As pediatricians we are comfortable with the notion of giving “catch-up” vaccines to children who come into the office and may have missed some of the routine immunization series in childhood. But have we ever had to “catch up” a whole country? Pediatricians in practice have noted the significant drop in routine checkups and subsequent administration of recommended vaccines since the COVID-19 pandemic began in March 2020 with the shuttering of routine care and reluctance of parents to bring children into doctors’ offices. But now we have data showing the impact.
Pre-published in March, but in this month’s Pediatrics, Ackerson et al used the full patient database from Kaiser Permanente of Southern California and compared vaccine rates from 2019 to 2020 (10.1542/peds.2020-047092). Comparing almost a million children from year to year, they found a 25% initial drop-in vaccination rates for children under 2, but an 87% drop in children older than 2. While over time, the rates did begin to show recovery, they did not recover completely to pre-pandemic levels, especially for older children and teenagers. As the authors noted, “Complete vaccination coverage during the reopening period remained lower than it was in 2019 in all age cohorts, particularly among the 7-month-old and 17-year-old cohorts.”
So what can we do? How can we “catch-up” an entire cohort of children spread across the United States? The authors recommend some practice-based system suggestions – like immunization registries, reminders, and recalls – which are really best practices even for normal times. And the American Academy of Pediatrics has launched a social media campaign to #CallYourPediatrician and bring children back for routine care and immunizations. But I think we may need to do more in the setting of increasing science denialism and vaccine refusal across the country. Now is the time for a coordinated and wide-spread public health communication program to increase public support for vaccines. Finally, we need to turn the tide on the increasing number of state legislatures rolling back vaccine mandates and increasing exemptions for personal and religious beliefs. Now is the time for all pediatricians to get involved in the effort to increase vaccination rates and decrease barriers for families to bring their children in for routine care.
