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Why It’s Essential to Keep up With Your Child’s Vaccinations

Why It’s Essential to Keep up With Your Child’s Vaccinations

Vaccination rates have plummeted during the pandemic. Here’s why that’s dangerous—and how you can maintain your child’s schedule safely.

Updated on August 21, 2020 at 3:00pm EDT.

The COVID-19 pandemic has caused frightened parents to delay or skip well-visits and routine immunizations that ward off dangerous childhood diseases. If your kids aren’t caught up, it’s time to roll up some sleeves. These shots are more important than ever in the midst of the pandemic.

Here’s why: Unvaccinated children could contribute to a trifecta of woe this fall and winter: flu, COVID-19 plus vaccine-preventable diseases like measles.

“As many schools reopen, it’s critical that all these kids are up to date on their immunizations,” says Tina Tan, MD, board member of the Infectious Diseases Society of America and professor of pediatrics at Northwestern University Feinberg School of Medicine in Chicago. “The last thing you want to have is an outbreak of a vaccine-preventable disease on top of COVID-19 and on top of influenza.” This combination could put additional stress on crowded hospitals, she notes.

The current driver of falling vaccination rates is fear of catching SARS-CoV-2, the virus that causes COVID-19. “Parents are petrified to go into a health care setting to do anything,” says Dr. Tan. But she wants to assure patients that doctor’s offices, clinics and hospitals are safe because of the precautions taken by health care workers.

A troubling drop in vaccination rates
The Centers for Disease Control and Prevention (CDC) reported in May 2020 that routine vaccination rates plummeted after the national emergency was declared in March and stay-at-home orders were mandated.

From mid-March to mid-April 2020, doctors in the Vaccines for Children program ordered about 2.5 million fewer doses of all routine non-influenza vaccines and a quarter of a million fewer doses of measles-containing vaccines compared to the same period in 2019.

In New York City, once the world’s COVID-19 epicenter, vaccination rates declined steeply as well. Compared to the same period in 2019, vaccinations for children under age 2 fell 62 percent during the week of April 5 to 11. The drop was even more severe for kids aged 2 to 18—a 96 percent drop from the previous year. After a vigorous campaign within the city to convince the public to keep vaccinating, however, rates for kids under age 2 returned to pre-pandemic levels in May. But as of late June, shots for older children were still down 35 percent compared to the previous year.

The lag in vaccinations isn’t limited to the United States. A World Health Organization poll taken in June found that vaccination rates worldwide dipped dramatically because of the pandemic. Of the 61 countries that reported on their current immunization status, 85 percent said that the level of vaccination was lower in May than in January and February 2020.

Why vaccines are crucial to control outbreaks
Though measles, whooping cough and other preventable illnesses still circulate, they are much less widespread due to vaccines. “They do a great job at controlling the transmission and spread of these diseases,” says Tan.

It all has to do with what’s called herd immunity, explains Tan. That’s when a large enough portion of a community—the so-called herd—is immune to a specific disease due to vaccination or prior illness. Herd immunity makes it harder for illness to spread and offers some protection to people who are vulnerable and cannot receive vaccinations, such as newborns and those with chronic illnesses.

In the case of many childhood diseases, herd immunity is achieved through vaccines. Immunity is important because these illnesses can be serious. Measles, whooping cough, mumps and others can cause brain swelling, pneumonia, paralysis, deafness and even death.

Another reason to get your child the measles, mumps and rubella (MMR) vaccine is that it may prevent some of the worst symptoms of COVID-19. A June 2020 opinion article published in the American Society for Microbiology’s journal mBio suggests a recent vaccination may prevent lung inflammation and sepsis—often-deadly consequences of COVID-19.

How? Results from lab testing showed that the MMR vaccine could jump-start the immune system to create cells that help fight this inflammation.

Anti-vaccination sentiments persist
Plunging vaccination rates allow preventable childhood diseases to come out of the shadows, Tan says. Even before the pandemic, there have been troubling outbreaks of childhood diseases —particularly measles—that had previously been brought under control by vaccination. The reason is that some parents are reluctant to get their kids vaccinated.

In 2019, a measles outbreak caused almost 1,300 infections. In New York, for example, one unvaccinated child, infected in Israel, spread the highly contagious disease to 649 under-vaccinated children in one community, with some falling seriously ill.

Many parents are hesitant to vaccinate their children, or are flatly opposed to one, some or even all immunizations. Parents who express misgivings about vaccines are primarily worried about the safety of shots or feel they need more information about them. Others oppose them for religious or philosophical reasons.

The persistence of vaccine hesitancy in the U.S. begs an important question: Will enough Americans get COVID-19 vaccinations in sufficient numbers if and when they become available? Results of an August 2020 Gallup poll suggest it could be a hard sell for some, with one in three Americans responding that they would take a pass even if a vaccine was free and approved by the U.S. Food and Drug Administration (FDA).

A big problem is misinformation put out by anti-vaccination groups on social media sites and around the internet, Tan says. Parents searching for facts about vaccines may unknowingly click on anti-vaccination sites.

And the COVID-19 crisis may be giving anti-vax groups a shot in the arm. A June 2020 investigation by the Center for Countering Digital Hate, a non-profit group aimed at fighting online misinformation, found that the largest English language anti-vaccination social media sites have swelled to almost 50 million followers. That’s an increase of nearly 20 percent since 2019.

Contrary to what these groups often profess, the current vaccine supply is actually the safest in U.S. history, according to the CDC. Safety is actively monitored long after vaccines are on the market. A July 2020 review in the Annals of Internal Medicine found that safety monitoring led to label changes in 25 out of 57 vaccines approved by the FDA from 1996 through 2015. Most changes were related to the vaccines’ effect on specific groups of people, like pregnant women or people with allergies or compromised immune systems.

Misinformation thrives online
Still, some stubborn myths about vaccine safety live on. Some of these include:

Vaccines cause autism. A long-discredited small study from the 1990’s made a link between the MMR vaccine and autism. Larger studies have since debunked the theory.

Vaccines cause diseases they’re meant to prevent. They don’t contain active virus, so they can’t give your child a disease. Vaccines stimulate the immune system to make antibodies to protect your child from viruses. 

Vaccines are toxic. They may contain tiny amounts of formaldehyde, mercury and aluminum salts to keep them sterile and work effectively. But the amounts of these substances in vaccines are so small that they are not harmful. In fact, these chemicals are more often found in foods or occur naturally in the body. Thimerosal—once a concerning additive for many parents—was removed from pediatric vaccines in 2001, even though many studies have proven it is safe. 

How to keep your child healthy
Now’s the time to make sure your children are current on immunizations, especially if they’re headed back to the classroom, whether kindergarten or college. Not only is it safer for your kids, but your state likely mandates vaccinations and may have tightened the rules on exemptions.

Here are some tips to stay on top of your immunization schedule:

  • Play catch-up. There are protocols on how to get caught up on shots your child may have missed. Talk to your pediatrician and work out a plan.
  • Schedule a well-child visit. If you skipped one earlier in the pandemic, call your healthcare provider (HCP) to make an appointment now. In addition to shots, your child may need other important physical and developmental exams and evaluations. If you’re skittish, ask about safety precautions. Don’t forget your masks, too. Children over 2 years old should wear a cloth face covering during their well visit. If your child is high-risk or has serious cognitive or respiratory impairments, speak to your HCP before your visit about any necessary precautions.
  • Get your flu vaccine. In addition to following the childhood vaccination schedule, it’s important that everyone in the family gets their yearly flu shot. Preventing influenza is crucial this fall, so hospitals are not overwhelmed by illnesses during the pandemic.
  • Ask about telehealth. Rules and regulations on virtual appointments have eased. Your pediatrician may offer more telehealth appointments in the era of COVID-19. Ask if it’s an option for your child.

Medically reviewed in August 2020.

Sources:
Centers for Disease Control and Prevention. “2020 Recommended Vaccinations for Infants and Children (birth through 6 years) Parent-Friendly Version.” Accessed August 21, 2020.
American Academy of Pediatrics News and Journals Gateway. “AAP urges vaccination as rates drop due to COVID-19.” May 8, 2020. Accessed August 21, 2020.
Centers for Disease Control and Prevention. “Notes from the Field: Rebound in Routine Childhood Vaccine Administration Following Decline During the COVID-19 Pandemic — New York City, March 1–June 27, 2020.” July 31, 2020. Accessed August 21, 2020.
World Health Organization. “Special feature: Immunization and COVID-19.” Accessed August 20, 2020.
Johns Hopkins School of Public Health. “What is Herd Immunity and How Can We Achieve It With COVID-19?” April 10, 2020. Accessed August 21, 2020.
Jane R. Zucker, MD, Jennifer B. Rosen, MD, et al.  “Consequences of Undervaccination — Measles Outbreak, New York City, 2018–2019.” The New England Journal of Medicine. March 12, 2020. 382:1009-1017.
Chephra McKee and Kristin Bohannon. “Exploring the Reasons Behind Parental Refusal of Vaccines.” The Journal of Pediatric Pharmacology and Therapeutics. March April 2016.
America Society for Microbiology. “MMR Vaccine Could Protect Against the Worst Symptoms of COVID-19.” June 19, 2020. Accessed August 21, 2020.
Center for Countering Digital Hate. “The Anti-Vaxx Industry: How Big Tech Powers and Profits from Vaccine Misinformation.” Accessed August 21, 2020.
Centers for Disease Control and Prevention. “Vaccine Safety.” Accessed 21, 2020.
Noam Tau, Dafna Yahav, Daniel Shepshelovich. “ Postmarketing Safety of Vaccines Approved by the U.S. Food and Drug Administration. Annals of Internal Medicine. July 27, 2020.
Rush University. “7 Vaccine Myths.” Accessed August 20, 2020.
Gallup. “One in Three Americans Would Not Get COVID-19 Vaccine.” August 7, 2020. Accessed August 21, 2020.
Centers for Disease Control and Prevention. “Vaccine & Immunizations Glossary.” Accessed 21, 2020
Centers for Disease Control and Prevention. “Vaccines Do Not Cause Autism.” Accessed 21, 2020
PublicHealth. “Vaccine Myths Debunked.” Accessed August 21, 2020.
Centers for Disease Control and Prevention. “Thimerosal in Vaccines.” Accessed August 21, 2020
Centers for Disease Control and Prevention. “Catch-up immunization schedule for persons aged 4 months–18 years who start late or who are more than 1 month behind, United States, 2020.” Accessed August 21, 2020.
Centers for Disease Control and Prevention. “Frequently Asked Influenza (Flu) Questions: 2020-2021 Season.” Accessed August 21, 2020.
Healthy Children. “Cloth Face Coverings for Children During COVID-19.” Accessed August 21, 2020

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