Schools and pediatricians want to make up for the loss of non-COVID vaccination

Melissa Blatzer is determined to have her three children receive routine immunizations at a walk-in clinic in suburban Denver on a recent Saturday morning. About a year has passed since the children’s last injection, and Blazer blamed the delay on the pandemic.

Two-year-old Lincoln Blatzer wore flannel dinosaur pajamas, anxiously waiting in line for hepatitis A vaccination. His siblings, 14-year-old Nyla Kusumah and 11-year-old Nevan Kusumah, were vaccinated there with TDAP, HPV and meningococcal vaccines, and Nyla was vaccinated with COVID-19.

Blazer, who lives in the commercial city a few miles away, said: “You don’t have to make an appointment. You can take three people at once.” This convenience surpasses the difficulty of getting everyone up early on weekends.

Child health experts hope that community clinics like this, as well as the resumption of face-to-face classes, more child visits, and the introduction of COVID vaccines for younger children, can help increase routine child immunizations that have fallen during the pandemic. Despite the rebound, the immunization rate is still lower than in 2019, and the disparity in ratios between races and economic groups has increased, especially among black children.

“We have not returned to where we need it,” said Dr. Sean O’Leary, a pediatric infectious disease doctor at the Colorado Children’s Hospital and a professor of pediatrics at the University of Colorado School of Medicine.

Routine immunization can protect children from 16 infectious diseases, including measles, diphtheria, and chickenpox, and curb transmission to the community.

O’Leary said that launching COVID vaccines for young children is an opportunity to catch up with regular vaccinations, adding that children can get these vaccines together. Many primary care facilities where children may be vaccinated against COVID usually have other children’s vaccines on hand.

Dr. Malini DeSilva, physician and pediatrician at HealthPartners in Minneapolis-St. Louis, said: “It is very important for parents and healthcare providers to work together so that all children can get these recommended vaccines.” Paul area. “Not only for the health of our children, but also for the health of our community.”

Karen Miller, the immunization nurse manager of the Denver District Health Department, which runs the Westminster Clinic, said that people are reluctant to come out for routine immunizations during the worst of the pandemic. National and global data confirm what Miller saw on the ground.

According to a recent study by scientists from the Centers for Disease Control and Prevention, the World Health Organization and the United Nations Children’s Fund, the global coverage of children’s vaccines has declined from 2019 to 2020. According to the study, the reasons include reduced visits, lack of traffic, concerns about exposure to COVID and supply chain disruption.

According to this study, the third dose of diphtheria, tetanus and pertussis (DTP) vaccines and polio vaccine coverage dropped from 86% of all eligible children in 2019 to 83% in 2020. Globally, 22.7 million children did not receive the third dose of DTP in 2020, compared with 19 million in 2019. Three doses are far more effective than one or two doses in protecting children and communities.

In the United States, researchers studied routine vaccination data in California, Colorado, Minnesota, Oregon, Washington, and Wisconsin in 2019 and 2020, and found that during the pandemic that lasted until September 2020, vaccination There has been a substantial interruption in the rate. For example, 7-month-old babies vaccinated with the latest vaccine have dropped from 81% in September 2019 to 74% a year later.

In almost all age groups, the proportion of black children vaccinated to date is lower than that of children of other races and ethnic groups. De Silva, who led the study, said this was most pronounced in children as young as 18 months: by September 2020, only 41% of black children of the same age had been vaccinated, and among all children 18 months old , This proportion is 57%.

A CDC study of data from the National Immunization Survey found that race and ethnicity, poverty, and lack of insurance caused the biggest differences in vaccination rates. The authors pointed out that additional efforts are needed to deal with the pandemic’s devastation.

Miller said that in addition to the problems caused by COVID, competing life priorities such as work and school have also prevented families from keeping up with the filming. Weekend vaccination clinics can help working parents get their children routinely immunized when they are vaccinated against flu or COVID. Miller and O’Leary also stated that reminders via phone calls, text messages or emails can increase immunization rates.

“Vaccines are very effective, and I think it’s easy for families to put immunization in a secondary position because we don’t often hear about these diseases,” she said.

This is a long and annoying list, which includes hepatitis A and B, measles, mumps, whooping cough, polio, rubella, rotavirus, pneumococcus, tetanus, diphtheria, human papillomavirus, and meninges Inflammatory coccosis and so on. Even a small drop in vaccination coverage could lead to an outbreak. Measles is a perfect example that worries experts, especially when international travel is open.

“Measles is one of the most infectious diseases known to mankind, which means that we must maintain a very high vaccination coverage rate to prevent its spread,” O’Leary said.

In 2019, there were 22 measles outbreaks in 17 states, mainly unvaccinated children and adults. O’Leary said the outbreak in New York City is under control because of the high vaccination coverage in the surrounding areas. But he said that outbreaks in unvaccinated communities may still spread abroad.

In some states, due to religious or personal reasons, a large number of parents opposed routine child vaccination even before the pandemic, which poses another challenge for health professionals. For example, in the 2018-19 school year, 87% of kindergarten children in Colorado were vaccinated against measles, mumps, and rubella, one of the lowest rates in the country.

These ratios soared to 91% in 2019-20, but they are still below the CDC’s target of 95%.

O’Leary said that he believes that the degree of hesitation in routine immunization is different from COVID. “There have always been vaccine hesitations and vaccine rejections. But we have long maintained the vaccination rate of all conventional childhood vaccines above 90%,” he said.

Marini said the “ripple effect” of missed vaccinations in the early stages of the pandemic will continue until 2021. With children returning to face-to-face learning this fall, schools may be the first place families hear about missed vaccinations. Individual states have established vaccination requirements and permitted exemptions for admission to schools and childcare facilities. Last year, Colorado passed a school enrollment immunization law, tightening the allowable exemptions.

O’Leary said: “Schools that usually enforce vaccination requirements have become thinner due to various reasons (including COVID),” he added, adding that for some (but not all) schools, it may be more difficult to manage vaccination requirements.

13-year-old Anayeli Dominguez is receiving TDAP vaccination at Westminster Clinic because her middle school noticed that she was not updated in time.

Denver Public Schools spokesperson Will Jones said: “School nurses play an important role in helping identify students who need immunization and linking families with the resources of the school district and the larger community.”

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