COVID-19 Impact on Child Vaccinations

A perfect storm may be forming, as many parents are not getting their children wellness exams and routine vaccinations.


A potentially devastating perfect storm is forming due a combination of COVID-19 fears and many parents now not getting their children wellness exams and routine vaccinations. The National Foundation of Infection Diseases has reported a 50% decline in well child office visits due to COVID-19 fears since the beginning of this pandemic. The World Health Organization just stated: “The avoidable suffering and death caused by children missing out on routine immunizations could be far greater than COVID-19 itself.”

As we approach the fall and the new school year, new flu season and a potential second surge of COVID-19 cases, there has been a dramatic decline in children receiving routine vaccinations in my home state of New Jersey. According to the NJ Department of Health Commissioner, there has been a 40% decline in the rate of vaccinations in children under two years of age and a 60% decline among children over two. 

Parents need to know that the need to protect their children from COVID-19 does not eliminate the need to protect their children from serious childhood disease like the measles, mumps, chicken pox and whooping cough. This alarming trend is just not happening in NJ; rather, pediatricians around the country and around the world are deeply concerned that proven vaccines will not be received by large numbers of children, resulting in serious unintended consequences in the spread of preventable illnesses.

The Lancet has reported a major disruption in childhood vaccination efforts in poor rural areas around the world.  During the recent COVID-19 lockdown in the province of Karachi in Pakistan, the rate of immunizations dropped over 50% compared with the previous six months. Once the lockdown was lifted, the situation improved, but there was still over a 25% decline in the rate of childhood immunizations. 

What makes matters worse in these impoverished countries are hot spots for not only preventable diseases like the measles but also polio. Pakistan and Afghanistan are the only two remaining countries where polio is still a major problem. In Pakistan, the number of reported polio cases went from 12 in 2018 to 147 in 2019.

The overwhelming challenge now faced by public health officials around the world is how to address not only the worldwide COVID-19 pandemic but the real danger of the resurgence of 100% preventable childhood diseases once thought eradicated. The World Health Organization declared in 2019 that the anti-vaccination movement was a major threat to public health. The anti-science, anti-vaccination and anti-mask movement is a dire threat to all of us.  

See also: COVID-19’s Impact on Delivery of Care

Long before the COVID-19 outbreak, 2019 was the worst year for the outbreak of the measles in 27 years in the U.S., where there were 1,300 cases in 31 states. The major outbreaks in Washington state, New York and New Jersey were all linked directly to unvaccinated people spreading the measles in airports, at ballgames, at weddings and in other public venues.

As a result, there was a major education effort, and several state legislatures voted to take on the anti-vaccination movement. In Washington state, two major outbreaks resulted in the state legislature banning personal and philosophical exemptions for the MMR vaccine. The city of Seattle provided free vaccines prior to banning unvaccinated children from attending school, which was said to be 2,000 students. 

In New Jersey, the state legislature in 2019 fell one vote short of removing personal, philosophical and religious reasons for parents not getting children vaccinated, much to the delight of the anti-vaccination protesters, who held loud protests in the state capital with slogans like “my body, my choice” and actually called members of the state legislature “murderers.” The 2019 measles outbreak in New York and New Jersey were all based in orthodox Jewish neighborhoods where people were declaring “religious freedom.” In a public education campaign, several rabbis went on TV declaring there is no religious prohibition on vaccines. None. There is no major religion in the world that has a religious exemption for vaccinations, except for the Taliban version of Islam.

The anti-science and anti-vaccination movement is beyond dangerous to all of us. As the world awaits a proven COVID-19 vaccine, the anti-science and anti-vaccination movement is already spreading conspiracy theories. 

Let’s get the facts and the truth straight. The entire anti-vaccination movement is based on a documented hoax linking the MMR vaccine to autism, which has been called “the most damaging medical hoax in the past 100 years.” (See, "To Be or Not to Be (Vaccinated)?" 4/28/15.)

These are the undisputed scientific facts about the MMR vaccine, which is considered one of the great public health success stories of all time, along with the polio vaccine and Louis Pasteur.

The MMR vaccine is 99% effective and provides a lifetime of immunity. There is a 90% chance of an unvaccinated person getting infected if exposed to the measles. There is only a 1 in 3,000 chance of a mild reaction to the MMR vaccine. The measles is, in fact, extremely dangerous and can result in hearing loss, pneumonia and even encephalitis, or swelling of the brain. 

It is completely understandable during this pandemic why parents have been afraid of going to the doctor to get their children what should be routine vaccinations. However, if parents do not believe the measles is still around and very dangerous, look at the results of the recent measles outbreak in Samoa. The outbreak there began in September 2019, and by January 2020 there were over 5,700 cases and 83 deaths. The cause was directly attributable to a drop in vaccination rates, from an already low 74% in 2017 to roughly 30% in 2018. Neighboring islands, with 99% vaccination rates, had no such outbreak. Parents need to call their child’s pediatrician office, which can schedule needed vaccinations at safe and effective times, when there are no known sick children present. 

A public education campaign to remind parents that routine vaccinations are critical should be included in the COVID-19 public health announcements from governors and state health officials in coordination with other state executive orders, such as mandating masks in public places and plans for re-opening schools in the fall. 

See also: Strategic Planning in the COVID-19 Era

Parents need to protect their own children, who then might infect other children. The Imperial College London found lockdowns in Europe saved over 3.1 million lives. The University of California, Berkeley Global Health Lab stated that without restrictions in place there would nearly 14 times as many COVID-19 cases in the U.S.  

Don’t be a knucklehead like the protesters last week outside the governor’s home in New Jersey who had a “burn the mask" protest. Wear a mask in public places, get your child the routine vaccinations before school starts and get the flu shot. You will help save lives and prevent major diseases, including your own.

Daniel Miller

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Daniel Miller

Dan Miller is president of Daniel R. Miller, MPH Consulting. He specializes in healthcare-cost containment, absence-management best practices (STD, LTD, FMLA and workers' comp), integrated disability management and workers’ compensation managed care.


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