In a time of trying to ensure everyone 16 years of age and older are vaccinated with COVID-19 vaccine, how can we focus on childhood vaccinations? Just over one year ago, on March 11, 2020, The World Health Organization (WHO) declared the coronavirus a global pandemic. Since then, Michigan has seen a significant impact on our pediatric vaccination rates, which has been our kryptonite if you will. Until Michigan providers are able to vaccinate pediatric patients with COVID-19 vaccines, we must focus our efforts on getting children caught up on all the recommended vaccinations.
As of March 2021, and according to Michigan Care Improvement Registry (MCIR) data, Michigan’s rate for children 19 to 36 months of age for the 4313314 series is 69.5% (assessing 4 DTaP, 3 Polio, 1 MMR, 3 Hib, 3 HepB, 1 Varicella, 4 PCV). This is the lowest that the rate has been in several years. When two doses of hepatitis A vaccine are added to the series (43133142), the rate drops down to 54.6%. These rates reflect, why it is important to ensure patients continue to receive well-child exams and routine immunizations.
It is easy to see the impact that COVID-19 has had on parents and caregivers in respect to routine appointments for well-child exams and vaccinations. Parents have fears about the transmission of illnesses and with the lack of COVID-19 vaccine to protect their children, it is understandable. It is up to the provider community to work together with parents, to assure parents that now is the time to get back on track with vaccinations. Parents need to know that physician offices have made great strides to keep families safe during their appointments.1 There are resources to assist with educating parents at MDHHS – COVID-19 Vaccine Provider Guidance and Educational Resources (michigan.gov).
Also, the impact of COVID-19 has affected our local health departments (LHDs). They are overwhelmed with running COVID-19 mass vaccination clinics, completing contract tracing, and doing COVID-19 testing. Currently LHDs are struggling to conduct their routine vaccination clinics. Primary care physicians play a significant role in vaccinating Michigan’s children and can help make sure our youngest Michiganders are fully vaccinated with all the routinely recommended vaccinations.
Michigan’s rate for adolescents 13 to 18 years of age for the 1323213 series is 42.8% (assessing 1 Tdap, 3 Polio, 2 MMR, 3 HepB, 2 Varicella, 1 MenACWY, 2 or 3 HPV doses for both male and females). To demonstrate the important role that primary care physicians play in vaccinations, 79.2% of adolescents aged 13 through 17 years, who were vaccinated with HPV, reported receiving it in a doctor’s office, according to a recent NIS teen study.2 Currently with Michigan’s expanded priority groups, adolescents who are 16 years of age and older may be vaccinated with COVID-19 vaccine. The only vaccine currently approved for those adolescents 16 and 17 years of age is the Pfizer-BioNTech COVID-19 vaccine. The American Academy of Pediatrics (AAP) recommends everyone 16 years and older to get vaccinated against COVID-19 and continues to push for trials in younger children and teens.3
Until there is a COVID-19 vaccine approved for use in all children and an ample supply of vaccine available, providers must focus on getting Michigan children protected from vaccine preventable diseases. This will protect and better prepare children for childcare, school, sports, and college. Research consistently shows that a provider’s recommendation to vaccinate is the single most influential factor in convincing parents to vaccinate their children.4 Assure parents that well-child exams and immunizations are both strongly recommended and important for their child’s health. In order to provide optimum protection, follow the Advisory Committee on Immunization Practices (ACIP) and the Centers for Disease Control and Prevention’s (CDC) full immunization schedule by administering all recommended vaccines not just the ones required for school.5 By doing this, the child will be up to date, parents will be thankful, and you will have provided the best defense possible until there is a COVID-19 vaccine indicated for all children. Vaccinating physicians have the opportunity to get children back on track and fully protected by employing their superpowers and vaccinating Michigan children!
1 Interim Guidance for Routine and Influenza Immunization Services During the COVID-19 Pandemic (https://www.cdc.gov/vaccines/pandemic-guidance/index.html)
2 2016-2018 NIS-Teen data
3 AAP recommends COVID-19 vaccines for eligible teens | American Academy of Pediatrics (aappublications.org)
4 Technically Speaking: A Strong Provider Recommendation Matters. Don’t Just “Offer” HPV Vaccine to Parents for Preteens. Recommend It! (immunize.org)
5 CDC Immunization Schedules (https://www.cdc.gov/vaccines/schedules/index.html)Dhs/0,5885,7-339-73971_4911_4914_68361-344843–,00.html on January 26, 2021.
6 Bramer CA, Kimmins LM, Swanson R, et al. Decline in Child Vaccination Coverage During the COVID-19 Pandemic — Michigan Care Improvement Registry, May 2016–May 2020. MMWR Morb Mortal Wkly Rep 2020; 69:630–631. DOI: https://www.cdc.gov/mmwr/volumes/69/wr/mm6920e1.htm on January 26, 2021.