Amid rush for COVID-19 vaccine, preventable childhood disease risks grow
Ava is four years old and can’t catch her breath. Without a vaccine, 1 in 5 children like her are hospitalized; 1 in 20 have pneumonia, and 2 in 1,000 die from swelling of the brain or respiratory failure. I am not describing an infection with SARS-CoV-2 or the vaccine we are seeking, but another highly-contagious respiratory virus with a preventative vaccine that has already helped contain the disease’s spread. Ava has measles.
As scientists and medical professionals work relentlessly to identify effective treatments for those suffering from COVID-19 and rush to create a vaccine to suppress the pandemic, another alarming public health storm is gathering. One of the most worrisome health consequences of COVID-19 is a dramatic drop in the rate of childhood vaccinations. Without successful immunization programs, we face the resurgence of devastating diseases once thought to be left in the past.
The latest statistics on these issues are shocking. We are now seeing an 85 percent decline in pediatric vaccinations for children under five-years-old. On May 8th, the CDC reported that 2.5 million fewer doses of routine non-influenza vaccines were distributed just through the Vaccine for Children program between mid-March and mid-April of this year compared to the same period in 2019. At the same time, 250,000 fewer doses for measles were delivered.
Another CDC report showed a decline in childhood immunizations in Michigan during the pandemic to under 50 percent. In California, routine vaccinations for children declined by 40 percent compared with April of last year, according to the state Department of Public Health. This problem goes beyond our borders – it is a global phenomenon. The WHO estimates that over 80 million children under the age of one are now at risk of contracting diphtheria, measles, polio, mumps, and chickenpox because they lack standard vaccinations.
These diseases conjure images of another time in our history when these diseases were not preventable through immunization. Diphtheria was a leading cause of death, with a case-fatality rate of 20 percent in patients younger than five years of age and over 40. Polio primarily affected kids under five years of age, with 1 in 200 suffering irreversible paralysis and up to 10 percent of those children dying when their muscles used for breathing became immobilized. Between 1980, when 2.6 million people died, and 2014, vaccination decreased deaths from measles by 97 percent. As coverage falls below the level needed to establish herd immunity, measles outbreaks and deaths will occur again.
Bacteria and viruses inhabited the earth long before people did. Still, we developed vaccines to protect our children, ourselves, and through herd immunity, who are vulnerable because they have cancer or are otherwise immunocompromised. As we seek a vaccine for COVID-19, the failure to immunize against diseases we can already prevent will rapidly resurface. The impact of delayed childhood vaccination will be most evident when schools reopen, and kids are hospitalized with these dangerous, preventable diseases. For those of us who care for children, this information is a call to action.
COVID-19 has kept families at home, but this cannot be at the expense of the wellbeing of the same children we are sheltering for their safety. If parents have concerns about visiting the clinic to have their children immunized, they should call and ask for reassurance. Most providers now have safety measures, such as separating sick and healthy children or curbside visits, where you stay in or near your car.
Pediatricians worldwide are urging parents to catch up on their children’s vaccinations. These diseases are preventable. We must not let a legacy of the COVID-19 pandemic be children harmed by other conditions that we have already overcome.
Steven A.N. Goldstein, M.D., Ph.D., is an internationally recognized pediatrician and researcher. He currently serves as vice-chancellor, Health Affairs, University of California, Irvine.