Staying up-to-date on immunizations is crucial to prevent outbreaks of vaccine-preventable diseases.

Due to the coronavirus disease 2019 (COVID-19) pandemic, a national emergency was declared on March 13, 2020.1  Shelter-in-place and stay-at-home orders to reduce the spread of COVID-19 were issued across the United States, which limited movement outside the home to essential activities. The CDC posted recommendations on March 24, 2020 emphasizing the importance of routine well-child visits and immunizations, especially for children 24 months of age and younger when most vaccines are recommended.1

CDC Report Findings
Data was evaluated from the Vaccines for Children (VFC) program from the CDC’s Vaccine Tracking System for ordering information and the Vaccine Safety Datalink (VSD) for administration data to determine the impact of COVID-19 on pediatric immunizations in the U.S.1 The VFC is a national program that provides federally purchased vaccines to approximately 50% of US children through age 18 years. The VSD monitors vaccine safety through studies and uses electronic health data from each participating site.1

The report revealed that approximately 2.5 million fewer doses of all routine non-influenza vaccines, and 250,000 fewer doses of measles-containing immunizations were ordered compared to the same period in 2019.1,2 There also was a decline in measles-containing vaccine administrations starting the week of March 16, 2020, with the decrease being less evident in children age 24 months and younger than among older children.1 There were more prominent increases in vaccine administration in late March among younger than older children, which may be due to enhanced promotion of immunizations and social distancing strategies at office visits.1 

Public Health Implications
This report demonstrates the importance of educating families about staying-up-date on immunizations during COVID-19 to prevent disease outbreaks.1,3 The decline in vaccines may be the result of families’ fears of contracting COVID-19 at the office visit.1 Pharmacists can also play an important role in the vaccine education process, especially since there are many unknowns about the COVID-19 pandemic. Many states are beginning to ease social distancing guidelines and reopen businesses, which can make children more vulnerable to vaccine-preventable diseases.4

Measles outbreaks during this time can be especially devastating, and parents and caregivers should be reminded that children should receive their first dose of the measles, mumps, and rubella (MMR) vaccine at ages 12-15 months and the second dose at ages 4-6 years of age. There should also be plans in place to ensure that children receive their influenza vaccine before flu season begins, especially if COVID-19 cases increase during the fall and winter months.

In response to the decline in vaccines, the American Academy of Pediatrics (AAP) created guidance to support the health of children during the COVID-19 pandemic.4 The AAP advises that pediatricians should identify children who have missed well-child visits and/or recommended vaccinations and contact them to schedule in person appointments.4 Pediatrician offices should make families feel comfortable that there are strategies in place to protect their health during COVID-19. Other recommendations include scheduling well visits and sick visits at different times of the day and separating patients. 

“While we wait for scientists and doctors to develop a vaccine for coronavirus, let’s work together to protect our children in every way that we can, today,” says Sally Goza, MD, FAAP, president of the AAP, in a press release.4


REFERENCES
  1. Santoli JM, Lindley MC, DeSilva MB, et al. Effects of the COVID-19 Pandemic on Routine Pediatric Vaccine Ordering and Administration — United States, 2020. MMWR Morb Mortal Wkly Rep. ePub: 8 May 2020. DOI: http://dx.doi.org/10.15585/mmwr.mm6919e2.
  2. Jenco M. AAP News. AAP urges vaccination as rates drop due to COVID-19.  https://www.aappublications.org/news/2020/05/08/covid19vaccinations050820. Published May 8, 2020. Accessed May 14, 2020.
  3. AAP. Guidance on providing pediatric well-care during COVID-19. https://services.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/guidance-on-providing-pediatric-well-care-during-covid-19/.  Last updated May 8, 2020.  Accessed May 14, 2020.
  4. AAP. AAP statement on new data showing declines in childhood immunizations. https://services.aap.org/en/news-room/news-releases/aap/2020/aap-statement-on-new-data-showing-declines-in-childhood-immunizations/. Published May 8, 2020. Accessed May 14, 2020.