Covid-19 Is Threatening Vaccination Rates. Here’s How to Help.

I think all of us remember where we were in March, 2020 when we heard the news: the federal government had declared a national emergency due to the coronavirus and was shutting the country down.

We knew the stay-at-home orders were going to have an effect on our pediatric and family medicine practices. However, none of us could foresee what a devastating impact the pandemic would have on our immunization programs and how it would put our otherwise healthy patients—young and old—at risk.

The reduction in immunizations post-Covid, as documented by Scientific American, is shocking: During the month and a half after the World Health Organization (WHO) declared a pandemic, states’ immunization rates plummeted; in some states, the rates were 60% lower than the same month in 2019. In fact, the WHO and UNICEF issued a statement calling the drop in vaccinations “alarming.” And doctors around the country started to fear that the lack of immunizations could spark new epidemics of vaccine-preventable diseases.

After pulling together to do our best to flatten the pandemic curve, the country began reopening in early June—but our offices remained quiet. Yes, some patients came back, but it was typically for treatment, often via telehealth, rather than for preventive services like annual physicals or well-child exams. And though our vaccination rates rebounded ever so slightly over the summer, current rates remain well below 2019 figures. With virtual patient visits becoming the norm, we’re worried this trend won’t be changing anytime soon.

And now with the flu vaccine season upon us and more states loosening their quarantine restrictions, there is a potential that we’ll be dealing with a “twindemic.” That’s why it’s absolutely critical that we do whatever we can to increase both awareness of and access to immunizations.

I’ve been in practice long enough to remember treating children with some of these horrific diseases. Even if you haven’t seen these diseases in your own practice, I know you share my passion for not returning to a time when a person could die from something we could have easily prevented with an immunization.

Searching for silver linings

In the Covid-19 era, we can—and must—look for silver linings, and here’s one I’ve found: the pandemic has, paradoxically, shone a bright light on the importance of immunizations. It’s also renewed interest in improving the data infrastructure and communication around immunizations. But you don’t have to be in a lab working on a vaccine or in your state capitol working on vaccine policy to play a role in this crisis. You’ve got the power to change things for the better, right from your office.

Take action

Here’s how you can play a part in narrowing the immunization gap in your practice and better serve your patients and your community:

• Create a “culture of immunization” in your practice to get everyone on your staff educated, inspired, and activated to meet the challenges of this unprecedented time.
• Take extra care to stay up-to-date on this year’s influenza vaccine recommendations.
• Develop a plan to educate your patients (or their parents) about the importance of vaccines, in general, and this year’s flu vaccine in particular.
• Be proactive and make a personal recommendation about immunizations to your patients: “You’re important to me as a patient, and I want you to get this vaccine.” The patient can always say no, but your words have power.
• Seize the moment: Always check your patients’ immunization schedules, even if they are in your office for something else. If they’re due, get the immunization done during that visit; don’t make them come back. The CDC is recommending that ALL due and overdue vaccines be given in that visit unless medically contraindicated.
• For your pediatric patients without private insurance, make sure they know about the CDC’s Vaccines for Children program that helps them access vaccines at no cost. If you are not a VFC practice, make sure your pediatric patients can access vaccines at alternative locations, such as at your local health department.

I like to think that Covid-19 could be an inflection point, one of those rare pivotal moments where we have the opportunity to fix our ailing immunization infrastructure and, more broadly, what’s ailing health care. Instead of giving in to pessimism, frustration and fear, we can use the pandemic as an opportunity to rethink and redesign our healthcare system and put the focus back where it belongs—on primary care and on our patients.