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As the world descended into a state of confusion and fear this past spring, patients across the nation put routine visits to the doctor on the back burner. That included many concerned parents who chose to forgo well-child visits for their kids, causing pediatric vaccination rates to plummet nationwide.The Centers for Disease Control and Prevention reports that childhood vaccination rates have dropped nearly 15% due to disruptions in routine preventive and nonemergency care caused by the pandemic. As a result, many children are facing the start of the school year with incomplete vaccination compliance.
Fortunately, according to our analysis of routine childhood vaccinations, that trend is starting to correct course, but an undercurrent of volatility remains.
The Underlying Storm
As we’ve observed within the last five years with localized measles outbreaks, delaying or skipping routine childhood vaccinations can carry massive public health consequences. Measles, for example, can spread quickly through susceptible populations and account for significant complications if kids are not vaccinated. That disease has a reproductive (or R) number as high as 12, making it three to six times more contagious than COVID-19. Even a small outbreak can become serious quickly.
What’s more, vaccination is attuned to a rigorous schedule, particularly in the first 19 months of a child’s life. Any significant delay in a vaccination schedule puts a child at greater risk to catch vaccine-preventable diseases that still circulate, such as chicken pox, whooping cough, and Hib. Delaying routine vaccines creates the potential for a shadow pandemic, lurking underneath the surface of the challenges posed by COVID-19.
What We Found
To get to the root of exactly how COVID-19 was affecting this segment of the population, we analyzed our Healthcare Map of real-world patient encounters to track trends in routine childhood vaccines throughout 2020 and compared them year over year to the rates for the same vaccinations in 2019.
The results were stark. Childhood vaccination rates began to fall sharply across the U.S. starting in March of 2020, hitting a low point the week of April 6, 2020, when routine childhood immunizations fell by 50% versus the same week in 2019. Weekly immunization rates continued to stay significantly suppressed vs. 2019 totals throughout April and May, though the magnitude of decline became smaller with each month. By the week of May 25, 2020, the weekly childhood immunization rate was just 6% below the rate seen in the same week of 2019. Starting on June 22, 2020, vaccine rates began to match those of 2019.
Interestingly, these rates of decline followed the same overall trajectory nationwide, regardless of when COVID-19 levels spiked in a given region. All states showed a precipitous drop in vaccination rates in the midst of the COVID-19 peak in the Northeast. This includes the Sunbelt states (Arizona, Texas, and Florida), which experienced outbreaks of COVID-19 that peaked in July, as well as the seven states that never issued stay-at-home orders.
The findings underscore the need for public health messaging that accounts for a pragmatic, stratified, and longitudinal approach across a multifaceted healthcare continuum. This will be important in the absence of a COVID-19 vaccine, as it can allow us to develop both broader strategies that reflect the vulnerabilities for each respective disease and better localized efforts that reflect a specific community’s present situation.
Download the research brief to learn more.