Physicians locally and across the nation worry that fear of coronavirus and school closures have parents postponing routine but critical childhood vaccinations, setting the stage for a return of debilitating diseases that had been all but eradicated.
Ensuring children receive timely vaccinations is critical to preventing outbreaks and maintaining herd immunity against illnesses such as measles and chickenpox that modern medicine has significantly reduced, physicians said.
Early in the pandemic, many people were nervous about visiting doctors’ offices and switched to televisits, but physicians can’t give shots over the internet, said Dr. Richard Rupp, medical director for the University of Texas Medical Branch Pediatric Clinic.
“All of those diseases that we vaccinate for are more or less all serious or they can be serious,” Rupp said. “You don’t want your children to have to go through that or suffer or die from those diseases.”
A May study by the U.S. Centers for Disease Control and Prevention found declining vaccination rates among all age groups younger than 2 years, except for 1-month-olds.
For example, only about half of American children 5 months old had gotten age-appropriate vaccines, as opposed to about two-thirds of children from May of 2016 to 2019, according to the CDC.
It’s a problem because the schedule of vaccines is developed for specific reasons, said Dr. Keith Jensen, regional medical director for pediatric emergency medicine for HCA Houston Healthcare.
“The vaccine schedule has a lot to do with when kids are prone to these illnesses, but also how it all goes together,” Jensen said.
The schedule was developed so the vaccines work at their peak and in conjunction with other vaccines, he said.
There’s a real concern that parents might allow their children to fall further behind on their immunizations, he said.
“The concern is if parents get behind on the schedule, they won’t ever catch up,” Jensen said. “If you’re missing visits, it’s a lot harder to get caught up.”
Schools play a vital role in ensuring children have all their necessary shots, but the education calendar also has been in flux this year, Rupp said.
“The schools seem to be looking at their school records even though they’re in online school and sending the parent information that they need vaccines,” Rupp said.
But with many students learning online, Rupp worries schools won’t have the same level of influence on students’ vaccinations.
“That’s always been a problem with homeschool kids,” Rupp said. “Although they’re supposed to be vaccinated, there’s no one who checks.”
Aside from protecting each individual child, vaccinations are key to immunizing a community, said Dr. Oscar W. Brown, a past president of the Texas Pediatric Society and co-chair of the organization’s emergency preparedness committee.
Brown also is a physician at the medical branch.
“The big fear was that we did not want to set up the population to be vulnerable to these old illnesses that are still out there,” Brown said. “We didn’t want to have that compounding everything else that we’re dealing with.”
That’s the whole idea of herd immunity, when enough people are immune to a disease such as chickenpox — either through vaccination or having contracted the illness — that the pathogen can’t spread as rapidly through a community, Jensen said.
It takes time to lose herd immunity, just like it takes time to build it, but losing that immunity is the big fear, Jensen said.
“That’s the hardest part with vaccines,” Jensen said. “When they work well, you don’t see the diseases that they’re preventing and it’s easy to be complacent.”
The consequences could be dire, Brown said.
Many of the diseases that are now all but eradicated because of vigorous vaccine programs were once common and haunted parents with fears of their children’s death or injury.
In the early 1990s, chicken pox killed 100 to 150 people annually, according to the centers.
Before a measles vaccine program launched in 1963, the disease killed 400 to 500 people, put 48,000 people in the hospital and produced brain swelling in 1,000 people annually.
Forms of pneumococcal diseases can cause brain damage, hearing loss and death.
But it’s not too late to catch up, Brown said.
“We think we’re going to be OK,” Brown said. We think that the overall level of immunization was negatively impacted.”
But, if parents get back onto a regular schedule, adverse effects of missing immunization doses can be halted, Brown said.
Even in non-routine times, it’s important to keep up with routine vaccinations, he said.