Sharp Decline in Immunization Rates Warrants Cause for Concern

Key Takeaways

A May 2020 CDC report showed a worrying drop in immunization rates for children.
This drop is largely due to parental concerns about bringing their children to any healthcare facility during a pandemic.
Doctors are urging parents to keep children on their regular vaccine schedule to prevent a possible outbreak of preventable diseases like measles, mumps, and rubella.

When the COVID-19 pandemic began this past March, parents were understandably frightened. Suddenly, a highly dangerous virus full of unknowns was sweeping our world and our country. It’s a parent’s instinct to keep their children safe, and that’s exactly what parents did when the pandemic began—and it’s what they continue to do now.

Understandably, parents have felt anxious about visiting doctor’s offices for well visits and immunizations. It makes sense: doctor’s offices are where sick people go, and we don’t want to potentially expose our children to COVID-19. At the same time, health check-ups and immunizations are a vital element in keeping our kids healthy—and should be considered essential.

Sadly, doctors have seen a dramatic drop in immunization rates over the past few months as a result of COVID-19 fears. But it is still very important that you keep up with your child's vaccination schedule.

Data About Childhood Immunization Rates Amid the COVID-19 Pandemic

In May 2020, the CDC released a report about a worrisome drop in immunization rates they had observed over the months since the pandemic began. Data was compiled from the Vaccines for Children Program (VFC) provider order data as well as the Vaccine Safety Datalink (VSD) vaccine administration data.

Here’s what the CDC found:

From mid-March to mid-April, the VFC program decreased its order of childhood vaccines (non-influenza vaccines) by about 2.5 million. There were 250,000 fewer doses of measles vaccines ordered as well.
VSD saw a dramatic decline in measles vaccination in mid-March, most notably among older kids.
Although measles vaccines rates are picking up for kids over 2 years old, VSD is still seeing lower rates among kids over two.

How Have Doctors Reacted to These Statistics?

“The fact it has dropped so significantly in such a short period of time across the U.S. is really concerning because of the potential for outbreaks,” Sean T. O'Leary, M.D and member of the Academy of American Pediatrics (AAP) Committee on Infectious Diseases, commented in an AAP memo.

It’s not just vaccines that have doctors concerned, though.

“I’m also concerned that children who have missed vaccines have also missed other health care that occurs during those visits, including physical exams, developmental screenings and other important care that should not be delayed,” Sara H. Goza, M.D. and AAP President commented.

What Is Causing Immunization Rates to Drop?

The dropping immunization numbers are very concerning. But before we discuss the ramifications of delaying vaccinations during the pandemic, we need to understand why parents are feeling this way. What exactly is driving parents' fears about coming to the doctor for well visits and immunizations?

Dr. Florencia Segura, MD, of Einstein Pediatrics in Virginia

Because daycares, schools, workplaces, and stores have closed in the past couple of months, most parents have been nervous about taking their young babies and children anywhere, especially to the pediatrician's office. Parents are anxious that their babies will be exposed to COVID-19 or another type of virus at an office where typically both sick and well children are evaluated.

— Dr. Florencia Segura, MD, of Einstein Pediatrics in Virginia

Dr. Cory Fish, MD, Chief Medical Officer at Brave Care in Portland, OR, agrees: It’s fear and anxiety that is stopping parents from bringing their kids into the doctor. “My own experience and experience talking to colleagues is that the overwhelming reason for this is that parents (understandably) are scared to take kids to the doctor,” Dr. Fish said in an interview.

Dr. Fish wants parents to know that although their fears are understandable, pediatrician offices are doing everything in their power to keep kids safe. “I totally understand,” says Dr. Fish. “People are worried. However, when it comes to pediatric offices in particular, I encourage parents to ask what steps are being taken.”

Dr. Fish encourages worried parents to ask beforehand about what protocols their pediatrician’s office has taken to keep patients safe. Most offices are taking appropriate steps, such as mask wearing and social distancing in waiting rooms, which should put parental fears at ease.

What Are the Dangers of Lower Immunization Rates?

Although parent fears are understandable in these unprecedented times, it’s important to understand that there is actually a real danger in not visiting the pediatrician right now—especially when it comes to vaccination.

Dr. Segura explains that in order for us to be protected from vaccine preventable illnesses, our babies and young children need to be vaccinated consistently and according to the current vaccine schedule. It all goes back to “herd immunity” – meaning that we rely on the overall immunity of our population to keep these viruses at bay.

Dr. Florencia Segura, MD, of Einstein Pediatrics in Virginia

These falling vaccination rates will jeopardize the herd immunity that communities need for diseases like measles, whooping cough, meningitis, and bacterial sepsis. For measles, we need at least 93-95% of the population immunized to prevent a widespread outbreak, which is especially worrisome because many states are easing social distancing restrictions.

— Dr. Florencia Segura, MD, of Einstein Pediatrics in Virginia

Measles outbreaks have happened periodically over the past few years, so that’s a concern for many pediatricians as immunization rates see this sharp decline. But it’s not just measles they are worried about.

“The administration of routine vaccines, such as measles, mumps and rubella, whooping cough, amongst others, are incredibly important for the health of your child and the communities we live in,” explained Dr. Savita Ginde, MD, a family planning expert and Chief Healthcare Officer at Stride Community Health Center, in an interview.

“We’ve worked too hard to keep vaccine-preventable illnesses at bay to let this happen,” Dr. Ginde added. “I can’t stress enough how important it is to have your children vaccinated.”

What Doctor’s Offices Are Doing to Keep Kids Safe

Again, if you have any fears or concerns about visiting your pediatrician, one thing you can do is call ahead and discuss exactly how the visit will work in our “new normal” of COVID-19. It’s likely that simply learning about your pediatrician’s safety protocols will put your mind at ease.

Dr. Ginde shared some of the precautions her practice is taking during the pandemic, which are similar to protocols doctors all over the country are implementing:

Only one adult is allowed to accompany a child (or children) per visit
Any person over the age of two must wear a face mask
No one who is sick is allowed into the office, specially anyone experience COVID-type symptoms
Anyone who enters the building must have their temperature taken and must answer a health questionnaire

The Academy of American Pediatrics (AAP) also has some safety suggestions for doctors’ offices that may put your mind at ease, including:

They recommend having sick patients enter the building at different times than well patients
They recommend separating patients spatially (socially distancing) and/or keeping sick and well patients in separate locations in the office

What This Means For You

It’s easy to be swept into debates with other parents—and even our own well meaning parents and family members—about the best practice when it comes to something like immunizations. Everyone is going to have an opinion about whether now is a good time to go to a doctor’s office or if your child’s vaccinations are something you can afford to skip or delay. Now is a good time to listen to doctors and to science—and what they are telling us loud and clear is that despite all our understandable fears—skipping our children’s vaccines right now is a dangerous proposition, both to our children, and to our communities.