The return to school each year often serves as a reminder for parents to review their children’s immunization records. While the impact of the COVID-19 pandemic means the start of this school year will look different for many, it does not lessen the importance of children getting vaccinated. In fact, as the virus continues to spread, protecting children against vaccine-preventable diseases is more important than ever.
The Impact of COVID-19 on Child Vaccination Uptake by Age
When COVID-19 was declared a pandemic in March 2020, stay-at-home and shelter-in-place orders caused a decline in outpatient pediatric and primary care visits. In a report released in May, the Centers for Disease Control and Prevention (CDC) found that between March and April 2020, doctors in the Vaccines for Children (VFC) program ordered 2.5 million fewer doses of all routine pediatric vaccines and 250,000 fewer doses of measles-containing vaccines, when compared to the same period in 2019. The report confirmed this drop in orders did correlate with a drop in vaccination rates among children aged 0 to 18.
At each age and stage, it will be critical for primary care providers to explain how COVID-19 impacts vaccine-preventable diseases and the importance of staying on the CDC-recommended schedule.
Infants
The first few years of a child’s life are an important time within the vaccination schedule. If infants fall behind in the recommended vaccine schedule, they can be exposed to up to 14 preventable illnesses, including the highly contagious measles disease. Children younger than five years of age are more likely to suffer from measles complications, according to the CDC. In a report published by PCC, measles, mumps, and rubella (MMR) administration rates dropped by 50% in early April, compared to the pre-coronavirus baseline. With MMR vaccination down during the pandemic, the risk of a measles outbreak among young children is a concern as children return to daycares.
School-Aged Children
With schools also reopening, booster doses are critical health measures to help reinforce children’s immunity to vaccine-preventable diseases. A report from the CDC found that in early April, children 2 to 10 years old saw a 76% drop in vaccine administration, with a subsequent improvement of 30%. Despite the rebound, the lower vaccination rates have left many children unprotected and in need of catching up on missed vaccines. In particular, the MMR booster for 4- and 5-year-olds, and tetanus and whooping cough (Tdap) vaccine for children aged 11 to 12.
Preteens and Adolescents
While preteens and adolescents living through the pandemic are more likely to have received early childhood vaccinations, they may be eligible for new vaccines such as the meningitis vaccine and the HPV vaccine series. In the CDC’s report, children ages 11 to 18 experienced the highest decrease in vaccines administered. In particular, PCC reports that the administration of HPV vaccines decreased by 73% in early April. A report from the CDC shows that preteens and adolescents have been the slowest to resume immunizations, making them a key population for providers to engage during their efforts to get patients back in the office, particularly as older teens prepare to return to crowded college campuses.
Promoting Child and Adolescent Vaccine Uptake
Among all ages, sudden drops in vaccination rates put children at risk of outbreaks and exposure to disease later in life. In response, health experts and healthcare organizations are encouraging parents to continue in-person care, such as physical exams and immunizations. The American Academy of Pediatrics recently said in a statement that “in-person visits should occur whenever possible...” Additionally, the Centers for Medicare & Medicaid Services (CMS) Administrator, Seema Verma, wrote a public op-ed urging Americans to “get back to non-COVID healthcare.”
Many parents are now weighing the benefits of routine doctor visits for their child against the risk of exposure to COVID-19. Providers can help ease hesitations of returning to the doctor’s office and help improve vaccine uptake by:
Sharing the new precautions your practice has implemented to provide clarity and reassurance for parents and patients so they feel at ease during a well-visit.
Offering alternative ways to deliver vaccinations such as walk-thru or drive-thru immunization clinics.
Discussing the importance of staying up to date on vaccines and the impact of coronavirus to keep preventive measures top of mind as the pandemic continues.
Identifying and alerting patients that are behind schedule, taking care to engage age groups that have been slow to rebound.
While the modality of school in the fall remains uncertain for many students, all can benefit from vaccination whether learning at home or in the classroom. By taking extra measures to get patients back in the office, providers and practices can help ensure all students are protected against vaccine-preventable diseases in a time when overall wellness is so critically important.