Some kids aren’t getting routine childhood immunizations because health departments are cutting back on vaccine clinic hours as they respond to COVID-19.
Other families are delaying care because they’re afraid to go to the doctor’s office during a pandemic.
“Parents may have said back in May, June, ‘We’re going to skip this right now. Things are just crazy, and we’re going to do this later.’ And it’s so easy to forget later,” said Dr. Jennifer Schuster, a pediatric infectious disease specialist at Children’s Mercy Hospital.
In the spring, the Centers for Disease Control and Prevention reported that vaccine rates declined in the spring. In some states, only about half as many vaccines were administered in the first four months of 2020 as in 2019, according to Scientific American. (Kansas provided Scientific American with data; Missouri did not.)
Vaccination rates are starting to rebound, but many school districts are still behind where they would normally be at this point in the school year, especially those that are online-only. By mid-October, all students in Center and Hickman Mills usually have their required immunizations, but this year, both districts are at 97% compliance and trying to catch kids up.
But vaccine compliance among Kansas City Public Schools students is only 88% — below the threshold for herd immunity for some of the most contagious childhood diseases, like measles.
“Our records suggest that a majority of our parents do go to the health department for their immunizations, at least for school-aged children. In the past, the health department has come to the middle and high schools in the spring to immunize seventh and 11th graders. That wasn't able to happen this year due to the pandemic,” KCPS spokesman Ray Weikal wrote in an email.
Pandemic is the priority
There have been fewer opportunities for families to get children vaccinated this year because of the coronavirus. Local health departments are focused on their community’s COVID-19 response, and some haven’t been able to staff immunization clinics because staff members have had to quarantine. That happened a couple of weeks ago in Kansas City.
It also takes longer to administer vaccines now, so even when clinics are operating, they can’t get through patients as quickly.
“With the various personal protective equipment that the providers giving the shots have to be wearing and all of the struggles with keeping people distanced in lines, that’s slowed down some of the activity,” said Dr. Rex Archer, the director of the Kansas City Health Department.
Archer said families whose students’ schools aren’t open for in-person learning are skipping their shots because they don’t think they need them this year.
That couldn’t be further from the truth, Archer said. “We still have these diseases that these shots help protect circulate from time to time in our communities. Parents need to do their civic duty of protecting everyone’s kids.”
Herd immunity happens when a virus can’t spread effectively because most people have either been inoculated or had the disease. It helps protect vulnerable community members who can’t be vaccinated, such as babies who aren’t old enough to be immunized yet. Infants and young children are often the victims of measles outbreaks.
Returning to the doctor’s office
Samuel U. Rodgers Health Center is trying to get patients caught up on critically important childhood vaccinations by calling families whose kids are overdue for their well-child check-ups.
Pediatrician Archana Kulkarni says her schedule is starting to fill up.
“In March and April, we saw a huge drop in the patient numbers because patients were just afraid of coming out of the house, but they’ve actually started scheduling and coming in. We’ve been doing well-child checks and vaccinations, just catching them up,” Kulkarni said.
She said the health center is trying to put families who might be reluctant to come in during a pandemic at ease by keeping sick kids and their families separate.
“We always take extra precautions, like appropriate PPE — N-95 masks and infectious gowns — when we do the COVID testing,” Kulkarni said. “We’ve put up new walls.”
Kulkarni says families trust pediatricians, and they often come in wanting advice about sending their kids back to school. She tells them to pick the right option for their family, but whether that’s in-person or online, kids still need to get their well-child check-ups, immunizations — and flu shots.
“The American Academy of Pediatrics recommends every child receives a flu shot, so that is our goal,” said Schuster, the Children’s Mercy doctor. “This year is no different. If anything, it’s actually even more important.”
Flu shots at school
Schools really want students to get their flu shot, too. The Kansas City Health Department has said it wants at least 80% of kids vaccinated in every school.
Genesis School has sent home permission slips to administer flu shots at school next week.
“We have to use the form the health department would use to give the kids a shot,” said Kevin Foster, the charter school’s executive director. “It’s not the easiest thing for a parent to understand. You have to sign here and here, and I anticipate it’ll take a fair amount of work to get them all returned.”
But he says he’s only gotten positive feedback so far. Right now, the plan is to give students shots during the school day, then host a drive-through clinic in the parking lot immediately after. That way, siblings, parents and community members can also get vaccinated.
The CDC recommends everyone 6 months and older get vaccinated for the flu this year. It’s especially important for people in high-risk categories for COVID-19, as they also tend to have more serious complications from the flu.
Schuster said pediatricians need to take every opportunity to talk to parents about the importance of flu shots and other childhood vaccinations.
“Maybe you’re seeing the child because they're sick and they actually need COVID testing, or you are refilling ADHD medications, but take every single encounter to think about vaccines and preventative medicine,” she said.
