COVID-19 is rightly the disease on all our minds now. However, as public-health pediatricians, we are also worried about the unintended consequences the COVID-19 pandemic may have for vaccine-preventable diseases. Measles, whooping cough, and the chickenpox are just a few of the diseases that, unlike COVID-19, we can prevent through vaccination now.
And although COVID-19 seems to cause mostly mild disease in children, these vaccine-preventable infections can be serious and even life-threatening for kids. Vaccination is our best prevention tool to keep children from getting sick in the first place, especially when they are most vulnerable. Thanks to the vaccines routinely recommended today, we can prevent an estimated 20 million cases of illness and 42,000 early deaths.
Fortunately, most children in Philadelphia have received the vaccines they need, but COVID-19 has made it more difficult for kids to stay up to date. Due to social distancing and stay-at-home orders, families may be worried about taking their children out of the home to see the pediatrician. However, the American Academy of Pediatrics recommends that even in areas such as Philadelphia, where COVID-19 is prevalent, pediatricians should prioritize in-person visits for immunizations for children age 2 and under. But our Philadelphia data show us this has not been the case.
Since COVID-19 hit Philadelphia, we have seen a precipitous and dangerous decline in childhood immunization rates. In the month of April, we saw a 50% decline in the number of vaccines administered to young children in Philadelphia compared with before the epidemic. These trends are not unique to Philadelphia, and sharp declines in childhood immunization rates have been seen throughout the U.S.
Some may question that because we should all be staying at home, why does it matter whether children get their immunizations? Gov. Tom Wolf recently announced Pennsylvania’s process for slowly reopening our society. As we prepare for this re-integration into more normal life — which includes sending our kids to child care, and eventually back to summer camps and school — our children need to be protected. Many of the childhood immunizations take a few weeks to take effect, so taking the time now to make sure your child is up to date will ensure that you are ready to safely get back into the community.
If we do not keep our children and communities protected, we’ll start to see such diseases as measles, whooping cough and chickenpox, too. We have recently seen what can happen when immunization rates decrease with the 2019 measles outbreaks in the U.S. and worldwide. Let’s not see measles again, while we are still recovering from COVID-19.
We know that parents are scared and want to do whatever they can to keep their children safe. And as pediatricians, our goal is the same. We want to reassure Philadelphia families that pediatricians have changed their practice to protect children during COVID-19:
First, pediatricians are wearing appropriate personal protective equipment (PPE), including gloves and masks for all clinic visits.
Many practices are holding well visits and immunization visits in the mornings and allow visits for sick patients only in the afternoon. With this approach, well children won’t share the waiting room with ill children and you and your family are less likely to be exposed to someone with COVID-19 in clinic.
This practice also allows time for thorough disinfection of the office before well visits the next day.
Pediatricians are also using telehealth for well visits for older children and some sick visits. This keeps the offices less crowded and makes it easier for families to practice social distancing in the waiting room.
As we do when going to the grocery store, at the pediatrician’s office, you can protect yourself and others by wearing a mask, using hand hygiene and maintaining a distance of at least six feet between your family and others.
Call your pediatrician and ask about adaptations for COVID-19. Discuss your fears and concerns. Then, armed with this information, vaccinate your young children. A healthy community is an important defense against any infection and a healthy community is a vaccinated community. This way we won’t end one epidemic only to see the beginning of another.
Stacey Kallem is the director of the division of maternal, child, and family health at the Philadelphia Department of Public Health, and Kristen Feemster is the medical director of the immunization program and acute communicable diseases at the department of health.