A Pediatrician’s View of Vaccines and the COVID-19 Pandemic

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It’s a bit of an understatement to say we’ve had a lot on our minds lately, and much of it is stuff we may not have had to think about for a while. Staying healthy. Keeping our kids healthy (to say nothing of our baby-to-be). Dealing with different work situations and new economic realities. Finding ways to live together under one roof 24/7. Lots and lots of changes have been brought on by the COVID-19 pandemic.

With everything going on, there is an understandable tendency to put some formerly routine things on the back burner. Unfortunately, some of those items on our regular “to do” lists are related to our health. As much as we’re trying to maintain healthy habits at home, we may be skipping appointments with our health care providers—our own and our children’s. And while you are certainly justified in your heightened level of concern for setting foot in a doctor’s office (or, for that matter, any public establishment), let’s talk about why it might be a good idea to keep those appointments.

Immunization Rates May Be Declining

As much as the medical community has been focused on treating and preventing COVID-19, providers, including those who care for kids, have not lost sight of the fact that other diseases are still out there. Many can be prevented by vaccines, and most pediatricians vaccinate against at least 16 diseases.

It appears that may not be happening nearly as much since COVID-19. Chip Hart is a practice management consultant at PCC, a medical software company that designs an electronic record just for pediatricians. His company looked at data from pediatricians all over the country to get a sense of immunization rates before and after COVID-19. He found that the rate of MMR (measles/mumps/rubella) vaccines had dropped by 50% of normal by the middle of April. The figure was 42 percent for DTaP (tetanus/diphtheria/whooping cough) vaccines and 73 percent for HPV (human papillomavirus, the “cancer-causing virus”) vaccines.

Now, much too little time has elapsed since the pandemic started to say if this will actually lead to more disease. These numbers, however, are concerning for a variety of reasons. Take measles, for example. In the United States, we were already just above the level required for “herd immunity,” meaning that the measles virus was unlikely to spread widely within a community. Some developed countries have actually already (pre-COVID-19) lost herd immunity due to less children being immunized. If immunization rates against preventable “person-to-person” diseases drop, so do the chances of herd immunity. What this means is that other previously eradicated (or nearly so) infections will more likely be seen in our communities.

These other illnesses may nowadays seem like small potatoes compared to COVID-19. Yet a lot of what will happen with this infection is still largely unknown, whereas we’re quite familiar with these other diseases. In fact, some people compare the unsettling nature of COVID-19 to that of polio in the 1940s and 1950s. We don’t have to worry as much about polio these days because we have a very effective vaccine for it.

Getting Those Vaccines: Problems and (Maybe) Solutions

You may be totally on board giving your baby or child her routine vaccines, but there can still be roadblocks from all directions. Certainly, it’s understandable that parents may be reluctant to take their children to an office where there’s a chance of COVID-19 exposure. Providers share those concerns as well, and some may be recommending postponement of some shots.

There are logistic issues as well. Some providers may be unavailable if they have been called into service for COVID-19 patients. Others may not be able to keep their doors open with the drop in routine visits or may be offering telehealth visits only.

Doctors are dealing with many of these obstacles in a variety of ways. Some offer well/immunization visits in the mornings and sick visits in the afternoons, with thorough office cleanings in the evenings. Many do “drive-up” sick visits, especially if the symptoms could be those of COVID-19. Large practices may use one site for well visits and another for sick visits: it may mean a little more driving, but at least everyone is cared for.

This is another one of those situations where a call to your provider is a good idea. See how she wants to handle the situation. Most providers strongly recommend that at least the “baby shots” be done on time (the immunizations up through 2 years—at the very least, up through 6 months), since young infants are at the greatest risk for most vaccine preventable diseases. School-age and teenage patients may have a little more leeway but should be immunized as soon as possible, especially if travel is in the future.

Although at this writing, many of us are seeing some light at the end of the COVID-19 tunnel, there are still many unanswered questions. Certainly, on our list of questions is whether we will see an uptick in the diseases that the medical profession has been able to prevent. Providers want to ensure that as we venture out and about again, we lessen the chances of passing on anything we don’t have to. Have a dialog with yours and your children’s to make sure you have the best possible protection.

Stan Sack
Dr. Stan Sack has 29 years’ experience as a primary care pediatrician in Massachusetts and Florida. A medical writer since 2015, he enjoys blogging on topics that are on parents’ minds but are covered less often in books and on websites. He lives in the Florida Keys with his family and enjoys healthy cooking, fitness activities and singing in his spare time.

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