According to two May studies released by the Centers for Disease Control and Prevention, vaccination rates nationally have declined to as low as 50 percent in some age brackets. Typically, more than 90 percent of children nationwide, and nearly 95 of children in Connecticut, are fully vaccinated.
In Connecticut, the distribution state-supplied pediatric vaccines dropped 13 percent in March, 43 percent in April and 34 percent May compared to previous monthly figures for 2019 according to the Connecticut Department of Public Health.
“We had a couple months where very few children were being vaccinated,” explained Dr. Juan Salazar, the physician-in-chief executive vice president of academic affairs at Connecticut Children’s Medical Center.
He attributed the drop to shortages of personal protective equipment, fear of visiting a medical office during the pandemic and the lockdown.
“Now, most everyone has really ramped up their services to provide vaccinations and well-child visits. The next two months before school starts are critical,” said Salazar.
Despite significant barriers to medical care this spring and summer, the state Department of Education has decided not to provide new exemptions for students without up-to-date vaccinations.
“The Connecticut Immunization Program surveyed pediatric vaccine providers to determine whether a grace period should be considered for immunizations required for the start of school this fall,” Kathy Kudish, the Immunization Program Manager for the Department of Public Health, explained in a June 17 letter to superintendents across the state. “Based on the responses from the survey and from discussions with other state and federal partners, the Immunization Program has decided that it is in the best interest of all students to be up to date on their immunizations for the start of school, and that catch up of children who are overdue for vaccines is logistically feasible.”
Two critical months
“We have a window right now. We have the lowest percentage of positivity in the country, so we are in really good shape. Before it changes, let’s get those kids in to the pediatrician,” Salazar said.
At many pediatric offices, extended hours including evenings and Saturdays, have been added in an effort to catch up. Some facilities have even begun offering drive-through vaccinations, the same model now being used for COVID testing.
According to state officials, the lack of flexibility from the Departments of Education and Public Health is due to the potentially catastrophic effects that an outbreak of diseases like measles, polio or meningitis could have on the school-age population.
“We all worry about measles,” Salazar said. “When comparing the SARS virus to measles, there is a logarithmic difference in magnitude when it comes to transmissibility between the two.”
As Salazar put it, a mask will help against COVID-19. It will do nothing to prevent the spread of measles.
“An outbreak could be devastating,” he said.
The next hurdle
When school resumes in late August, rather than a break, pediatricians across the state will face the next hurdle, beginning in September, the flu.
With similarities in symptoms between influenza and COVID-19, Salazar said it will be important to prevent as many children as possible from contracting the flu in order to prevent unnecessary school closures.
“In recent years, we’ve gotten better at flu vaccinations in kids, but still only about 40 to 50 percent of kids typically get it. We really need to push this year,” he said. “It’s not a perfect vaccine, but if you can prevent the more severe cases of flu it would put less burden on our hospitals as we anticipate a second wave of COVID.”
Salazar said that the goal is for between 80 and 90 percent of children to receive the flu vaccine by the end of October.
The sooner everyone gets the flu vaccine the better, according to Matthew Carter, the State Epidemiologist, in preparation for the second wave of COVID-19 anticipated to hit early in the fall.
“If we are seeing lots of COVID-19 activity and we are trying to give people vaccines at the same time,that could put a real strain on all the systems and cause more spread of the virus,” Carter said.
Both Carter and Salazar agreed that how the flu vaccine is delivered by pediatricians and family practice providers alike during the COVID-19 pandemic will require a lot of creativity.