Doctor’s Notes: COVID-19 May Create Another Public Health Crisis

A child rides a bike on the Venice beach boardwalk last month. Photo by Ana M. Amortegui.

Children are missing vaccinations at an alarming level, and the likelihood of vaccine-preventable outbreaks could increase in the coming months.

Children have largely been spared from the devastating symptoms of the novel coronavirus, but the pandemic has put them at risk for a number of preventable illnesses. Since COVID-19 was declared a pandemic and stay-at-home orders were put in place, pediatricians across the nation have experienced a substantial decline in patient visits. Understandably, the public feared contracting COVID-19 through community spread and life as we know it was upended in every way imaginable. 

The pandemic put many things on pause, but it wasn’t going to stop children from being born, experiencing illness, requiring follow-up care for chronic conditions and needing important vaccines. Pediatricians quickly adapted to telemedicine; however, you can’t administer vaccinations virtually. 

For years, public health programs have worked hard to make immunization equitable, shielding all children from preventable illnesses such as whooping cough, measles, mumps and rubella, which can lead to serious complications and even death. If children fall behind in their vaccination schedule, immunity will begin to wane, and the likelihood of vaccine-preventable outbreaks will increase in the coming months.

A Centers for Disease Control and Prevention report shows that from mid-March to mid-April, doctors in the Vaccines for Children program ordered about 2.5 million fewer doses of all routine non-influenza vaccines and 250,000 fewer doses of measles-containing vaccines compared to the same period in 2019.

The good news is that many pediatric practices will re-open this month with modifications to resume children’s well visits. If you haven’t heard from your pediatrician yet, call your medical home to ask how and when they plan to resume well visits and vaccinations. With children potentially returning to school in August, it’s important that parents keep their children’s vaccination schedule up to date.

Some health centers will provide vaccinations in the morning and see children who are ill in the afternoon, giving health center staff time to sanitize offices. Some centers will be designated only to see children for well visits, while other centers will only see the sick. Some health centers have even launched drive up vaccination clinics. 

The American Academy of Pediatrics recommends in-person visits should occur whenever possible and are necessary for vital services like comprehensive physical exams, laboratory testing, hearing, vision and oral health screenings, and immunizations.

As a father and a pediatrician, I want to assure you that doctors and health scientists have been meeting regularly to map the best way to deliver care in the months ahead in a safe and efficient way.

It will take time to find our “new normal” and I’d like to remind everyone that we will get through this difficult time together. 

Dr. Ilan Shapiro writes the Doctor’s Notes column for the California Health Report. He is a pediatrician and the medical director of health education and wellness at AltaMed Health Services, the nation’s largest federally qualified community health center. A fellow of the American Academy of Pediatrics, he practices medicine in East Los Angeles.

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