Routine childhood vaccines decline due to the coronavirus

SPEARFISH, S.D. (AP) — More than 20% of South Dakota children have missed routine vaccinations since the COVID-19 pandemic swept the country.

The numbers are in line with a national trend that shows significant decreases in the number of vaccinations administered in 2020, according to a recent study by Wellmark Blue Cross/Blue Shield. The national data shows that children across the country missed approximately 9 million vaccines, or at least 26% of the recommended doses.

According to the Blue Cross/Blue Shield Association, 40% of parents and legal guardians report that their children missed vaccinations during the pandemic. The first vaccines were missed when COVID-19 swept the nation last spring. The second drop off occurred in August 2020, when students who would ordinarily be receiving shots to prepare for the school year discovered instead that they would be remote learning at home.

Dr. Rose Oakley, a pediatrician with Monument Health in Spearfish, said though it is difficult to gauge exact percentages of vaccines distributed locally, due to the families who simply do not seek vaccines, the report does not surprise her.

“This year in particular there has certainly been a drop off in immunizations,” she said. “We have families that are nervous to take their children into clinic because of COVID, and so they are skipping multiple well child checks.”

Oakley said the drop in regular visits and vaccinations worries her because children who are not vaccinated miss out on a critical period for protection against diseases, some of which can be life threatening. Oakley cited meningitis (an infection of fluid that surrounds the brain and spinal cord), and epiglottitis (a condition that occurs when cartilage surrounding the wind pipe swells and blocks air flow to the lungs) as two main examples.

“There are some life threatening illnesses prevented by vaccines that occur more often in kids, such as epiglottitis,” Oakley said. “This is why it is so important to immunize children before they are adults. It is for the same reason we make children wear seatbelts in the car, cover electrical outlets in the home, or give them bitter tasting medicine when they have an infection: they are too young to know better and it is in their best interest.

“Every year in our community we have multiple children who come into our clinic or emergency department with life threatening illnesses that could have been prevented if they had been immunized,” she continued.

Additionally, Oakley said she is very concerned about children who are missing regular well-child checkups, where conditions can be identified and treated early, the Black Hills Pioneer reported.

“Well child checks are the time that we make sure a child is growing well,” Oakley said, adding that it’s not always possible to gauge healthy growth simply by looking at a child. “We make sure that they have good vision, that they don’t have hernias, scoliosis, or exam findings concerning for some types of cancer. When children miss these visits, they are missing out on both immunizations and an important checkup.”

Oakley said parents who stay away from the clinic due to COVID-19 concerns should know about and be encouraged with the protocols in place to ensure the health and safety of patients. All patients and their families are screened before coming in to the clinic, and appointments are rescheduled for those who exhibit symptoms. Additionally, parents are not allowed to bring extra children who do not have appointments in to the clinic. The patient schedule has also been adjusted to minimize risk of exposure.

“We try very hard to see healthy and higher risk children in the morning and sick children in the afternoon,” she said. “We also have different exam rooms where we see sick versus healthy children.”

In addition to COVID-19 concerns, there are other reasons parents don’t immunize their children. Families who live in rural areas sometimes decline the shots because they believe their children are rarely in contact with others because of living on a ranch or in small communities. But many immunizations, such as tetanus, protect against environmental diseases, to which these children are equally susceptible. HIB (hemophilic influenzae) is a bacterium that can unknowingly develop in the back of the throat of healthy individuals, and easily spread to unimmunized children who have weak immune systems and can develop a more life threatening condition.

Some parents, Oakley said, refuse immunizations because of faulty information they have received about their safety or efficacy. If parents have concerns about vaccines, Oakley said it is important for them to discuss them with a healthcare provider, rather than relying on a variety of information sources that are circulating. Some anti-vaccination information may seem legitimate, she said, but it often takes a trained professional to identify the flaws in studies or reports.

“I appreciate so much when parents are open with me about their concerns,” she said. “This allows me to address those concerns directly, and make sure that they are receiving information from non-biased sources. When parents are closed off and don’t want to discuss concerns it is harder to make sure that they have all the information they need to come to an informed decision.”

There are also vaccine booster shots that parents need to be conscious of keeping on schedule. The whooping cough (pertussis) vaccine is a good example. Oakley pointed to a 2014 outbreak of whooping cough in the Northern Hills, which was the result of people failing to receive booster shots against the illness.

Oakley said while there is still high herd immunity from certain vaccine prevented diseases such as polio and smallpox, parents’ hesitancy to immunize their children on a regular schedule could tip the balance and risk a preventable outbreak that would be devastating to the population.

“We live in a time when we are fortunate to still have a lot of herd immunity from major diseases that immunizations prevent because most people are immunized,” she said. “We are, however, approaching a tipping point. If immunization rates continue to decline, we will see more resurgence of disease. My aunt was part of the last group of people in the United States to have polio. She was in an iron lung for several months and had paralysis of her right leg for the rest of her life. Most people have never seen the horrifying scars left behind by small pox, if someone survived. These are horrible, traumatic diseases that we are sheltered from because of immunizations. It would break my heart if that were to change because it is preventable.”