Pandemic hampers progress on childhood vaccinations

Author: Maren Meyer
northwest asia weekly

Dr. Esther Chung recalls her last year as a resident decades ago when a school-age child was brought to the emergency room with diarrhea. Within minutes, the child became seriously ill, developing a massive rash and requiring intensive care.

“This is one of the worst cases I’ve ever seen,” said Chung, now a professor of pediatrics at Washington University School of Medicine. “The child lost all four limbs due to severe meningococcal disease.”

We now have a vaccine that can help prevent this devastating disease. In 2005, the Centers for Disease Control and Prevention first recommended meningococcal vaccine MenACWY for prepubescents and adolescents.

Today, however, this progress is being reversed. Although a number of vaccines have been developed to prevent diseases such as meningococcal infections, tens of millions of children have not received these vaccines in recent years.

The United Nations Children’s Fund’s “State of the World’s Children 2023” report shows that due to the epidemic, 67 million children have not received some or all childhood vaccinations.

The pandemic has worried frontline health care workers, disrupted the health care system and created supply shortages needed to make vaccines.

“Disruptions caused by the pandemic have disrupted childhood vaccinations almost everywhere, driving vaccination rates to their lowest levels since 2008,” the report said.

Even in Washington state, routine childhood vaccination rates are down 13% in 2021 compared with before the pandemic, leaving children and families here at risk for vaccine-preventable diseases that in many cases had previously been eliminated .

Suspect

Another reason for declining childhood vaccination rates, especially in the United States, is widespread distrust of vaccines. In the United States, only 79% of people have “confidence” in childhood vaccines, the same number as Mongolia (the highest proportion is in India, where 98% believe vaccines help children).

Opposition to vaccines in the United States has only grown since the pandemic began, according to a UNICEF report.

“One of the main reasons for vaccine hesitancy is fear,” Chung said in an interview. “When people feel scared, they turn to anecdotal reports of adverse events and other reasons that heighten their fear.”

Eliminate disease

Typically, a child receives a series of injections to protect him or her from two dozen of the most horrific diseases that have been largely eliminated.

The sequence begins on the baby’s first day of life, when the hepatitis B vaccine is delivered to the hospital.

It is recommended that parents understand the dangers of hepatitis B and any rare side effects that may occur from the vaccine.

“We don’t give the vaccine right away, but rather give the family time to bond with the child and ideally breastfeed, which you could say is the first form of immunization,” Zhong said, because the mother passes some immunity to the child. Had a child. her children.

Ideally, clinicians will share the CDC information sheet and obtain parental consent.

“We want parents to have the opportunity to ask questions and discuss their concerns,” Chung said.

In recent years, medicine has simplified children’s immunization schedules by combining multiple vaccinations into one shot.

Children receive more than a dozen routine vaccines throughout childhood and adolescence, ranging from rotavirus, diphtheria and tetanus to HPV and meningococcal infections.

Why the setback?

But now, because of the pandemic, kids around the world are missing out on the series.

“Why has the pandemic hampered childhood immunization? It has placed huge new demands on health systems, which are often unable to cope. This has exacerbated shortages of existing health workers. This has placed significant pressure on frontline health workers (mainly women), who also have to cope with the additional caregiving burden at home.

Can’t see

Distrust of vaccines exacerbates this effect. For example, in some parts of the United States, some religious groups have been opposed to vaccines. Members of these communities, often high school or college students, sometimes travel abroad, contract food or other diseases and then bring them home.

The current wave of medical students and residents also aren’t necessarily advising parents about vaccines the way previous generations did.

“Most students haven’t seen firsthand the impact of some of these diseases, which have largely been eradicated,” Chung said.

“For example, many people may think mumps is just swelling of the cheeks,” Chung said.

But in fact, childhood illnesses can cause swollen testicles and fertility problems,

Haemophilus influenzae type bIt has only recently weakened, potentially causing lifelong catastrophic damage.

“I see this as a resident — kids are getting very sick and continue to have neurological damage, and some of them are now wheelchair-bound,” Chung said. “I’m happy to say that because of childhood vaccinations, we don’t see many of the diseases that I saw as a resident.”

one of the greatest achievements

What’s even more regrettable is that by many benchmarks, progress in eliminating many of these diseases through vaccination is considered one of the greatest achievements of modern medicine.

“Since 1900, the average American life expectancy has increased by more than 30 years; 25 years of this gain attributed to advances in public health,” according to the CDC. “Vaccination… has eradicated smallpox; eliminated polio in the Americas; and controlled dietary, rubella, tetanus, diphtheria, Haemophilus influenza b and other infectious diseases in the United States and other parts of the world. “

Additionally, the financial returns from vaccination efforts are unprecedented in the history of health care.

Globally, for every $1 spent on vaccinations, $26 is saved in health care costs.

From a strictly financial perspective, that’s like a stock returning 26% of its value every year, which is almost unheard of.

And the “return” here is measured in the life of the child.

hope

As a result of the strain the pandemic has put on health care, we are now back to vaccination rates where we were nearly two decades ago, roughly equivalent to the 2008 baseline, when the vaccine campaign really started to take hold and take hold.

The good news is that, according to UNICEF, a similar campaign to vaccinate children is possible given that much of the world’s population can be vaccinated against COVID-19 so quickly and effectively.

“The decline in immunization rates throughout the pandemic should be a wake-up call: routine immunization must become a priority in the coming years. We must take concerted action to catch up with children who have missed out on vaccinations during the pandemic, rebuild systems and address critical gaps in the health system. “Failing to act will destroy the lives of today’s children and teenagers and tomorrow’s adults. “

priorities

However, UNICEF says that for many children, this will soon be too late as they are beyond the typical childhood vaccination age.

In fact, due to insufficient vaccination, some of the worst diseases of the past are almost certain to return.

What can be done?

“To achieve vaccination, political will must become a priority for countries,” the report said.

It urges policies that find the will to vaccinate every child, increase vaccine confidence, use it in more and more effective ways for immunization, and build shock-proof health care systems.

Mahlon can be reached at info@nwasianweekly.com.

This health series is made possible with a grant from the Seattle and King County Public Health Department, which has no editorial input or oversight of this content.

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