Keith Ruder, Kaiser Health News
WESTMINSTER – Melissa Blatzer was determined to get her three children to receive routine immunizations on a recent Saturday morning at a clinic in this Denver suburb. It’s been about a year since the kids got their last shots, a delay that Blatzer attributed to the pandemic.
Lincoln Blatzer, 2, in his dinosaur fleece pajamas, waited anxiously in line for the hepatitis A vaccine. COVID-19 vaccinations for Neela.
“You don’t have to make an appointment and you can take all three at once,” said Blatzer, who lives a few miles outside the city, in Commerce City. This convenience outweighed the difficulty of getting up early on the weekend.
Child health experts hope such community clinics, along with a return to face-to-face classes, more frequent visits to children and the introduction of COVID vaccinations for young children, can help increase routine immunization rates for children, which have declined during the pandemic. Despite the recovery, immunization rates are still lower than in 2019, and differences in rates between racial and economic groups, especially among black children, are widening.
“We’re still not back where we should be,” said Dr. Sean O’Leary, pediatric infectious disease physician at Colorado Children’s Hospital and professor of pediatrics at the University of Colorado School of Medicine.
Routine immunization protects children from 16 infectious diseases, including measles, diphtheria and chickenpox, and prevents the transmission of infection to society.
The introduction of COVID shots for young children is an opportunity to catch up after routine shots, O’Leary said, adding that children can receive these vaccines together. There are usually other childhood vaccines available in primary care units, where many children can get COVID shots.
“It is very important that parents and healthcare providers work together to ensure that all children are aware of these recommended vaccines,” said Dr. Malini De Silva, a physician and pediatrician at HealthPartners in Minneapolis. Floor area. “Not only for the health of the child, but also for the health of our community.”
According to Karen Miller, an immunization nurse at the Denver County Health Department that ran the Westminster Clinic, people were reluctant to get routine immunizations in the midst of the pandemic. National and global data confirm what Miller saw on earth.
According to a recent study by scientists from the Centers for Disease Control and Prevention, the World Health Organization and UNICEF, the global vaccination coverage of children dropped from 2019 to 2020. Reasons include limited access, lack of transportation, fears of COVID contamination and supply chain interruptions, the study said.
According to the study, third doses of diphtheria, tetanus and pertussis (DTP) vaccines and polio vaccines have dropped from 86% of all eligible children in 2019 to 83% in 2020. Globally, 22.7 million children did not receive their third dose of DPT in 2020, up from 19 million in 2019. Three doses are much more effective than one or two in protecting children and communities.
In the United States, researchers looking at routine vaccination data for 2019 and 2020 in California, Colorado, Minnesota, Oregon, Washington, and Wisconsin found significant irregularities in vaccination rates during a pandemic that lasted until September 2020. For example, the percentage of 7-month-old babies vaccinated dropped from 81% in September 2019 to 74% a year later.
The proportion of black children vaccinated was lower in almost all age groups than children from other racial and ethnic groups. This was most pronounced in those 18 months old, with only 41% of black children of this age having been vaccinated in September 2020, compared with 57% of all children aged 18 months, said DeSilva, who led the study.
A CDC study of data from the National Immunization Survey found that race, ethnicity, poverty, and lack of insurance create the largest differences in vaccination rates, and the authors noted that more efforts are needed to tackle the disruption of the pandemic.
In addition to the challenges posed by COVID, Miller said competing life priorities such as work and school keep families from keeping up with vaccinations. Weekend vaccination clinics can help working parents get their children routine immunizations while they receive their flu or coronavirus shots. Miller and O’Leary also said reminders by phone, text, or email can boost immunization.
“Vaccines are so effective that I think it’s easy for families to put vaccinations on the back burner because we don’t hear about these diseases often,” she said.
This is a long and unpleasant list, which includes, among others, hepatitis A and B, measles, mumps, whooping cough, polio, rubella, rotavirus, pneumococcus, tetanus, diphtheria, human papillomavirus and meningococcal disease. Even a small decrease in vaccination coverage can lead to outbreaks. And measles is a fine example that worries experts, especially with the opening of international travel.
“Measles is one of the most contagious diseases known to mankind, which means we must maintain a very high vaccination rate to keep it from spreading,” O’Leary said.
In 2019, there were 22 measles outbreaks in 17 states among unvaccinated children and adults. O’Leary said the outbreaks in New York were contained because the surrounding areas had high vaccination rates. But an outbreak in an under-vaccinated community could still spread beyond its borders, he said.
In some states, significant numbers of parents opposed conventional childhood vaccines even before the pandemic for religious or personal reasons, posing another problem for healthcare providers. For example, 87% of kindergarten teachers in Colorado were vaccinated against measles, mumps and rubella during the 2018-19 school year, one of the lowest rates in the country.
These rates rose to 91% in 2019-20, but are still below the CDC’s 95% target.
O’Leary said he does not see the same level of hesitation with routine immunizations as he does with COVID. “There have always been indecisive people and have refused vaccinations. But we have been keeping the vaccination rate above 90% for all common childhood vaccines for a long time, ”he said.
Malini said the “ripple effect” of missed vaccinations at the start of the pandemic will continue into 2021. As children returned to full-time education this fall, schools may have been the first place families heard of missed vaccinations. Some states have vaccination requirements and allowable exceptions for admission to schools and childcare. Colorado passed the Immunization School Enrollment Act last year that tightened the permissible exceptions.
“Schools that generally adhere to vaccine requirements do not operate for a variety of reasons, including COVID,” O’Leary said, adding that in some, but not all, schools, managing vaccine requirements may be more difficult.
Anaeli Dominguez, 13, was at the Westminster Clinic for the TDAP vaccine because her high school noticed that she was not in the know.
“School nurses play an important role in identifying students in need of vaccinations and by connecting families to resources both in the district and in the community at large,” said Will Jones, a public school spokesman for Denver.
Kaiser Health News is the national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation and is not affiliated with Kaiser Permanente.