By Dr. Peter Jung
A major silver lining of the COVID-19 pandemic is that children as a whole have been relatively safe from severe complications from the virus. This is not to discount the fact that there have been young patients who have ended up in the intensive care unit, developed Multisystem Inflammatory Syndrome in Children (MIS-C) and in rare cases some reported deaths. But for the most part, our kids have fared well. However, there are dark clouds forming on the horizon as immunization rates across the world are at all-time recent lows.
Anyone who has kept abreast of the pandemic has likely received an important and eye-opening education in public health. Herd immunity is the COVID-19 unicorn that is desperately sought after so that life can return to normal without a constant need for masks or social distancing.
Under normal circumstances, everyone should get vaccinated against any germ that they are at risk for. We as a society are blessed to have vaccines against most modern day scourges. Even without reaching 100 percent immunization status of every individual, herd immunity kicks in at some point, effectively preventing a germ from spreading even if a small group of people in society are unvaccinated. The optimum rate to maintain herd immunity for most vaccinations is about 90 to 95 percent.
Unfortunately, as a result of the pandemic and parental fear about visiting the pediatrician’s office, the American Academy of Pediatrics (AAP) is reporting a 20 percent to 30 percent drop in office visits with a subsequent reduction in immunizations administered. One pediatric electronic health records company looked at 1,000 independent pediatricians across the nation and found a 50 percent drop in the measles, mumps and rubella (MMR) vaccine and a 42 percent drop in the tetanus, diphtheria and whooping cough (Tdap and DTap) vaccines.
To put things in perspective, consider that before the measles vaccine was available, the United States typically reported 500,000 cases per year with 500 deaths. Even as recent as 2001, the World Health Organization estimated that there were approximately 30-40 million cases and 745,000 deaths from measles worldwide.
Thankfully, vaccine preventable pathogens have been largely kept at bay by diligent immunization efforts. But even before the pandemic, within the United States, there were pockets of outbreaks of measles, mumps and whooping cough due to enclaves of unvaccinated children. The COVID-19 pandemic is exacerbating these small fires with the potential for another epidemic to erupt.
Pediatricians are well aware of this risk and have been working with the AAP and public health officials to make the office a safe and sterile place for children. Some of the measures we have taken at our office include mandatory mask wearing, separation of well child visit appointment times from sick appointment times, and telemedicine visits and car visits when appropriate. The overarching goal has been to stay on track with immunization schedules and wellness check-ups so that we maintain the health of our patients and the community at large.
As vaccine rates drop across the world, it increases the risk that children will become exposed to a vaccine-preventable illness. This increases the urgency for all parents to stay current with their children’s immunizations.
If the pandemic has taught us anything it is that we are incredibly interconnected with the rest of the globe, and as such, diseases will not abide by borders. Hopefully, in the very near future a vaccine for COVID-19 will be discovered and the world will recover from this wretched virus, but until then we must stay diligent with the vaccines which are already readily available to us.
As Benjamin Franklin once said, “An ounce of prevention is worth a pound of cure.” Nowhere is this more pertinent in public health than it is with immunizations. Our children depend on us to take advantage of this.
Dr. Peter Jung is a pediatrician with Blue Fish Pediatrics in association with Children’s Memorial Hermann Hospital.