frame poses a new challenge for providers to keep their patients on schedule with recommended immunizations. Below we outline how providers can proactively work with patients of all ages to prevent them from missing routine vaccines when planning for the COVID-19 vaccine.
Seniors: Utilize Telehealth to Communicate
Joining the ranks of healthcare workers and first responders, seniors are a high-priority group in the distribution of the COVID-19 vaccine in most states. However, this emphasis on seniors receiving the COVID-19 vaccine shouldn’t detract from the importance of other recommended immunizations for this vulnerable age group.
A 2020 study by the CDC found that after the declaration of the national COVID-19 emergency in March, weekly vaccination rates among Medicare beneficiaries aged 65 years or older declined by 25%–62%, compared with the corresponding period in 2019. Additionally, pharmaceutical company GlaxoSmithKline witnessed a decline in sales for its shingles vaccine recommended for seniors, Shingrix, over the course of the pandemic. Research shows a similar decline in uptake among seniors for Merck’s Pneumovax 23.
To improve vaccination rates for this age group, providers can utilize telehealth to communicate with patients about necessary immunizations to catch up on after they receive their COVID-19 vaccinations. Telehealth adoption among seniors has dramatically increased with a HealthInsurance.com survey revealing a 300% rise among seniors during the pandemic. In these telehealth appointments, providers can work with senior patients to schedule vaccination appointments and send reminders afterward to aid with follow-through.
Pre-teens, Teens and Young Adults: Plan for Multi-dose Vaccines
Each year, there are an estimated 44,000 new HPV-associated cancer cases in the United States. The CDC recommends the two-dose or three-dose series of the HPV vaccination for all people through age 26. Yet, Blue Cross Blue Shield reported in October 2020 a 13.5% decline in the number of HPV vaccines administered compared to 2019. These results reflect the pandemic’s negative effect on routine immunization rates at large reported by Johns Hopkins.
In addition to HPV, there were a few other vaccines recommended for teens that may have been skipped during the pandemic. The CDC reports that provider orders for MenACWY (recommended at ages 11 and 16) and the Tdap combination booster vaccines (recommended for age 11) fell at the onset of the pandemic and throughout 2020.
Given that two of the COVID-19 vaccines and many teen vaccines are multi-dose series, providers should contact patients about scheduling the HPV vaccine along with the COVID-19 vaccine accordingly. In addition, providers can offer alternatives to in-person visits, as the American Institutes of Research revealed that 37% of respondents were hesitant to visit a healthcare provider due to the risk of contracting COVID-19. Curbside or drive-through vaccination clinics can improve patient access to vaccinations for those who are still young enough to easily move around. These alternative options also make it safer and more convenient for patients to keep up with their immunizations.
Children: Get Ahead of the Back-to-School Rush
Children especially have fallen behind on their vaccinations during the pandemic. According to a survey by Blue Cross Blue Shield, 40% of parents said that their children missed vaccinations due to COVID-19. Use of Pfizer’s Prevnar 13® — among one of the CDC-recommended vaccines for this age group — fell by 72%. Furthermore, a study published by Pediatrics found a 10% decrease in the number of children who had received their first measles vaccine between March 2020 and August 2020 compared to pre-pandemic numbers.
As of late February 2021, children under 16 years old are not included in the early phases of the nationwide COVID-19 vaccine rollout, creating a window of opportunity now for providers to remind families to bring their children for recommended vaccinations. When the COVID-19 vaccine becomes more readily available for all children in later phases, the timing could interfere with back-to-school vaccinations. Providers should work with parents in the spring and early summer to ensure that children are up-to-date on the vaccinations recommended for their ages, particularly as anticipation of in-person school re-openings in the fall grows.
Though the COVID-19 vaccine is dominating discourse, it should not replace or overshadow other routine immunizations that patients need. Providers are responsible for not only administering many of these vaccinations, but also communicating with their patients about planning ahead. By working with patients of all ages to carefully time their immunizations, providers can help ensure that those under their care are protected against both the novel coronavirus and the more familiar vaccine-preventable diseases that we’ve kept at bay for long.