Vaccination rate dip sparks fears
EXPERTS WORRY ABOUT INFECTIOUS OUTBREAKS
Vaccination rates among children have dropped by as much as 20 per cent in parts of Canada, ramping up anxieties that the country could face a series of infectious outbreaks while still battling COVID-19.
As public health officials peel back coronavirus restrictions, allowing Canadians to return to a form of pre-pandemic normalcy, pediatricians worry children who are delayed in their vaccination schedules may be at higher risk of contracting preventable diseases, such as measles and bacterial meningitis.
The National Post reached out to a number of pediatric infectious disease specialists in recent days, and nearly all said child and infant immunization rates are declining, but the full extent of this decline is unknown because most provinces and territories do not maintain upto-date data.
Every specialist pointed to COVID-19 restrictions implemented across the country as an inadvertent cause for diminishing immunity among child and infant populations.
One of the few provinces to provide the Post with data, Manitoba saw a 25-per-cent decline in measles, mumps and rubella (MMR) vaccines for the months of March and April 2020, compared to the same period last year for children two and younger.
Manitoba also recorded a 21-per-cent decline in diphtheria, tetanus and pertussis (DTAP) vaccinations in the same age group for the same periods.
Children between the ages of two and 17 saw a far greater drop during the same time period. Administrations for the MMR vaccine dropped by more than 60 per cent and administrations for the DTAP vaccine dropped by 55 per cent.
A provincial spokesperson said the preliminary data is likely attributable to the COVID-19 outbreak.
Dr. Jim Kellner is a pediatric infectious disease specialist based in Calgary, who also sits on the federal government’s COVID-19 immunity task force. Kellner divulged a conversation he had with an unnamed public health physician. The physician told him that Calgary had seen an estimated 20-percent decline in overall vaccinations in March and April.
Some experts warned about the potential for an imported case of measles to wreak havoc on vulnerable populations in which a vaccination threshold of 95 per cent or more must be maintained. Otherwise, there is no herd immunity and outbreaks can emerge with even the slightest dip, said Dr. Caroline Quach-thanh, a pediatric infectious disease specialist in Montreal, who also sits on the federal government’s COVID-19 immunity task force. Most jurisdictions strive for vaccination rates of 90 per cent or higher when it comes to other infectious diseases.
Kellner said that a measles outbreak is highly worrisome because measles is far more contagious than COVID-19. Measles causes flu-like symptoms and rashes. In rare cases, it can lead to death.
In 2018, more than 142,000 people died due to measles and more than 9.7 million became infected worldwide, according to estimates from the World Health Organization.
Even if families follow social distancing guidelines, that is no guarantee a baby or toddler is safe from contracting a vaccine-preventable disease, warned Dr. Joan Robinson, a pediatric infectious disease specialist in Edmonton.
Which infectious disease should a parent particularly worry about? In Robinson’s mind, it’s bacterial meningitis.
Meningitis can readily infect younger children because older kids and adults can carry the disease for months without so much as a symptom.
Most people who get it recover, but the disease can also cause lifelong problems such as learning difficulties, hearing loss and, in rare cases, death.
“Getting routine infant and toddler vaccinations are especially important,” Dr. Vinita Dubey, an immunizations and vaccine-preventable diseases expert with Toronto Public Health, wrote in an email.
“Vaccinations often require time to build up immunity, and many doses are required in infancy to get the best protection. Waiting to provide these vaccinations can leave a child vulnerable to disease infection.”
One of the major contributors to declining vaccination rates could be something as simple as a parent inadvertently forgetting to get their child immunized, said Dr. Scott Halperin, a pediatric infectious disease specialist and a member of the immunity task force in Nova Scotia.
Most public health clinics and many pediatricians have continued to administer vaccinations throughout the lockdowns. The only public vaccination programs that were cancelled were in-school vaccination clinics.
However, because of the strong public health messaging to avoid doctor visits, parents may confuse the message and delay bringing the child in for routine immunization for fear of contracting COVID-19.
The Post reached out to every province and territory, requesting data on child and infant vaccination rates for the months of January to April 2020 and for the same period in 2019.
British Columbia, Prince Edward Island, Nova Scotia, and the Yukon did not respond to the Post’s request for data. Ontario, the Northwest Territories, New Brunswick, Newfoundland, Nunavut and Quebec all said they did not have the requested data. Alberta did not provide a month-by-month breakdown, but rather the vaccination rates for January through April combined.
Aside from Manitoba, the only other province to get back to the Post with data for January to April 2020 was Saskatchewan, which didn’t see any huge fluctuations in pertussis and measles vaccines among children who are registered in the province’s immunization database.
Toronto pediatrician Daniel Flanders — who personally saw a 50 per cent decline in vaccinations at his practice — questioned the data coming from Saskatchewan.
“It would seem odd to me that the COVID situation would not impact vaccination rates at all,” in Saskatchewan, he said, whereas Manitoba — a province right next door — had a 20 per cent drop.
Quach-thanh said the lack of data available on population immunity is “absolutely” concerning.
“We don’t have any great figures of how great of a problem delayed immunization is during the pandemic,” said Halperin, the specialist from Nova Scotia. “If anyone gets delayed, that’s a concern.”
WAITING TO PROVIDE THESE VACCINATIONS CAN LEAVE A CHILD VULNERABLE.