key: cord-1031287-jg9zpfjv
authors: Brooks, Hannah E.; McLendon, Lane A.; Daniel, Casey L.
title: The Impact of COVID-19 on Pediatric Vaccination Rates in Alabama
date: 2021-02-05
journal: Prev Med Rep
DOI: 10.1016/j.pmedr.2021.101320
sha: 70d253dd4227d74c1fd3746c04296f49c92b470b
doc_id: 1031287
cord_uid: jg9zpfjv

nan

The United States (U.S.) declared a national emergency in response to the coronavirus disease 2019 (COVID-19) pandemic, on March 13, 2020. Public health officials have emphasized the importance of preventive measures, particularly social distancing, which has demonstrated significant success in slowing the transmission of COVID-19. 1 To facilitate such distancing, 42 states initiated stay-at-home orders of varying stringency and duration in spring 2020. 2 Alabama was among these, introducing its stay-at-home order on April 3, 2020 which was in effect until April 30 th , 2020. 3 This stay-at-home order required residents to stay in their place of residence except as necessary to perform any essential activities which included: to obtain necessary supplies, to obtain or provide necessary services, to attend religious services, to take care of others, to work, to engage in outdoor activities, to seek shelter, to travel as required by law, and/or to see a family member. 3 This national state of emergency and the subsequent state-level restrictions forced physicians to adapt their practices in ways previously unfathomed.

Telehealth visits became the forefront of patient care, with outpatient in-person visits decreasing approximately 60% in early April. 4 This drastic shift in traditional care delivery was made primarily to protect patients and providers from unnecessary exposures and was initially implemented as a brief, temporary measure.

Despite some rebound of in-person visits, the general volume of these remains substantially lower than prior to the pandemic. This is particularly true for pediatric populations when comparing current rates of overall visits and well-child visits to pre-COVID-19 rates. 4

Well-child visits are extremely important for children and adolescents for many reasons. These visits allow providers to conduct appropriate screenings, perform physical exams, complete laboratory evaluations, and provide essential vaccinations. 5 Routine vaccination within this population is critically important to reducing the risk of disease outbreak, preventing associated morbidity and mortality, and maintaining public health and safety. Vaccine administration at recommended ages and according to recommended intervals, keeping with the guidelines of the

Practices (ACIP) provides optimal immune response in pediatric patients. 6 Although perhaps a less prominent outcome of the COVID-19 pandemic in the U.S., unsurprisingly, declines in well- have resumed in-person visits continue to experience a lower volume than in the past, presumably due to lingering concerns among patients and/or their parents/guardians. 4 An additional concern is what the public has come to view as "nonessential." Many perceive wellvisits as fitting into this category and consequently not worth the risk of potential exposure to COVID-19, despite possibly denying the opportunity for crucial pediatric vaccinations. Those visits may have seemed elective in the spring and into the summer when postponements were thought to be temporary measures, but as the pandemic has staggered on, not everyone has been vigilant with catching up. And while many pharmacies offer some vaccinations, most do not keep a wide range of pediatric vaccinations in stock, and pharmacists nationwide were only given broad permissions to administer any ACIP-recommended vaccination to children ages 3-18 in August 2020. 7 Currently, the U.S. government, healthcare professionals, and researchers are rightly focused on the immediate response to COVID-19. However, the medical community must be cognizant that the pandemic continues to be a marathon rather than a sprint and adapt accordingly. We must emphasize to parents that routine healthcare cannot be deprioritized To ensure success in improving vaccination rates, all of the proposed efforts will also require pairing with campaigns to increase knowledge and awareness among parents and even among other providers. The initiatives that succeed will be those that are comprehensive and employ multilevel strategies. As providers endeavor to close the gap for missed vaccinations and routine patient care, they should choose sustainable, feasible solutions that fit their practice model and their patients' needs. Immediate risks should be balanced with long-term care to ensure individual and population-wide health in the present and for the future. Increasing vaccinations to prevent the spread of vaccine-preventable diseases is inarguably a vital part of achieving these goals.

Potential Indirect Effects of the COVID-19 Pandemic on Use of Emergency Departments for Acute Life-Threatening Conditions -United States

Timing of State and Territorial COVID-19 Stay-at-Home Orders and Changes in Population Movement -United States

The Impact of the COVID-19 Pandemic on Outpatient Visits: Changing Patterns of Care in the Newest COVID-19 Hot Spots. 2020. 5. Guidance on Providing Pediatric Well-Care During COVID-19

ACIP Timing and Spacing Guidelines for Immunization | Recommendations | CDC 2020

Third Amendment to Declaration Under the Public Readiness and Emergency Preparedness Act for Medical Countermeasures Against COVID -19. Department of Health and Human Services; declare the following financial interests/personal relationships