Preventive care use has declined significantly amid COVID-19 without major rebound

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The use of preventive care early in the coronavirus pandemic declined significantly and has not resumed despite the reopening of medical offices, according to a new analysis.

Childhood vaccinations dropped 60 percent in April at the height of the pandemic compared to 2019 levels and by June were still down close to 30 percent, according to the nonprofit Health Care Cost Institute (HCCI).

Mammograms and Pap smears were down nearly 80 percent in April and by June were down nearly a quarter from 2019.

The data comes from a sample of millions of health claims across 18 different states and shows most preventive services exhibited significant declines in 2020 compared to 2019, particularly mid-March through mid-April. 

Even by June, utilization appeared to be running below 2019 levels. 

Colonoscopies had the biggest decline, down almost 90 percent at one point in mid-April compared to 2019.  As of June, the procedures have rebounded, but are still down about 30 percent compared to last year.

Mammograms, which fell 77 percent at the height of the pandemic, are still down 23 percent.

The decision to forgo preventive care could have serious implications for Americans’ long-term health and well-being, especially for children. 

Childhood immunizations were down about 60 percent in mid-April in 2020 compared to 2019. This ranged from 75 percent for meningitis and HPV vaccines to 33 percent for others like the diphtheria, tetanus and acellular pertussis family of vaccines.

Parents have likely been concerned about exposing their children to the coronavirus. While other diseases may pose a greater risk to children than COVID-19, the messages to stay at home and only visit a doctor in an emergency likely contributed to the declines.

Vaccine rates had previously been declining in some parts of the country, and the U.S. nearly lost its measles elimination status last year.


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