COVID-19 Continues to “Unravel” Progress on Routine Vaccinations
VeryWell Health | June 13, 2022
Research shows many children and adults may be behind on routine immunizations because of the pandemic. Stay-at-home orders and healthcare staffing shortages have likely contributed to a decline in vaccinations.
Routine vaccination rates continue to lag behind pre-pandemic levels, so researchers worry people aren’t catching up on their shots.
If you aren’t sure if you or your child have missed a vaccine, consult your healthcare provider.
New reports suggest that many people are not still caught up on routine vaccine schedules that were disrupted by missed appointments throughout the pandemic. The reports suggest stay-at-home orders, fear of COVID-19 exposure, and healthcare staffing shortages have likely contributed to the decrease in vaccinations for measles, hepatitis A and B, meningitis, tetanus, and more. As pandemic restrictions ease up, immunization rates have yet to rebound enough to make up for the decline. Soumi Eachempati, MD, co-founder and CEO of health management platform CLEARED4, told Verywell that vaccination rates dropped dramatically in 2020 and they’ve only gone back to baseline in 2021, but not higher. By late 2021, routine vaccination rates still lagged well behind pre-pandemic levels. Therefore, many children and adults likely need to catch up on their immunization schedules in 2022. “The pandemic is unraveling years of progress in routine immunization and exposing millions of children to deadly, preventable diseases,” Seth Berkley, MD, CEO of Gavi, the Vaccine Alliance, said in a UNICEF press release. Falling Rates and Not Enough Rebound The bulk of COVID-related restrictions from the Centers for Disease Control and Prevention (CDC) lasted from mid-March through the end of May 2020.2 Many people did not see a healthcare provider in-person during that time except for emergencies or critical illness, and routine vaccinations, in many cases, fell to the wayside. “We had really transitioned to just trying to triage and trying to get our hands around this pandemic,” Lori Weir Solomon, MD, MPH, chair and clinical associate professor of family and community medicine at New York Medical College, told Verywell. “We limited our patient visits, and some offices closed altogether. It was really difficult.” COVID-19 Is Impacting Vaccination Rates of All Ages, Including Adults Even when restrictions were eased, not everyone was comfortable visiting a doctor’s office. Now, staffing shortages are stalling preventive care even further. “There’s such a pent-up demand for primary care,” Solomon said. “I had a patient come in and say that she had tried to schedule an appointment with her primary care doctor for a physical and was told that she wouldn’t get one for two years.” Pediatric vaccines are generally given at wellness visits, for which many families fell behind and are still catching up. “Now we’ve got this big backlog of children that need their well exams and their vaccines updated. And it’s hard to get them all through all at the same time,” she said. Another issue may involve fear of vaccine side effects. The shingles (herpes zoster) vaccine, for example, can cause a temporary fever and chills; both are symptoms that overlap with COVID-19. “I had to stop giving the shingles vaccine because I found that I was having to bring people back in to test for COVID,” Solomon said. She’s returned to administering this vaccine now. But in the early months of the pandemic, access to testing was unavailable or limited and getting results took time. That meant if side effects from the shingles vaccine occurred, people had to quarantine because they couldn’t rule out COVID-19. What You Say to Your Child Minutes After Vaccination Can Calm Them The pandemic may have also exacerbated existing healthcare disparities. A 2021 study reviewed children’s vaccination data from the Vaccine Safety Datalink for eight different health systems across six states. The researchers found that the proportion of those up to date on their vaccines was lowest in non-Hispanic Black children across most age groups, both during and before the pandemic. As of September 2020, only 41% of 18-month-old Black infants in the cohort were up to date with their vaccinations.
“They may have had a higher chance of losing a parent to COVID,” Eachempati said. “They may be socially disadvantaged in getting to a clinic that’s open, and the clinics that are open may be too busy.”
How Are Healthcare Providers Keeping People Safe? As families work to get caught up on vaccines, healthcare providers should have safety measures in place to keep patients safe, Solomon said. These include the basics of masking and social distancing. But other precautions may include screening people for COVID-19 symptoms when they arrive and keeping sick patients separated from those who aren’t. “In our practice, anyone who’s sick, who has symptoms, is roomed immediately by certain people in protective equipment,” Solomon said. Additionally, some clinics may keep separate hours for patients who are feeling ill and those who are getting check-ups. Ask an Expert: How Can Adults Stay on Top of Routine Vaccines? How to Know If You’ve Missed a Vaccination The CDC website lists recommended immunization schedules for children and adolescents and for adults. If you know you or your child have missed a routine vaccination or booster, Solomon says to talk to your physician about what to do. The CDC has released catch-up guidance for healthcare providers to follow for pediatric and adolescent immunizations. In the case of a booster, Solomon says, “You can usually just pick up where you left off for most vaccines.” If you’re not sure which vaccines you need, your primary care provider should be able to access your healthcare records to let you know. If you’ve moved or switched providers, you can have your old records transferred. Solomon also recommends reviewing your health insurance plan for healthcare services you’ve received, such as inoculations. When it comes to children's vaccinations, most states have an immunization information system (IIS), operated by the state’s health department, which allows providers to keep track of vaccine history. But for some registries, like in New York state, according to Solomon, you’ll need a physician to access the database for you. Depending on the state, an IIS may also keep track of adult vaccine history. In some situations, your doctor may be able to test for antibodies to see if you or your child has immunity to a disease, which can help determine if you need a vaccination. If you’re unable to access your vaccination history or test, the CDC says it’s safe—though not ideal—to repeat a vaccine. The important thing is to make sure you and your loved ones are up to date on vaccinations. “With the COVID vaccine, we’ve seen clear data on what happens when you vaccinate,” Solomon said. “We see that it may not always prevent the disease, but it certainly prevents the bad complications of the disease. And that concept holds true for pretty much every vaccine that we have.”