Infectious Disease

Pandemic fueled confusion, decline in routine pediatric immunizations

January 20, 2022

3 min read

Source/Disclosures

Disclosure:
The relevant financial information of all authors can be found in the studies.

ADD TOPIC TO EMAIL ALERTS

Receive an email when new articles are published

Please enter your email address to receive an email when new articles are published . ” data-action=”subscribe”> Subscribe

We could not process your request. Please try again later. If this issue persists, please contact customerservice@slackinc.com.

Back to Healio

Two studies published in Clinical Pediatrics last year described how COVID-19 lockdowns led to a lack of routine immunizations for infants and young children early in the pandemic.

The AAP expressed concern about this issue early on, and researchers noted that vaccinations had “dropped dramatically” in the first 8 months of 2020 compared to the same period in 2019.

In the first new study, physicians at Philadelphia’s Einstein Medical Center described the impact of the early lockdown on their practices in a low-income North Philadelphia community and a network of seven affiliated pediatric group practices in Northeast Philadelphia and surrounding suburbs.

“After the city’s stay-at-home order was issued on March 17, 2020, practices were limited to personal visits to healthy children,” they wrote. “In academic practice, in-person well visits were limited to infants 15 months of age or younger beginning March 23, expanded to children under 10 years of age on April 27, and expanded to children of all ages on May 3. The number of for the performance of The clinician available to visit the well was not fully utilized again until June 1.”

In a cohort of 1,093 children from diverse backgrounds, they found that the third doses of DTaP and the first doses of the MMR vaccine series from February to April 2021 increased from 59.3% to 41.5% for DTaP and from 55.6% decreased to 33% for MMR. While DTaP vaccination rates began to recover in May and peaked in September, MMR vaccination rates declined even more sharply through May, rebounding in August and peaking in October.

In addition, the authors found that more than two-thirds of the cohort received Medicaid and that those who used private insurance were more likely to complete their vaccination course.

“From mid-March to mid-April 2020, the Vaccine for Children program received orders for 2.5 million fewer doses of routine vaccines and 250,000 fewer doses of measles vaccine compared to the same period in 2019,” they wrote.

In the second study, researchers from Children’s National Hospital and George Washington University in Washington, DC, discussed their own experiences of early lockdowns.

“In our academic outpatient centers, the monthly average of in-person visits, sick and preventive, fell by almost half between March and August 2020 compared to the previous 6 months,” they wrote. “In addition to the health risks inherent in COVID-19 infection, the decline in screening tests puts infants at additional risk for vaccine-preventable infections, failed to detect developmental delays, and reduced the ability to manage mental health.” of family and child, which are the main pillars of provision.”

In a retrospective review of electronic medical records during this period, they found that the most common barrier to getting immunizations was concern about exposure to COVID-19 and “the belief that avoiding preventive visits by ordering the stay at home was required. ”

“Among those who used public transport (subway or bus), there was a statistically significantly increased concern about exposure to COVID-19 during travel (83.3% vs. 33.3%, P=0.006), although the number of participants was small (n=12),” they wrote. “Another issue cited was the difficulty in obtaining childcare for other children at home, as hospital/clinic guidelines encouraged visits with only the patient and an adult in accordance with COVID-19 guidelines. Parents also reported forgetting the appointment or having limitations in scheduling the same day. Insurance defaults or switching providers were not often identified as barriers.”

Some parents also believed a misconception that only emergency services were available during the lockdown, not preventive services, while others said they could not arrange childcare for their other children.

Researchers concluded that communication should be given more consideration due to confusion and mixed messages that led to a lack of follow-up vaccinations during this period.

“During the pandemic, our facility’s policies emphasized and encouraged in-person visits from healthy children ages 2, 4, 6, and 12 months, but prioritized in-person visits for other age groups,” they wrote. “This created confusion, particularly when older siblings were limited to preventative telemedicine visits. Improved communication between parents, particularly members of a higher-risk community, and medical service providers is important to improve adherence to well visits in critical age groups. Further studies should examine who parents trust when it comes to communicating about their child’s health care, as the American Academy of Pediatrics, local health departments, the general health system, and nonclinical staff have provided all the information.”

References:

Abuali M et al. clinic paediatrics 2022; doi: 10.1177/00099228211044840.

WeiszJ, et al. clinic paediatrics 2021;doi:10.1177/00099228211050476.

ADD TOPIC TO EMAIL ALERTS

Receive an email when new articles are published

Please enter your email address to receive an email when new articles are published . ” data-action=”subscribe”> Subscribe

We could not process your request. Please try again later. If this issue persists, please contact customerservice@slackinc.com.

Back to Healio

COVID-19 Resource Center

Related Articles