Exchanging One Outbreak for Another: The Risk of a Rise in Preventable Diseases Due to Disruptions in Routine Childhood Vaccinations

By the bioMérieux Connection Editors

The COVID-19 pandemic has upended our normal lives in nearly every way. Some effects are mundane inconveniences like having to wait in line outside the grocery store, while others are significant hardships like lost jobs or contracting the SARS-CoV-2 virus. Additionally, disruptions to routine medical care have posed significant challenges for doctors and patients dealing with chronic health conditions. Now, experts are also worried that we might experience a resurgence in preventable illnesses among children because the pandemic has interrupted normal vaccine schedules.

According to a global report from the World Health Organization (WHO), UNICEF, and Gavi, as many as 80 million children under the age of one are at risk for contracting deadly, vaccine-preventable diseases. Many poor and middle-income countries have had to temporarily suspend national vaccination programs because of the health risks that COVID-19 poses to doctors and patients. A recent New York Times article notes that, “Many public health experts say they are worried that deaths from diseases including cholera, rotavirus and diphtheria could far outstrip those from Covid-19 itself.”

Interruptions to vaccinations are not limited to poor and middle-income countries. In the United States, many children are behind on their vaccine schedules because of the pandemic. The Centers for Disease Control and Prevention (CDC) found a marked decline in measles vaccination compared to the same timeframe last year. They say that this finding, “might indicate that U.S. children and their communities face increased risks for outbreaks of vaccine-preventable diseases,” and that there is a “vital need to protect [your] children against serious vaccine-preventable diseases, even as the COVID-19 pandemic continues.”

The U.S. has already experienced a rise in measles cases in the last few years due to declines in vaccination, which has put many children at unnecessary risk for contracting measles and the long-term complications that can come with the disease. Recent research has shown that the measles virus can effectively erase your immune system’s memory, which removes the ability to fight off infectious diseases that you were immune to before. If children continue to fall behind in their vaccines and infectious diseases such as measles begin to circulate at higher rates, this could prove deadly.

While measles is extremely infectious and difficult to contain once it takes hold in a community, it’s not the only infectious disease that could threaten unvaccinated children. In the United States, pertussis (whooping cough) is another common and potentially deadly childhood disease that can be prevented with a vaccine.  Elsewhere in the world, polio poses a major health risk for children. The United States is considered polio-free, along with many other countries, but some nations are still actively fighting the virus. Because the U.S. is polio-free, most people have forgotten what it was like to have that disease run rampant prior to the introduction of a vaccine.

One 74-year-old man, recently profiled in The Guardian, is one of two people in the U.S. still confined to an iron lung, a device that helps people breathe when polio has stolen their ability to do so on their own. He recalls how similar the community impact of Polio was to COVID-19.  “It was like the plague, it drove everybody mad,” said Paul Alexander. “It’s exactly the way it was, it’s almost freaky to me.” The article elaborates, “In places where outbreaks occurred, families sheltered in fear at home with the windows shut. All kinds of public gathering places closed.”

While anti-vaccine sentiment has risen in recent years and is a major threat to our progress against infectious diseases, most people in the United States have continued to follow doctors’ advice and vaccinate their children.  The COVID-19 pandemic’s impact on vaccination may be the first time in recent history where a significant portion of children in the U.S. have gone without vaccines on the recommended schedule. The community health risk this represents is immense—Henrietta Fore, the executive director of UNICEF said that, “While circumstances may require us to temporarily pause some immunization efforts, these immunizations must restart as soon as possible, or we risk exchanging one deadly outbreak for another.”

It is estimated that community vaccination rates of 93% to 95% are necessary to achieve herd immunity and prevent a widespread outbreak of measles. Given that a recent CDC study in Michigan showed that just under half of children under five months old were up to date on their vaccinations (compared with about two-thirds the same time last year), there is significant cause for concern. While the COVID-19 pandemic has disproportionately affected older adults, an outbreak of measles or pertussis would primarily impact young children. Although children’s risk of contracting those infections has been mitigated by following stay-at-home orders, states are now re-opening and people are beginning to resume regular activities. If children don’t receive their vaccines, they may be more likely to contract measles or another preventable disease. Dr. Matthew L. Boulton, a professor of epidemiology and preventive medicine and the University of Michigan said in an interview that, “It is vital that parents and guardians catch up on their children’s vaccinations as soon as possible, because these lapses can become magnified over time.”

Opinions expressed in this article are not necessarily those of bioMérieux, Inc.

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