Child Vaccination Rate Drops Sharply, Worrying Pediatricians of Public Health Consequences

Florida Department of Health data show a 15 percent reduction in the number of vaccinations administered in March 2020 compared to March 2019 — and a whopping 40 percent reduction in vaccinations administered in April 2020 compared to the previous year. The drop coincided with Gov. Ron DeSantis’ decision to issue a statewide stay-at-home order to help prevent the spread of the novel coronavirus, the cause Covid-19.

The numbers are especially concerning for a county like Flagler, where child immunization was already among the lowest in the state, well before the pandemic struck. Last year, Flagler had the second-highest rate of children not immunized against measles and other communicable diseases, according to the Flagler Health Department. Immunization rates were just under 92 percent for children who’d enrolled in kindergarten. A small portion of those not immunized had a medical exemption, which is generally temporary. A larger portion had a religious exemption, which tends to be permanent.

“We are really emphasizing the need for kids to come in for their well visits and certainly to get their shots because the last thing we want to see is an outbreak of measles on top of everything else,” said Toni Richards-Rowley, a pediatrician in Hillsborough County. “And it’s not just measles. There are other vaccines out there that protect, especially the littlest ones, diseases that can cause meningitis, diseases that can cause blood infections, diseases that can cause whooping cough. All of these things are out there, and children are still at risk even if they are limiting their exposure to other children.”

The immunization data is compiled from the Florida SHOTS system, the statewide online immunization information system initially designed to help health care providers — as well as public and private schools and child-care providers — keep track of children’s immunization records.

While a growing number of people are refusing to vaccinate their children in the state, Richards-Rowley attributed the precipitous drop to the cancellation of pediatrician appointments during the pandemic. Her office has remained open and made changes to keep patients safer, such as eliminating the waiting-room area. Nevertheless, some parents rescheduled appointments for June or July, and others just didn’t show up. About three weeks ago, more than half of the appointments were canceled or rescheduled, she estimated. Now, that figure is closer to about 25 percent.

“People are honestly scared and with good reason. All the information coming out not only from China and Europe and New York and where have you,” she said. “And now the information about (multisystem inflammatory syndrome in children, or MIS-C) where the kids may have no symptoms but a month or two months later have a wicked rash and get very sick. It’s a frightening time, and we try to encourage them but it is still pretty scary for most people.”

Before he issued his stay-at-home order, DeSantis on March 20 issued an executive order directing that all non-essential health care services be halted as the state tried to conserve personal protective equipment and hospital space in case of a Covid-19 surge. The governor in recent weeks has reopened parts of the economy and gave the green light in May for health providers to resume all procedures.

But the green light hasn’t necessarily translated into patients returning. Across the country, anti-vaccine activists have seized on the coronavirus emergency to press their agenda.

South Florida pediatrician Audrey Ofir is the director of the pediatric outpatient clinic at Holtz Center Children’s Hospital and an associate pediatrics professor at the University of Miami. She said that in the last two weeks, as the economy has reopened, an average of 50 percent of families are keeping their children’s appointments at the clinic.

“There’s been an improvement in the show-rate,” said Ofir, who chairs the vaccination committee for the Florida Chapter of the American Academy of Pediatrics. “But it is not constant, is not stable and is still fluctuating. And I think that the fear factor is still here.”

To increase immunization rates, Ofir pointed to a need for a “massive vaccination campaign” that includes public education efforts on the benefits and safety of vaccinations. Doctors also could offer extended hours for vaccinations, and mobile vans could be dispatched at an even greater number of school sites, she said.

The efforts she said, would need the support from the Florida Department of Health, the state agency charged with ensuring public health.

“We cannot let our fight against one disease come at the expense of all our other long-term work in preventing other equally dangerous and other fatal diseases to be forgotten,” she said.

–News Service of Florida and FlaglerLive