Falling child vaccination rates worry experts
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 up-to-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-per-cent 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 QuachThanh, 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.
As restrictions are lifted around the world, the sense of urgency surrounding the novel coronavirus pandemic has weakened.
But this historic pandemic is not ending. It is surging.
There were 136,000 new infections reported on Sunday, the highest single-day increase since the start of the pandemic. There are more than seven million confirmed cases so far.
The number of deaths is nearing half a million, with little sign of tapering off, and global health experts are continuing to sound the alarm.
“By no means is this over,” Mike Ryan, the World Health Organization’s executive director, said Wednesday. “If we look at the numbers over the last number of weeks, this pandemic is still evolving. It is still growing in many parts of the world.”
Latin America has emerged as a hot spot, currently accounting for almost half of global deaths by the Financial Times’ tally. The problem is particularly acute in Brazil, where the central government has maintained a hands-off attitude to the outbreak even as cases surged to almost 750,000, second only to the U.S., but it has also hit countries, such as Peru, that took early steps against the virus.
Cases have surged in South Asia. WHO officials urged Pakistan to lock down after officials declared a record number of new cases in the past 24 hours. India is facing a new wave of infection; a top official in Delhi on Wednesday said that cases were expected to soar above 500,000 by the end of next month. Indonesia had its biggest daily increase in coronavirus cases for a second consecutive day on Wednesday, with 1,241 new infections.
Across sub-Saharan Africa, there are now more than 200,000 cases: There is widespread speculation that Pierre Nkurunziza, Burundi’s president, who died on Tuesday, was the first world leader to die of COVID-19, though Burundian officials have said the cause of death was cardiac arrest.
The scale of the coronavirus has made it hard to take in.
“In the period of four months, it has devastated the world,” Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told CNN on Tuesday. “And it isn’t over yet.”
Some nations that were devastated early in the pandemic look to be losing ground in their recovery. In Iran and the United States, two countries divided by geopolitical enmity, experts are united by fresh fears of a second wave; new cases in Iran have surged to record highs weeks after the country eased its lockdown.
U.S. states are seeing an increasing number of patients since Memorial Day weekend, when many people socialized in groups in parts of the country, while there are new concerns that the anti-racism protests sparked by the death of George Floyd in Minneapolis could add to a nationwide surge.
Almost all experts acknowledge that mass protests are a risk — just as the reopening of the economy seen in many nations around the world, including the United States, carries risks.
“The facts suggest that the U.S. is not going to beat the coronavirus,” the Atlantic’s Alexis Madrigal and Robinson Meyer write. “Collectively, we slowly seem to be giving up.”
But there are some reasons to be hopeful. A study by Britain’s Cambridge and Greenwich Universities released Wednesday suggested that widespread mask wearing could help prevent a second wave as damaging as the first.
Vaccine trials are beginning and many hope that the ambitious, accelerated development timetables will produce results as soon as the end of the year.