Fewer Michigan children got vaccinations while the state was in throes of coronavirus-related shutdowns, leaving health officials worried about the spread of preventable diseases like measles, whooping cough and influenza.
Vaccinations have increased since they took a precipitous drop this spring, but numbers are still down significantly compared to 2018 and 2019, according to the state health department.
In June 2020, dosages of vaccines administered through federal or state fundingdropped 10% compared to an average combining June 2018 and June 2019, according to the Michigan Department of Health and Human Services.
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That's an improvement over May's 44% decrease and April's 64% decrease compared to the prior two years.
As of June, 53% of Michigan toddlers between 19 months and three-years-old were considered up to date on vaccinations for a host of diseases includingchickenpox, polio, measles and hepatitis A. In June of last year, it was roughly58%.
Michigan Gov. Gretchen Whitmer ordered a suspension of "non-essential" medical procedures in mid-March with the intention of slowing the spread of COVID-19, a contagious respiratory disease.
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Pediatricians: Time to come back for vaccines
Whitmer lifted that restriction in May, but it appears many parents are still avoiding check-ups because of fears of COVID-19 infection. And other parents could be facing a wait list as pediatricians work through a backlog after cancelling appointments earlier this year, said Dr. Jonathan Gold, a pediatrician and an associate professor at Michigan State University's College of Human Medicine.
Plus, guardians may have lost health insurance along with their jobs during a virus-related recession, causing them to put off health care visits, said Dr. Sharon Swindell, president of the Michigan Chapter of the American Academy of Pediatrics.Families may not be aware of a federal program called Vaccines for Children that covers immunization for uninsured and under-insured children, she noted.
There is no vaccine to prevent COVID-19 infection— yet— but pediatricians and state health officials sayit is time for children to go back to their health care providers for other routine vaccinations.
Bob Swanson, director of MDHHS' immunization division, called Michigan's drop in vaccinations this spring "very concerning." Doctors can use an altered dosage schedule to catch up children who are behind on vaccines and the state health department plans to use social media and other resources to remind peopleto get vaccinated during the pandemic.
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CDC has guidelines on vaccinating during pandemic
Guidelines from the U.S. Centers for Disease Control and Prevention urge health care providers to give vaccinations during the COVID-19 outbreakwhile taking certain precautions. That includes requiring face masks for people over two years old andhaving patients wait in their cars instead of a crowded lobby.
Scientific evidence overwhelmingly points to the efficacy of vaccines, and groups including American Medical Association and theWorld Health Organization have affirmed their importance.
A small minority of people have medical conditions that prevent them from getting certain vaccines, but, if enough people are vaccinated, herd immunity should protect even vulnerable, unvaccinated people from disease.
Close to 95% of the population needs to be vaccinated to create herdimmunity against measles, which is highly contagious. For a less contagious disease, such as polio, herd immunity is between 80% and 85%.
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Immunization rates in Ingham, Clinton, Eaton counties
In Clinton County, 53% of toddlers in late July were up to date with a list of vaccines including hepatitis A, a decrease of 3% since a year ago, according to the Mid-Michigan District Health Department.
The Mid-Michigan District Health Department had closed its vaccination clinicsin March because of Whitmer's order, but reopened them in June, making it a "top priority to get infants through adolescents caught up on any vaccinations they may have missed," spokeswoman Leslie Kinnee said.
In Eaton County, 53%children between 19 and 35 months were fully up to date with their vaccines including hepatitis A compared to 47% in Ingham County, according to the most-recent numbers provided by local health departments.
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MDHHS plans vaccine push for flu season
"If we let the vaccine rates fall, we are opening up the situation for a vaccine-preventable disease outbreak," Swindell warned. "We don't want a measles epidemic adding to the COVID epidemic. We don't wantwhooping cough to start circulating on top of everything else."
The approach of flu seasonis a major concern and the state health departmentis planning a campaign this fall to encourage influenza vaccinations. An onslaught of flu cases could overwhelm hospitals, making it difficult for the health care system to devote resourcesto the novel coronavirus. Some flu symptoms, such asfatigue, fever and coughing, overlap with COVID-19 symptoms, which can complicate diagnosis, Gold said.
It's not clear how many Michigan schools will be holding classes in person this fall, but, even if kids are not gathering in classrooms, they could easily transmit vaccine-preventable diseases to each other in settings such asday cares and play dates, Gold said.
Children enrolling in Michigan schools and child care centers need to either get vaccinated or obtain a waiver citing their medical, philosophical or religious reasons for not doing so.
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Parents still need waiver to opt out of vaccines
Because of a 2015 policy, Michiganders seeking non-medical waivers must first attend a consultation with theircounty health department about the importance of vaccines.The policy, which made it more difficult to opt out of vaccines, led to an increase in Michigan's immunization rates.
The Department of Health and Human Services has not suspended its waiver requirement during the COVID-19 pandemic, but a vaccine consultation would not necessarily need to happen in person, depending on the procedures of a local health department,Swanson said.
Swindell, who haspracticed pediatrics for nearly 30 years, urgesparents to reconsider opting out.
"I would often say to my patients, 'If there's one thing I could doit would bevaccinate your child,'" Swindellsaid. "Vaccines have been so effective at protecting children from a number of infectious diseases that used to kill them or cause significant illness."
Contact reporter Sarah Lehr at slehr@lsj.com. Follow her on Twitter @SarahGLehr.