Strict blocking measures imposed in the spring of 2020 have led to a dramatic drop in vaccinations for both children and adults, according to a new study led by the Children’s Hospital of Philadelphia (CHOP).
The study, which focused on data from Michigan, also found a decline in sites offering pediatric vaccines, especially those dedicated to caring for more vulnerable populations, such as children provided by Medicaid. The results that were published today in American Journal of Public Health, emphasize that COVID-19 has costs beyond the direct consequences of the disease affecting primary care and prevention services.
As we strive to achieve routine vaccine levels before a pandemic, it is vital to ensure that vaccinees miss out on missed doses during a pandemic in order to prevent outbreaks of vaccine-preventable diseases such as measles. Both adults and pediatric providers need to identify which patients need catch-up doses and make sure these individuals are vaccinated so that we do not see a resurgence of the viruses we have in the prevention tools. “
Angela K. Shen, Ph.D., MPH, first author of the study, visiting research associate, Vaccine Education Center, Philadelphia Children’s Hospital
The researchers analyzed data from the Michigan Care Improvement Registry (MCIR), the state immunization information system (IIS), from 2018 to September 2020. They compared the monthly doses from January to September 2020 with the average doses applied from January until September in 2018 and 2019 to account for seasonal fluctuations. The research team also compared vaccinations among children aged 19 to 35 months on 30 September 2020 and 30 September 2019, according to rough estimates.
Overall, the researchers found a drastic reduction in lifelong doses and a decline in vaccination coverage for the full doses of the combined series of 7 vaccines (which prevented 13 diseases) in children aged 19 to 35 months in 2020 in compared to 2019. When looking at where adults receive their photos, the largest reductions were observed in local health departments, with an increase reported in the websites and pharmacies of obstetricians-gynecologists.
In all age groups, the largest decline occurred in April 2020. In adolescents, the largest decline was observed, with 85.6% reduction in vaccinations, followed by 82.7% reduction in children aged 2 to 8 years. month, while in children under 2 years of age the smallest change is observed, with a decrease of 34.9%.
The number of sites reporting vaccinations in children aged 0 to 18 decreased in the first months of the pandemic and remained below the levels from 2018 until the end of the study period. It also reduces the number of patients vaccinated through the Child Vaccine Program (VFC), a federal safety net that seeks to ensure that all children have access to vaccines without financial barriers.
The authors of the study give several recommendations for informing patients about vaccinations:
- Use of vaccination information systems throughout the country in addition to electronic health records to identify those liable for vaccination and liaise with them to schedule appointments;
- Extending the working hours of the clinic and the time of appointment in support of vaccination efforts; and
- The availability of providers ask each patient about their immunization status and provide vaccination or vaccination referral to those who are due.
“As society moves to a new normal state and calibrates in a world where SARS-CoV-2 is endemic, COVID-19 vaccines are sure to move to a routine immunization program in some form,” Shen said. “It is crucial to ensure that the immunization system maintains timely, accessible and reliable access to routinely recommended vaccines across the country, maintaining high historical coverage for children and enhancing outreach for adolescents and adults.”
Children’s Hospital of Philadelphia
Reference in the magazine:
Shen, AK, and others. (2021) Life-cycle coverage of vaccines in Michigan during the COVID-19 pandemic: January – September 2020 American Journal of Public Health. doi.org/10.2105/AJPH.2021.306474.