How COVID-19 Has Impacted Pediatric Wellness Visits

Our whole world has been turned upside down. One year ago, you were enjoying social activities, going to the beach, watching and participating in competitive sports, and visiting your physician if you had a medical problem. Since the beginning of this year, however, we have experienced a global pandemic with a coronavirus that has rapidly spread throughout the world. This phenomenon was fairly unknown to current generations, as the most recent pandemic of this nature occurred with the Spanish flu over 100 years ago. To date, the world has experienced tens of thousands of deaths and crippling, long lasting disease, overflowing hospitals, overwhelming fear and the addition of new terms to our vocabulary such as “social distancing” and “flatten the curve.”

With the onslaught of this international pandemic and no available adequate medical therapy, we have been forced to isolate ourselves and our families until a protective vaccine is developed. There is currently an international race to acquire this vaccine, however, vaccines require intensive safety and efficacy testing on thousands of people. It is likely that a vaccine for COVID-19 will not be available until the end of this calendar year.

One of the unintended consequences of this isolation due to the COVID-19 virus has been the disruption of routine childhood vaccinations. The decrease of administered vaccines is on a scale that hasn’t been  seen since widespread immunization programs began in the 1970s. Vaccine disruption has been caused by several circumstances. Parents are no longer taking children to clinics because of movement restrictions imposed by spread of the coronavirus or fear of risk of exposure to this virus. Health workers who provide vaccinations have also been diverted to help with response to the pandemic. This disruption has caused some 80 million children around the world to be at higher risk for preventable infectious diseases such as diphtheria, whooping cough, measles and polio.

According to the World Health Organization, UNICEF and the Sabin Vaccine Institute, childhood vaccine programs have been disrupted in at least 68 countries due to the COVID pandemic. With the expected continuation of the pandemic, this immense vaccination program is now under threat, risking the resurgence of previously controlled infectious diseases.

A CDC morbidity and mortality weekly report issued in May 2020 examined the pandemic’s effect on childhood vaccines. This report documented substantial decreases in the number of vaccines ordered and administered to children since the United States declared an international emergency in response to the COVID-19 pandemic in March 2020.

Routine childhood immunizations remain a vital component of pediatric healthcare, even during the COVID-19 pandemic. Children’s immune systems are still developing from passive immunity acquired through the mother’s placenta in utero. Vaccinations help produce antibodies (active immunity) in those who receive them, allowing the immune system to recognize viruses or bacteria and fight off these diseases or limit the severity of complications if exposed to the actual disease. Immunizations also protect public health through herd immunity, preventing widespread outbreak of highly infectious diseases, particularly measles and whooping cough. Individuals who have not been vaccinated and contract these infectious diseases could spread it to susceptible individuals for up to a week before developing any personal symptoms. Some childhood vaccines that were once believed to lead to lifelong immunity have actually been found to decrease in effectiveness during patients’ late teenage years, particularly for pertussis (whooping cough). Recently, recommendations for adult immunizations have changed to include boosters for diphtheria, tetanus, whooping cough and measles. The likelihood of catastrophic spread of common infectious diseases, such as whooping cough, drastically increases if a large portion of the adult population is able to contract the virus without realizing it.

The CDC continues to encourage childhood immunizations during the COVID-19 crisis, with recent recommendations for healthcare providers to continue with patient visits during this pandemic. For parents who choose not to immunize their children during the pandemic, there are “catch-up” schedules provided by the CDC so the children won’t need to start over or repeat doses that have already been received. Many childcare centers are also allowing a grace period for childhood immunizations at this time. In order to help reduce the spread of these viruses, the CDC recommends social distancing and separating sick children from well children.

As of yet, there have been no reports of localized outbreaks of common pediatric infectious diseases such as measles, whooping cough or polio. However, these diseases are still present in the community and if immunization levels drop and herd immunity slips below 70%, the potential for outbreaks both internationally and in the U.S. increase. Our team currently urges patients to please make every attempt to maintain routine childhood immunizations for your children during this pandemic. We are also hopeful for a rapid and effective COVID-19 vaccine!