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Plummeting childhood vaccines: the next health crisis?


In the midst of a pandemic, the last thing we need is another outbreak of a highly contagious infection like measles. Unfortunately, the diligent work of stopping the spread of Covid-19 has, for many parents, meant falling behind on having their children routinely vaccinated.

Individually, missing one vaccine shot may not seem like a big deal, but immunization schedules were developed after decades of study, and the sheer number of missed trips to pediatricians during the coronavirus crisis has meant a drastic fall-off in childhood immunizations across the country.

In fact, the Centers for Disease Control and Prevention reports 250,000 fewer doses of measles-containing immunizations ordered from March 23 to May 16 than during the same time period in 2019. And it’s not just measles. There were also about 2.5 million fewer doses of all routine non-influenza vaccines. Across Cohen Children’s Medical Center’s 18 pediatric offices, we saw a 45 percent drop in all vaccinations for children of all ages in that same period.

The good news is that you and your child can catch up. Pediatricians across the country have worked overtime to create safe environments, cleaning protocols and strategies to minimize the risk of Covid infection. Fear of contracting the virus is understandable, but unfortunately, a potential resurgence of preventable infections resulting from missed vaccines is also very real.

One year ago this month, a measles outbreak in New York caused a 30-year high in cases of the highly contagious illness — which still kills hundreds of thousands of people per year globally. That outbreak occurred because in some communities we have seen the number of people vaccinated dip below safe levels, threatening our hard-fought herd immunity, which protects the entire community. When that immunity declines, there’s a greater risk for the infection to spread.

Last year it was just the measles we had to worry about. Today it’s every vaccine-preventable illness, because if kids aren’t coming in for one vaccine, they’re not coming in for any. Measles is our main concern, because of how rapidly it spreads and how it can lead to dehydration, pneumonia and encephalitis, or swelling of the brain. But we also worry about Haemophilus influenzae Type b, a major contributor to meningitis and bacteremia, when the bacteria spreads throughout the blood. Before the Hib vaccination, about 20,000 children younger than 5 developed severe Hib disease in the U.S. each year. About 1,000 died. And that’s 1,000 too many.

Now that we’re in the recovery phase in New York, the risk — to young and old — of contracting Covid-19 is much lower than at any point during this crisis. Not only are there fewer patients, but the physical spaces are now safer, with measures in place to protect any patient who enters a doctor’s office.

That starts with limiting the number of patients. Once in the office, people remain six feet apart — six beach balls of space. To avoid overcrowding, families are sometimes asked to call from their cars when they arrive and wait to be called in.

Frequently, pediatric offices have designated mornings for visits from those who are well and afternoons for “sick visits,” which is another way of assuring the health and protection of those visiting the office. Everyone over age 2 must be masked, and is screened upon entry with a symptom checklist. You will be asked if you have a fever, any symptoms and any known exposure to Covid-19, and based on those answers, you’ll be managed and moved within the office appropriately. Health care providers are dressed in full PPE. You’ll see people with masks, face shields, gowns and gloves, which protect them — but also protect you.

From the waiting room to the medical rooms, frequently touched and trafficked areas are regularly cleaned and disinfected. Some organizations, like Northwell Health, are using ultraviolet light technology to create an additional level of disinfection.

So, health care offices are safe, and you shouldn’t be afraid to see your pediatrician. Vaccinations have changed the game on so many illnesses, saving millions of lives. But that progress can unwind, and it can do so quickly — as it is right now in other parts of the world.

Health care’s mission is to promote and protect the general well-being of the community. We need parents’ help. We can solve this problem together and ensure that we protect the entire herd. The time is now. Please don’t wait until we have another outbreak on our hands. And yes, wash those hands.

Dr. Joshua Rocker is the chief of pediatric emergency medicine at Cohen Children’s Medical Center. Dr. David Fagan is the center’s vice chair of pediatric ambulatory administration. Dr. Charles Schleien is senior vice president and chair of pediatric services at Northwell Health.