The baby seems to have a mild cold at first, with a runny nose and slight cough. But the cough soon becomes more persistent and severe. Her labored breathing is apparent by her chest tugging in and out, the indentation of her ribs visible as she uses all her effort to breathe. Soon, she becomes fatigued and is rushed to the hospital for respiratory support.
Another child seems slightly irritable and feverish. But within hours, he becomes more lethargic and begins convulsing. He is rushed to the hospital as the bacteria insidiously moves from his nasal passage into the bloodstream and spinal fluid.
No, neither of these are COVID-19, but both equally are frightening. Fortunately, we have a vaccine that protects against the above cases — Pertussis (also known as whooping cough) and Haemophilus b (Hib) meningitis. Unfortunately, one of the many negative impacts of the COVID-19 pandemic is an alarming drop in vaccination rates among children who have stopped coming to their regular checkups due to parental fear of exposure. As the pandemic lingers on for the foreseeable future, this delay is creating a secondary public health risk: the potential for a large cohort of unvaccinated children in our communities.
Pediatricians throughout Virginia are seeing a decline in childhood immunization rates among their patients. The Virginia chapter of the American Academy of Pediatrics did a recent survey of more than 100 providers in Virginia. The results are alarming: Since early March, infant vaccination rates are down 30% and adolescent vaccinations are down 76%.
As a physician, I find this development extremely concerning. When you see a child with Pertussis or Hib meningitis, you never forget it. You want every baby you treat to be protected from contracting these life-threatening diseases.
Before the introduction of the Hib vaccination in 1985, Haemophilus b was the leading cause of meningitis in children under age 5. Of those who survived, 15% to 30% had hearing loss or neurological complications. It also caused other invasive diseases such as epiglottitis and pneumonia in an estimated 20,000 children per year. Since the advent of the Hib vaccine, incidences of bacterial meningitis have dropped to only 2 in 100,000 children. We rarely, if ever, see complications of Hib today.
Many of my colleagues and I fear that this sudden drop in childhood immunization rates will have devastating impacts in the near future. High vaccination rates prevent outbreaks of communicable diseases like those discussed above, as well as measles, polio and diphtheria.
I understand why parents might feel hesitant to bring their otherwise healthy child to a doctor’s office at this time. This pandemic is unlike anything I’ve experienced in my lifetime and we all are figuring out a new normal. And yes, we need to stay at home as much as possible and only go out for essential services. But we must remember that vaccines are essential. They are critical to the health and welfare of our children and communities.
Gov. Ralph Northam spoke to this at his April 27 press briefing and explained that it is essential to vaccinate children on time. The governor, himself a pediatrician, confirmed we are seeing a decline in immunization rates as a result of COVID-19. He urged parents to call their pediatrician or family practice provider, and make sure their children are getting vaccinations on schedule.
Pediatric practices throughout Virginia have made significant accommodations to provide this crucial service during unprecedented times — blocking off morning hours for only well-child visits, examining patients in cars and even home visits, while limiting sick visits to primarily telemedicine. Parents should be reassured that it is both safe and necessary to still receive this care.
As we are inundated with media reports of COVID-19 fatalities, we are reminded of what a world without a much-needed vaccine looks like. When that lifesaving vaccine arrives, and after the initial rush to receive it abates and years go by, let us remember this moment in a time of great fear and vulnerability. Vaccination is the safest thing we can do to protect our children and the health of our communities at large.