The pandemic has thrown most families a few curve balls in the last few years, leading to understandable disruptions and delays to so many parts of their lives. This has also bled into the realm of healthcare, with many children’s routine vaccine appointments getting put off due to the many triage situations that parents have had to navigate — whether that’s a positive case in the household, juggling childcare and demands at work or just pure exhaustion.
But as we near a third year of the pandemic, more and more pediatricians are sounding the alarm about the impact of missed and delayed vaccines. A July 2022 report from UNICEF and the World Health Organization (WHO) looking at global vaccination data warned of the “largest sustained decline in childhood vaccinations in approximately 30 years,” citing a global count of more than 25 million children who missed one or more doses of the diphtheria, tetanus and pertussis (DTP3) vaccine. This coming just months after they noted that vaccine disruptions have created a “perfect storm” risk for measles outbreaks in children as well.
“This is a red alert for child health. We are witnessing the largest sustained drop in childhood immunization in a generation. The consequences will be measured in lives,” said Catherine Russell, UNICEF Executive Director in a statement on the joint report. “While a pandemic hangover was expected last year as a result of COVID-19 disruptions and lockdowns, what we are seeing now is a continued decline. COVID-19 is not an excuse. We need immunization catch-ups for the missing millions or we will inevitably witness more outbreaks, more sick children and greater pressure on already strained health systems.”
And, while the tired parents playing catch-up are undoubtedly on most healthcare providers’ radar, the larger picture of vaccine disruption as we head into yet another pandemic-era back-to-school season remains multifaceted. To get a better idea of what exactly is happening with pediatric vaccine rates — and what has healthcare professionals alarmed, SheKnows caught up with Dr. Christopher Youngman, chief medical officer of Wayne Pediatrics in Detroit.
“With the state of the pandemic, we had a decreased number of well child visits across the nation. And the result of that is a delay in the immunization schedules for many children. So We are seeing a large number of patients come to the practice behind on their immunizations — and we’re working diligently with the families to get caught up,” Dr. Youngman says. “But we also have noted vaccine hesitancy seems to have increased a bit; not just to the influenza vaccine and in the COVID vaccine, but some families are questioning vaccines due to misinformation campaigns that they may come across on social media.”
Understanding the rise of vaccine hesitancy
Hesitancy toward the COVID-19 vaccines have been well-documented as parents wrap their heads around vaccinating themselves and their families with something completed in what appeared to be such a short period of time. In recent years countless experts have made the rounds trying to debunk myths and soothe concerns about the mRNA COVID-19 vaccines (they have been in development for years! They have been studied aggressively!), but many have also noticed that the hesitancy toward this one vaxx, paired with an eroded trust in the healthcare system and government, is leading to some individuals (those who likely wouldn’t have previously fallen into the anti-vaxxer camp) side-eyeing additional vaccines that have previously been understood as safe, effective and necessary for keeping the larger community safe.
“I’m concerned [COVID-19 vaccine hesitance] making people think: ‘oh, well, maybe the measles vaccine isn’t great either, and maybe these other vaccines aren’t great,’” Professor Liam Smeeth, a physician and director of the London School of Hygiene and Tropical Medicine, told CNBC in early 2022, citing just how quickly a drop in vaccine rates could lead to something like a measles outbreak in communities in the UK.
A 2020 and 2021 survey from the American Academy of Family Physicians (AAFP) on vaccine attitudes and public confidence amid the pandemic noted that the rise of people expressing a “concerning decrease in confidence in vaccines” was “not insignificant” — and that people getting their information from unregulated social media channels and online news with questionable or unverified sourcing rather than their family doctors and trusted healthcare providers is a cause for concern.
Other research on social media and vaccine attitudes from May 2020 found that while full-out anti-vaccine “clusters” of users online are smaller, they are particularly effective at becoming “highly entangled with undecided clusters in the main online network, whereas pro-vaccination clusters are more peripheral.” Meaning the vaccine hesitant and anti-vaccine communities are more likely to cross streams and those vulnerable groups are less likely to encounter the kind of science-backed information that might satisfy their anxieties while also getting them and their families protected against severe illness.
What are the impacts of a significant disruption of vaccines?
Ultimately, there’s a very real and urgent impact to a decrease in vaccination rates: People who otherwise might not get sick with something severe and potentially life-threatening or debilitating are put at a higher risk.
As Dr. Youngman notes, vaccination isn’t simply a matter of an individual’s health. It’s a team sport that “moreso protects the community” from harm — particularly individuals who cannot get vaccinated against certain diseases because of medical conditions.
“So as we see vaccine numbers decrease in communities, it becomes an opportunity for infections to reintroduce themselves into those communities that were no longer there,” he says. “They have kind of a foothold to get back in the door, when immunization rates drop below certain percentages depending on the specific disease and how easy it is to get the disease.”
(Ex: Oxford Vaccine Group notes that “to achieve herd immunity for measles at least 90-95 percent of the population need to be vaccinated.” Meanwhile, in the case of polio, which is less contagious, “80-85 percent of the population would need to be vaccinated for herd immunity to work.”)
Citing the 2019 outbreak of measles at a California theme park or the more recent reemergence of polio in New York, Youngman notes it’s a “real concern when we see illnesses that we haven’t seen for a long time in this country start to show themselves again.”
“We’ve seen that in recent years, in communities, particularly with lower vaccination rates,” Dr. Youngman says. “Measles was tracked back to many different communities and communities that had lower vaccination rates against measles saw outbreaks develop there. So that’s obviously a concern — because these these are illnesses that can severely affect some individuals — typically individuals that were previously healthy — and then they can become susceptible to the illness that was preventable.”
What can parents do?
It can be nerve-wracking to read about how a statistically small group of individuals who are against vaccination can, in conjunction with individuals facing disruption for reasons beyond their control, derail community health incomes in such a significant and dangerous way. But there are some material ways parents can keep their kids and their communities safe:
- Play catch-up. To start, you can make sure your family and immediate circle are up-to-date on your well-child visits and vaccinations. It’s never too late to get back on track and your healthcare provider will be understanding and eager to help you and your family catch-up.
- Talk it out. Have frank conversations with parents in your community — particularly those that might be experiencing vaccine hesitancy. Point them toward peer-reviewed resources backed by science and encourage them to have conversations with their family healthcare provider to address their concerns instead of turning to Google.
- Debunk, debunk, debunk. Encourage media and social media literacy to avoid falling for misinformation.
- Keep safe. Continue to utilize masks as a tool to protect from severe illness and practice hand-washing, The COVID-19 pandemic is not over, unfortunately, and utilizing tools to prevent spread of illness is an effective way to keep our kids in school and getting the face-to-face learning they need.
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