Lessons learned from the ongoing COVID-19 vaccination campaign are helping healthcare providers revive childhood vaccination numbers that plunged during the pandemic.
Pediatric office visits fell 27% during the pandemic, the result of economic hardship and safety measures meant to limit exposure to COVID-19, according a report published by the American Academy of Pediatrics and Georgetown University Center for Children and Families Thursday.
The decline in well-child appointments has led to a lag in childhood vaccinations. Orders for vaccines from Vaccines for Children program were down by more than 11 million doses as of May 2 compared to two years ago. Vaccines for Children is managed by the Centers for Disease Control and Prevention (CDC) and provides free immunizations to families unable to afford vaccines.
Every state requires children to be vaccinated before they can attend public school but allows exemptions for medical reasons. Forty-four states have exemptions for religious objections and 15 offer exemptions for moral or personal beliefs. California, Connecticut, Maine, Mississippi, New York and West Virginia don't allow any non-medical exemptions.
The report's authors call for a coordinated public education campaign to bring vaccination rates back to pre-pandemic levels. Without more immunizations, children are at risk of contracting and spreading preventable, highly contagious diseases like measles, pertussis and mumps. Among the steps the authors recommend are paying clinicians to counsel patients on vaccines and extending the CDC's free vaccines program to kids enrolled in the Children's Health Insurance Program.
All stakeholders must take a more active approach to getting children inoculated by copying COVID-19 vaccination campaign strategies, such as coordinated outreach efforts underway to increase the vaccination rate now that the high-demand phase is over, clinicians said.
The decrease in childhood vaccinations has been a major concern among healthcare providers, who say a big lesson learned over the past 15 months has been the importance of being proactive in persuading parents to get their kids vaccinated against childhood diseases.
"It really needs to be a kind of all-hands-on-deck approach to encourage families that they should feel safe to go to their pediatricians or family doctors and get caught up on vaccines," said Dr. Christoph Diasio, a North Carolina-based pediatrician and member of the American Academy of Pediatrics.
Electronic medical records are a useful tool to identify children who haven't gotten their shots, Diasio said. Parents whose children are due for vaccinations are contacted by phone or given reminders to make an appointment electronically through patient portals.
"This is one of the silver linings of the pandemic," said Dr. Jerold Stirling, chairman of the pediatrics department for Chicago area-based Loyola Medicine. Loyola staff members contact parents to remind them that their kids need vaccinations rather than waiting for parents to call, he said.
Loyola experienced a dramatic decrease in childhood vaccination visits last year and performed just 30% as many immunizations as they would during a typical year, Stirling said. Pediatric visits rebounded as schools reopened this year, but they're still below pre-pandemic levels.
Like Loyola, Rush University Medical Center in Chicago saw a dip in well-child visits, said Dr. Renee Slade, a pediatrician at Rush. Some parents starting bringing in their children late last year when pandemic restrictions began to loosen, but many are still hesitant to come in, she said. Parents need reassurance that their pediatricians' offices have safety protocols in place to protect against COVID-19, she said.
Perhaps living through a pandemic and seeing the rewards of effective vaccines might encourage more parents to take their kids to get shots, Slade said.
"I do wonder whether people will start to have an appreciation for the benefits of vaccines," Slade said.