The Ukiah Daily Journal

Don’t delay well-child exams and vaccines

- By Casey Johnston, MD Casey Johnston is a pediatrici­an at MCHC Health Centersa local, nonprofit, federally qualified health center offering medical, dental and behavioral health care to people in Lake and Mendocino counties.

Since March, our community has taken great effort to curb the spread of COVID-19. Many of the normal routines of childhood have been altered. Most schools are doing distance learning. Playground­s are closed. Family trips have been adjusted or canceled.

Nationally, there has been a noticeable drop in children showing up for routine vaccines and wellchild checks—this concerns those of us in the local medical community. We agree with the Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics (AAP) that children still need their health check-ups, especially when those appointmen­ts include critical immunizati­ons and monitoring of mental health, developmen­t and growth. Our local clinics are dedicated to safely providing these services.

Globally, there has been a dramatic (and scary) decline in vaccine rates, placing children and communitie­s at risk for outbreaks of vaccine-preventabl­e infections. The CDC reports that the percentage of children younger than 2 years of age being up to date on vaccines dropped below 50 percent! If too few people get vaccinated, we will be at risk for outbreaks of debilitati­ng and potentiall­y deadly illnesses.

Did you know that measles is even more contagious than COVID-19 and

in severe cases can lead to pneumonia and brain swelling? It requires a community vaccinatio­n rate of 93-95 percent to prevent outbreaks, which wasn’t a problem until recently. In recent years, we have had outbreaks of measles and pertussis (whooping cough) in California, and we are even more at risk now.

These diseases are extremely contagious and can be very serious, especially for babies and young children. While COVID-19 generally causes mild or no symptoms in young children, pertussis causes severe symptoms in young children. About half of babies with pertussis who are younger than 1 year of age require hospitaliz­ation. Children younger than 6 months are also at higher risk than older children for getting severe flu symptoms and requiring hospital treatment. In other words, many of the illnesses prevented by routine vaccinatio­ns are a greater threat to your child than COVID-19.

As we head into fall and winter, rates of respirator­y illnesses such as influenza will start to increase. In most years, hospitals reach capacity and can be overwhelme­d during flu season—this is without the presence of COVID-19. Getting ill with the flu also makes the body more susceptibl­e to other infections including COVID-19 and severe bacterial infections.

Without a coronaviru­s vaccine, one of the best tools we have right now heading into fall is the flu vaccine. Most years, the flu vaccine reduces the risk of getting the flu by 40 to 60 percent. Those numbers will make a big difference when there is a shortage of hospital beds. For people vaccinated against the flu who may still get the flu, the risk of requiring hospital care or developing complicati­ons is lower, and if hospitaliz­ation is required, the hospital stay will likely be shorter.

Regular checkups remain essential during this pandemic. In the last six months, rates of anxiety, depression, sleep disorders, obesity, and metabolic disorders (such as diabetes) have increased significan­tly. During routine checkups, children are screened for a number of conditions including growth problems, anemia, developmen­tal delays, hearing and vision problems, and mental health concerns. Primary care medical providers help coordinate specialty medical care, reach out to the school district, obtain therapies, and provide general support for families during these challengin­g times. With the wildfires, it is more important than ever to monitor children’s asthma and not to delay medical care for breathing concerns.

Our local clinics are taking great precaution­s to keep patients, their families, and the staff safe. We have separate waiting rooms for sick and healthy patients, and we schedule appointmen­ts to keep those population­s separate from one another to minimize potential exposures. All employees follow proper precaution­s using personal protective equipment, and all visitors (patients and family members) 2 years and older are instructed to wear face masks. When appropriat­e, some visits are done by telemedici­ne.

I understand people changing their behaviors to reduce the risk of COVID-19, but I encourage all parents to recognize that the coronaviru­s is not the only threat (and maybe not the biggest threat) to their child’s health. Please do not put off regular check-ups. We want to help you keep your children safe and healthy.

 ??  ?? Casey Johnston, MD
Casey Johnston, MD

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