A recent health survey revealed that only two-thirds of parents say they’ll vaccinate their children against the flu this year, raising concerns among pediatricians as the flu season begins and COVID-19 cases spike.

As the cornerstone of public health practice, routine immunizations protect children against important vaccine-preventable diseases. Anything that lowers immunization rates in a community doesn’t just leave individual patients at risk but also sets the stage for a local outbreak or wider epidemic. This is particularly true for influenza, which causes many cases of severe illness, hospitalizations, and deaths every year, even with routine immunization available.

And this year, decreased vaccination rates could add to the burden of an already overtaxed health-care system trying to provide care during a pandemic. This is why we’re advocating for maintaining high immunization rates, especially among children, even during the COVID-19 pandemic.

Without immunization, events like the recent measles outbreaks in some communities could become more common. The decline in immunizations against pertussis, or whooping cough, could lead to more cases of this potentially devastating illness among our youngest patients.

Parents play a pivotal role in ensuring children are vaccinated during this pandemic. They should be aware of the recommended immunization schedule and their child’s immunization status, and contact their child’s primary care provider to schedule routine immunization visits. The American Academy of Pediatrics is encouraging routine immunization for all children during this pandemic. Parents should also vaccinate their entire families as early as possible before influenza takes hold in our area.

Children under age 9 who have never had a flu vaccine will need two doses 30 days apart. Families with infants under 6 months can protect their baby by immunizing the entire family, a term we call cocooning.

The COVID-19 crisis is a rapidly evolving situation. Although many providers and even some local health departments had to close their offices earlier during the pandemic, most are now open and available to immunize children.

We need to be open to new strategies to streamline the delivery of vaccines. We should prioritize patients whose vaccines are delayed and use strategies such as vaccine-only visits to allow more patients to be protected as quickly as possible. This is especially true for influenza immunization.

Parents who have concerns about side effects or vaccines' effectiveness should talk to their health-care providers. A trusted provider is the best source of reliable information for all their health-care needs, including immunizations.

Joseph Schwab is an associate professor of pediatrics at Rutgers New Jersey Medical School. Hanan A. Tanuos is the director of primary care and an associate professor of pediatrics at Rutgers New Jersey Medical School.