Pandemic-Related Decline in Childhood Vaccines Prompts State Plea to Parents

Department of Health also urges pediatricians to devise new office protocols to keep patients and parents safe from coronavirus, reduce fear factor
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Vaccination

With a dramatic decline in childhood vaccine rates during the coronavirus pandemic, New Jersey officials urged parents to ensure their kids are properly immunized to protect them from measles, mumps and other infectious diseases.

State Department of Health Commissioner Judith Persichilli also encouraged pediatricians to get creative in how they offer vaccines and other well-child visits — like setting up an offsite immunization clinic or providing curbside vaccinations.

Persichilli said data compiled through the New Jersey Immunization Information System shows a 40% decline in vaccines for children under 2 years and a 60% drop in inoculations for those over 2 years between March 1 and April 20, when compared with the same period last year.

The numbers were not surprising to clinicians, given the decline in preventive-care visits overall during the coronavirus pandemic — a situation some say is likely resulting in patients with more critical medical concerns. Elective surgeries were allowed to restart yesterday, under certain conditions, after the state suspended these procedures two months earlier.

Downside of keeping kids home

“While staying at home has slowed the spread of the virus, it has also resulted in delays and decreases in the number of children getting recommended vaccines,” Persichilli said at Tuesday’s media briefing.  “The need to protect against serious childhood diseases like whooping cough doesn’t disappear during the COVID-19 public-health emergency.”

New Jersey is not alone when it comes to the decline in inoculations. According to a May 15 report from the federal Centers for Disease Control and Prevention, doctors in the United States ordered and administered roughly 400,000 fewer vaccines during the first 15 weeks of this year, versus 2019. The steepest decline in immunizations began after a national emergency was declared on March 13, the CDC found.

Gov. Phil Murphy declared a public emergency for New Jersey on March 9 — two days after the state announced its first coronavirus case — and soon after closed schools and workplaces and strictly limited travel. COVID-19 has now been diagnosed in more than 155,700 residents, including 11,200 who have died.

Dr. Puthenmadam Radhakrishnan, a pediatrician in Mercer County and treasurer of the New Jersey chapter of the American Academy of Pediatrics (AAP), said this downward trend in vaccines was not surprising, given how many small practices have closed or severely cut back their hours during the pandemic. And when offices were opened, they saw far fewer patients, he added.

“People just didn’t want to come to the office,” Radhakrishnan said. Some pediatricians were seeing half or even a quarter of the normal patient load, he noted.

Radhakrishnan said telehealth visits have been a huge benefit for providers — enabling the doctor to see the young patient and the parent’s reaction — but these only goes so far. “This has been great, but it doesn’t help us with immunizations,” he said.

Changing up vaccination protocols

Some practices have already made adjustments to their protocols, he explained, like having families wait in their car until they are called into an exam room — eliminating the potential of becoming infected in the waiting room. Others have set up immunization stations in their parking lot, he added.

“There are a lot of changes being made,” Radhakrishnan said, encouraging parents to call their pediatrician and discuss the options.

While AAP guidelines call for certain vaccines to be administered by certain ages, Radhakrishnan said that, if needed, these can also be given safely in the months or year that follows. The big danger is leaving the child unprotected, he said.  “It means we have a lot of catchup to do,” he added.

Persichilli said another safe option for providers is to split their day to schedule well-child visits — including inoculations — in the morning and sick patients in the afternoon. She also suggested collaborating with other providers to create satellite locations for immunizations, away from the normal office where infection risk may be greater. If pediatricians have limited capacity, she urged them to prioritize vaccines for children under age 2.

“Ensuring access to vaccinations is an important part of maintaining the public’s health,” Persichilli said. Last year, there were more than 1,200 cases of measles diagnosed nationwide, she added, including 19 in New Jersey.

New Jersey now requires children receive more than a dozen vaccines, some with booster shots, by the time they attend grade school; state data from the last year shows more than 94% met these requirements. The remainder — nearly 33,000 children — received medical or religious exemptions to the law.

State lawmakers pushed to eliminate religious exemptions, which have become increasingly popular in recent years, in 2019 and early 2020, prompting massive protests in Trenton by vaccine opponents. Legislative leaders were unable to secure enough votes to end the exemption and cancelled a vote on the bill but have also vowed to revisit the issue.