Concerns about the Covid vaccine are starting to spill over into routine vaccinations
This has worried pediatricians, school nurses and public health experts that preventable and possibly fatal childhood diseases, once thought to be a thing of the past, may become more common.
“We just want to keep measles, polio and all the things we vaccinate against out of the political arena,” said Hugo Scornik, pediatrician and president of the Georgia Chapter of the American Academy of Pediatrics.
He was alarmed by the introduction over the past year of several bills in the state legislature to restrict vaccinations, including one that would end immunization requirements in schools. Several states have considered similar pieces of legislation that would have removed or reduced school vaccination requirements, although none have moved forward.
As the pandemic began, vaccination rates for children plummeted. In 2020, the Centers for Disease Control and Prevention recorded a 15% drop from pre-pandemic levels in state orders for vaccines for children, the federal program through which about half of the children in the country are immunized. In 2021, order levels were about 7% lower than pre-pandemic levels, according to the CDC.
In Florida, where the surgeon general announced last month that healthy children may not benefit from Covid vaccines, routine rates for 2-year-olds for all vaccinations in county-managed facilities plummeted from 92.1% in 2019 to 79.3% in 2021.
In Tennessee, nearly 14% fewer doses of the vaccine were given to children under the age of 2 in 2020 and 2021 than before the pandemic.
And in Idaho, the number of children who received the first dose of the measles, mumps, and rubella (MMR) vaccine within 2 years decreased from about 21,000 in 2018 and 2019 to 17,000 in 2021.
Proponents of immunization say polarized attitudes towards the Covid-19 injection have made it more difficult to organize and promote immunization events at school as school principals and nurses navigate the difficult territory of building trust within their own. community while encouraging vaccination. This makes it more difficult for children to get vaccinated even when their parents want them to be vaccinated.
Between 2010 and 2020, the last year for which national data are available, vaccination rates in children under 3 years hepatitis B, polio, chickenpox, and MMR hovered around 90 percent and were essentially unchanged, while rates for the pneumonia vaccine and rotavirus increased significantly. Meanwhile, the percentage of children without strokes has grown from 0.6% to 1%. The CDC is expected to release new data on national immunization rates for kindergarten children in 2020-2021 next week.
Parents who were reluctant to vaccinate their children before the pandemic have now been joined by people who think the government mishandled the crisis, see Covid-19 vaccine mandates as a federal override, or are exposed to misinformation about childhood vaccinations. , said Rupali Limaye, a professor of international health at the Johns Hopkins Bloomberg School of Public Health.
“You have a decline in trust in your government and people looking for other sources to inform their decision-making process,” he said. “So they go to social media, [where] disinformation is overtaking evidence-based information. “
Proponents of immunization say it was easier to suppress spurious claims that drove pre-pandemic hesitation, such as that vaccines cause autism. But it is more difficult to dismiss a discussion of personal freedom from government mandates.
“I would have told you in April 2020 that this was indeed our time to reverse the anti-vaccine trend,” said Melissa Wervey Arnold, Ohio Chapter CEO of the American Academy of Pediatrics. “Unfortunately, however, the freedom movement has taken over”.
Only approx 45 percent of eligible children in the United States have received at least one dose of the Covid-19 vaccine, according to the CDC.
“Parents are starting to ask the same questions they had with the Covid-19 vaccine,” said Nola Jean Ernest, a pediatrician at Enterprise, Alabama, and president-elect of the Alabama Chapter of the American Academy of Pediatrics. “‘Is it worth it? Do my children need this vaccine?’ This is the hesitation that begins to blossom. “
So far, there hasn’t been a spike in preventable childhood diseases, but public health experts fear it’s only a matter of time if they can’t significantly increase immunization rates. In 2019, the United States reported the largest number of measles cases in 27 years, with outbreaks clustered in parts of New York and the Pacific Northwest with low vaccination rates.
Part of the challenge for public health experts looking to anticipate the next epidemic or find vulnerable communities is that the availability of up-to-date vaccination data varies greatly from state to state.
Heather Gagliano, director of operations and education for the Idaho Immunization Coalition, said delays in the data make it difficult to prove the extent of the problem.
“In my years with vaccinations, I’ve seen people who always worried,” Gagliano said. “But they were very few. I am concerned that it is becoming much more mainstream in that conversation where disinformation and disinformation are somehow accepted as truth more than ever before.
Data on exemption requests, another window into how many families choose not to vaccinate their children, are also slow. But the information that exists shows a small but growing number of families giving up vaccination in some states.
In North Dakota, requests for religious, moral, and philosophical exemptions increased from 3.6% during the 2019-2020 school year to 4.46% for the current school year.
In South Carolina, which grants exemptions for religious reasons only, not personal beliefs, the number of exempt students has steadily increased over the past five years, from 1.2% in the 2017-2018 school year to 2% this year. .
A spokesperson for the South Carolina health department declined to comment specifically on the reasons for the change in vaccination patterns, but said “there are many factors and trends involved.” But Amanda Santamaria, director of nursing services at Dorchester School District Two in Summerville, SC, and president of the South Carolina Association of School Nurses, believes parents are now looking at vaccines in new ways.
“It made people look at vaccines in general for students and children under a finer microscope,” Santamaria said.
Pediatric service providers believe more information is circulating on how to circumvent vaccination requirements through exemptions, contributing to lower than usual immunization rates.
“It used to be very rare for a religious exemption,” said Kimberlee Wyche-Etheridge, senior vice president of health equity and diversity initiatives at the Nashville Association of State and Territorial Health Officers and Pediatrician. “Now, it looks like there’s that option on the table.”
In places like Colorado, Louisiana, Mississippi, and New York, state health officials and pediatricians say they don’t see obvious differences in parental attitudes towards immunization or in the available data.
There has always been a small group of parents who resist childhood vaccinations, but if doctors can get parents into the office and answer their questions, they can usually get them to vaccinate their children, said Eric France, pediatrician. and chief medical officer for the Colorado Department of Public Health and the Environment.
But in many parts of the country, the pandemic has affected parents’ views on vaccinations in ways that states shouldn’t ignore, warned Patsy Stinchfield, a pediatric nurse who has practiced infectious diseases as a vaccine specialist at Children’s Minnesota, a. non-profit organization pediatric hospital and elected president of the National Foundation for Infectious Diseases. In Minnesota, more than a third of 2-year-olds were not up to date with vaccines in 2021.
“It is worthwhile for all states, both in the private and public sectors, to pay close attention to it as well as extreme energy towards this problem, because it will not solve itself,” he said.
When it became clear that children were late on vaccines, the CDC, as well as other national organizations such as the AAP, launched campaigns to encourage parents to catch up, said Georgina Peacock, acting director of the division of children. CDC immunization services.
During the pandemic, the CDC provided grants to community organizations across the country to improve Americans’ confidence in vaccines. The agency has also hired and trained vaccine demand strategists, health equity officials and adult immunization coordinators to help state health departments promote Covid-19 vaccines and increasingly routine vaccinations. .
But immunization advocates fear that without further work to combat general vaccine hesitation, the anti-vaccination movement will strengthen.
Some vaccine advocates are finding it increasingly difficult to conduct awareness. Santamaria, South Carolina, said her school district has promoted vaccination clinics in schools as a program offered by the district, rather than individual schools, to protect school principals and nurses from anti vaccine knockback.
Erica Harp, chief nurse at Great Falls Public Schools in Great Falls, Montana, said she is cautious with her defense of immunization these days.
“Vaccination was something the school nurse always supported and talked about, and I hope we can continue to do that,” Harp said. “You are always concerned about how you are perceived in the community … Our schools are not obliged to have school nurses. You always try to make sure you protect your job, almost.