Story at a glance
- Pandemic lockdowns and restrictions in 2020 prevented many children from getting their regular vaccinations.
- Some pediatricians are seeing patients coming in with cases that could have been prevented by immunization.
- Parents and families did get a push to catch up on vaccines to meet requirements for in-person learning at the start of the 2021 school year, but some younger children may still be lagging.
While parents await the outcome of the Pfizer-BioNTech coronavirus vaccine for kids under 5 years old, others may be struggling to catch up with standard vaccinations for their young children. Especially for children born during the pandemic, lockdowns and missed doctor’s appointments may have delayed immunizations for diseases like measles, whooping cough and polio.
Pre-pandemic, these vaccination rates were high, with most in the 80 percent range. However, at the beginning of the pandemic, the rates for the measles, mumps and rubella vaccine dropped from 72 percent in March 2017 to March 2020 to as low as 62 percent by June to August 2020, according to a study published in Pediatrics. A study of European countries found that 22 percent of infants had their vaccination regimens interrupted during the spring of 2020.
As might be expected, lockdowns early in the pandemic kept people away from their regular appointments, and with most children taking part in remote learning for much of 2020 and part of 2021, there was less of a reason to get vaccinated.
School and day care requirements are some of the biggest drivers for vaccinations, says pediatrician Francisco Gonzalez Salazar at the Brooklyn Hospital Center. Without these requirements, there’s less of a need to stay on schedule with vaccines. People may have also been afraid to go to their doctor unless necessary, especially during coronavirus waves.
The children who are especially at risk of being behind schedule on their vaccines are those who were born during the pandemic, says Janet Englund, a pediatrician at Seattle Children’s Hospital and one of the researchers running clinical trials on the Pfizer/BioNTech vaccine. During the first 18 months of life, infants see their doctors every month or so at the beginning and then closer to every three months later on to receive immunizations at each visit.
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If a significant portion of younger children aren’t getting their regular vaccinations, that could have implications for the community. If vaccination rates for highly contagious diseases like measles drop too far, that could lead to local epidemics if it gets introduced to the population.
It’s unclear whether there still is a significant dip in vaccination rates since there aren’t recent data to look to. CDC has published vaccine coverage rates for children but no data from during the pandemic. For example, on the website there is data up to 2018 for children up to 35 months old, and up to the 2019-2020 school year for children in kindergarten for several vaccines including hepatitis and polio.
One recent study of data from several states through September 2020 found that childhood vaccination rates were lower than in 2019. In Texas, researchers found a 47 percent decline in immunization rates between 2019 and 2020 among 5-month-olds and a 58 percent decline among 16-month-olds. There was a smaller decline among 2-year-olds, and overall declines were more pronounced in rural areas.
Anecdotally, pediatricians say they are seeing patients who need to catch up or who are catching some of these illnesses. Englund says she’s been seeing cases of diseases in children that are vaccine preventable, like pneumococcal disease or whooping cough.
“The reality is that a lot of these diseases that we worry about large extent depend on children being around other children,” says infectious disease specialist Rick Malley at Boston Children’s Hospital. Now with the issue of unmasking in schools and other things, he continues, “It should make us redouble our efforts that every child that is out of date with their vaccines should be put back on schedules to get their vaccines on time.”
Gonzalez Salazar says that most of the patients coming in seem to have caught up on vaccinations. They especially saw a rush during the period before the 2021-22 school year started when parents and families were trying to get their kids vaccinated to meet school requirements. But he says he sees on average one child per week or every other week come in who is behind on their vaccinations.
There are catch-up schedules for children who are out of sync with the original schedule. In these cases, children would need to come for appointments potentially every month, says Gonzalez Salazar. But as long as kids are getting their vaccines at some point even if as a part of a catch-up schedule, they will be protected.
Englund tells Changing America, “So yes, we need life to get back to normal and normal would include giving our kids the regular vaccines that they need to really save their lives.”
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