Newest COVID-19 Side Effect: Measles
Image credit: UNICEF/UNI232413/Stephen
Between March 13 and April 19, the Vaccine for Children Program, which immunizes half of U.S. children, ordered 2.5 million fewer vaccinations than usual. As COVID-19 swept into the country, childhood vaccination was not a priority. Many healthcare centers cancelled well-child visits or replaced them with telemedicine visits that did not include vaccinations. Other facilities were open, but parents feared bringing their child into a doctor’s office during an infectious disease pandemic.
Current CDC recommendations are that children receive 14 vaccinations to protect against 19 different diseases. Many of these diseases can cause debilitation or death, and vaccination is essential to preventing widespread outbreaks. Vaccines are never 100% effective at preventing disease. However, if enough individuals are vaccinated or immune to the disease due to previous infection, then even if an individual gets sick, there is a very low risk that they will transmit the disease to others and cause an outbreak. This concept is known as “herd immunity,” and the threshold to achieve herd immunity varies per disease but is generally above 80%.
Due to COVID-19, the U.S. is now dangerously below that 80% threshold for many childhood diseases. As of May, less than half of 5-month-olds were up to date on their vaccinations. Before COVID-19, over two-third of them were up to date.
Which children are missing their vaccinations? A disproportionately high number of them come from low-income families. The vaccination rate for 7-month-olds is currently 20% lower for children on Medicaid than for other children. These children are already more likely to have trouble accessing healthcare, and now their communities are more likely to suffer disease outbreaks that should be prevented with vaccines. These communities are also significantly more likely to have underlying health conditions that increase the risk of serious illness or death from COVID-19.
Unfortunately, the problem is much worse in other countries. The World Health Organization estimates that over 117 million children will not receive a measles vaccine due to delays of vaccination programs caused by COVID-19. Many of these children live in regions that already have ongoing measles outbreaks, so the potential for a major public health crisis is high. The average person with measles will infect between 12 and 18 other people, making it difficult to stop disease transmission once it becomes widespread in a community. While the death rate of measles is low, 1 in 4 cases requires hospitalization, creating a significant medical care burden at a time when hospitals are crowded with or bracing for surges of COVID-19 patients.
While COVID-19 makes it unsafe to operate vaccination programs as usual, there are alternative ways to ensure that children in the U.S. and around the world receive essential vaccinations. Drive-up/walk-up vaccine clinics, home visits, and use of alternative community spaces to decrease crowding at healthcare centers are all options to consider. These alternatives may require an upfront cost and a diversion of resources from the COVID-19 response, but increased vaccination rates will significantly decrease the risk of a second deadly disease outbreak on topic of COVID-19. Such a “double pandemic” could cause the collapse of healthcare systems that are already overrun and have an unprecedented death toll. Increasing childhood vaccination rates is vital, and even more so during COVID-19
Sources:
https://www.statnews.com/2020/05/08/childhood-vaccinations-decline-coronavirus-pandemic/
https://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html
https://www.pbs.org/wgbh/nova/article/herd-immunity/
https://www.cnn.com/2020/05/18/health/vaccination-rates-drop-coronavirus/index.html
https://www.cdc.gov/mmwr/volumes/69/wr/mm6919e2.htm
https://www.bu.edu/sph/2020/04/28/race-and-income-shape-covid-19-risk/
https://www.who.int/immunization/diseases/measles/statement_missing_measles_vaccines_covid-19/en/
https://www.cdc.gov/measles/downloads/MeaslesDataAndStatsSlideSet.pdf?s_cid=cs_3520