Children are lagging behind in routine vaccination. The covid vaccine hesitation is not helping.

This has worried pediatricians, school nurses and public health experts that preventable and potentially fatal childhood diseases, once thought to be a thing of the past, may become more common.

“We just want to keep measles, polio and everything that we vaccinate against out of the political arena,” said Hugo Skornik, a pediatrician and president of the Georgia chapter of the American Academy of Pediatrics.

He was concerned over several bills introduced in the state legislature last year to limit vaccinations, including one that would eliminate vaccination requirements in schools. Several states considered similar laws that either removed or did away with school vaccination requirements, though none went further.

At the start of the pandemic, vaccination rates for children fell. In 2020, the Centers for Disease Control and Prevention saw a 15 percent drop from pre-pandemic levels in states’ orders for vaccines for children, the federal program through which nearly half of children in the country are vaccinated. According to the CDC, in 2021, order levels were about 7 percent below pre-pandemic levels.

in Florida, where the surgeon general last month’s announcement Healthy children may not benefit from COVID vaccine, 2-year regular rate for all vaccinations in county operated facilities Falling from 92.1 percent in 2019 to 79.3 percent in 2021.

In Tennessee, about 14 percent fewer vaccine doses were given to children under the age of 2 in 2020 and 2021 than before the pandemic.

And in Idaho, the number of children receiving the first dose of the measles, mumps and rubella (MMR) vaccine by age 2 dropped from about 21,000 in 2018 and 2019 to 17,000 in 2021.

Vaccination advocates say the polarized approach to the COVID-19 shot has made it difficult to capture and promote school-based vaccination programs as principals and school nurses work in the area of ​​building trust within their communities while encouraging vaccination. Let’s navigate. This is making it even more difficult for children to get their shots, even when their parents want them to get vaccinated.

Between 2010 and 2020, the last year for which national data are available, vaccination rates among children under 3 Hepatitis B, polio, chickenpox and MMR were about 90 percent and were remained largely unchanged, while pneumonia and rotavirus vaccine rates increased significantly. Meanwhile, the percentage of children without the shot increased from 0.6 percent to 1 percent. The CDC is expected to release new data on national vaccination rates for kindergartners in 2020-2021 next week.

Parents who were hesitant to vaccinate their children before the pandemic now join those who think the government handled the crisis unfairly, viewing the COVID-19 vaccine mandate as federal overreach. are, or are exposed to, misinformation about childhood immunizations, said Rupali Limaye, Prof. International Health at the Johns Hopkins Bloomberg School of Public Health.

“You get a decline in confidence in your government, and people look to other sources to inform their decision-making process,” she said. “So they go to social media, [where] Misinformation is overtaking evidence-based information.”

Vaccine advocates say it was easy to dismiss the spurious claims that pre-pandemic hesitation, such as vaccines cause autism. But it is hard to back down against an argument about individual liberties from government mandates.

“I would have told you in April 2020 that this would be our moment to really turn the anti-vaccine tide,” said Melissa Verve Arnold, CEO of the Ohio chapter of the American Academy of Pediatrics. “Unfortunately, instead, the independence movement took hold.”

only about 45 percent According to the CDC, eligible children in the US have received at least one dose of the COVID-19 vaccine.

Nola Jean Ernest, a pediatrician in Enterprise, Ala., and president-elect of the Alabama chapter of the American Academy of Pediatrics, said, “Parents are beginning to come to terms with the questions they have with the COVID-19 vaccine. were.” “‘Is it worth it? Do my kids need this vaccine?’ That’s the hesitation that’s starting to grow.”

So far, there has been no increase in childhood diseases, but public health experts fear it is only a matter of time if they are not able to boost vaccination rates meaningfully. In 2019, the US reported the most measles cases in 27 years, with outbreaks in New York and parts of the Pacific Northwest with low vaccination rates.

Part of the challenge for public health experts in forecasting the next outbreak or finding vulnerable communities is that the availability of up-to-date vaccination data varies greatly from state to state.

Heather Gagliano, director of operations and education for the Idaho Immunization Coalition, said the data lag makes it difficult to prove the scale of the problem.

“In my years with immunizations, I’ve seen people who are always anxious,” Gagliano said. “But it was really little. I worry that this is becoming too mainstream in a conversation where somehow misinformation and misinformation are being accepted as more true than before.”

Data on waiver requests – how many families are choosing not to vaccinate their children – is another window too slow. But the information that exists shows a small but growing number of families falling out of vaccination in some states.

In North Dakota, requests for religious, moral and philosophical exemptions increased from 3.6 percent during the 2019-2020 school year to 4.46 percent for the current school year.

In South Carolina, which only offers religious, not personal beliefs, exemptions, the number of exempt students has risen steadily over the past five years, from 1.2 percent in the 2017-2018 school year to 2 percent this year.

A spokesman for South Carolina’s Department of Health declined to comment specifically on the reasons for the shifting vaccination patterns, but said, “There are a lot of factors and trends involved.” But Amanda Santamaria, director of nursing services for Dorchester School District Two in Somerville, SC, and president of the South Carolina Association of School Nurses, believes that parents are now examining vaccines in new ways.

“It prompts people to look at vaccines under a better microscope for students and children in general,” Santamaria said.

Pediatric providers believe that more information is circulating about how to circumvent vaccination requirements through exemptions, which is contributing to lower-than-usual vaccination rates.

“Previously, it was very rare to have a religious exemption,” said Kimberly Wyche-Etheridge, senior vice president of the Health Equity and Diversity Initiative at the Association of State and Territorial Health Officers and a pediatrician in Nashville. “Now, there seems to be that option on the table.”

In places like Colorado, Louisiana, Mississippi and New York, state health officials and pediatricians say they aren’t seeing any significant differences in parents’ attitudes toward vaccination or their available data.

Pediatrician and chief medical officer Eric France said there has always been a small group of parents who oppose childhood vaccinations, but if doctors can bring parents into the office and answer their questions they can usually persuade them to vaccinate their children. Colorado Department of Public Health and Environment.

But in many parts of the country, the pandemic has affected parents’ views on vaccination in a way that states shouldn’t ignore, warned Patsy Stinkfield, a pediatric nurse who works as a vaccine specialist in Children’s Minnesota. Practicing Infectious Disease as a non-profit organization. Pediatric Hospital, and president-elect of the National Foundation for Infectious Diseases. In Minnesota, more than a third of 2-year-olds were not up to date with their vaccines in 2021.

“It deserves all states, both in the private and public sectors, with the utmost attention to this, as well as the utmost energy, towards this problem, because it just won’t fix itself,” she said.

Once it became clear that children were falling behind on vaccines, the CDC, as well as other national organizations such as the AAP, began a campaign to encourage parents to catch up, said Georgina, acting director of the CDC Immunization Services Division. Peacock said.

During the pandemic, CDC provided grants to community organizations around the country to improve Americans’ confidence in vaccines. The agency also hired and trained vaccine demand strategists, health equity officers and adult immunization coordinators to help state health departments promote COVID-19 vaccines, and facilitate rapid, routine immunization.

But vaccination advocates are concerned that without more work to tackle common vaccine hesitation, the anti-vaccination movement will strengthen.

Some vaccine supporters are finding it difficult to conduct outreach. Santamaria in South Carolina said its school district has promoted school-based vaccine clinics as a program offered by the district — not by individual schools — to headmasters and school nurses. to save. anti vaccine feedback

Erica Harp, chief nurse at Great Falls Public Schools in Great Falls, Montana, said she is cautious about her vaccination advocacy these days.

“Vaccination used to be something that the school nurse always advocated and spoke for, and I hope we can continue to do so,” Harp said. “You’re always worried about how you’re being treated in the community… Our schools don’t require school nurses. You’re always trying to make sure you protect your job. are, approx.”

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