Routine Pediatric Vaccinations, Should Not Be Overlooked Due to The Covid19 Pandemic
Dr. Pooja Khanna *, Dr.Kartik Deshmukh1, Dr. Isham Goel2, Dr.Arjun Khanna3
1.Dr. Kartik Deshmukh - MBA Candidate, Duke FUQUA school of Management, North Carolina, USA
2.Dr. Isham Goel - Manager, Medical affairs, Cipla, New Delhi, India.
3.Dr. Arjun Khanna - Consultant Pulmonologist, Yashoda superspeciality hospital, Kaushambi, UP, India
*Corresponding Author: Dr. Pooja Khanna, Consultant Pediatrician, Tarawati Ramgopal Medical center, Delhi, India.
Received Date: March 26, 2021
Publication Date: April 01, 2021
Sir,
A 15-month-old child was brought to the outpatient department with high-grade fever and an erythematous rash all over the body for 6 days. Investigations revealed a diagnosis of Measles, Enteric fever, and Urinary tract infection together. On further questioning, parents revealed that the child had not received any vaccination for the past 9 months. The last vaccine was received in March 2020 before the Covid pandemic struck. This has been the case with most children all over the world, especially in developing countries, where vaccination anyways has been a challenging issue.
India saw a dip of 23 percent in the number of children vaccinated in September 2020 when compared to September 2019 (1). In Saudi Arabia, vaccination visits dropped to 68.48 percent in May 2020 (5). Similarly, a reduction in vaccination rates was seen in Israel (2), Britain (3), and United States (4).
Due to lockdown and stay-at-home orders, there has been a disruption in routine immunization services. Many clinics and health care centers were closed for a long period. Though some health centers were open, people were not coming out due to the Covid 19 scare. Important vaccines
like BCG, Hepatitis B, Polio, Diphtheria, Pertussis, Tetanus, Hemophilus influenza, Measles, Mumps, Rubella, Typhoid, have been delayed or omitted for many children. This has led to an increased risk of vaccine-preventable diseases in under 5 children.
Pediatric vaccines need a high level of uptake to achieve a successful reduction in incidence and prevalence of vaccine-preventable diseases. They also need to be given at a specific age and time. To prevent a Measles outbreak, 95 percent vaccination coverage is required to establish herd immunity but this year, coverage with measles vaccine has been very less. This has led to an increased risk of a measles outbreak. Similarly, the first dose of the Rotavirus vaccine cannot be given if the child is above 14weeks 6 days of age, exposing the unimmunized children to an increased risk of gastroenteritis.
Pediatric consultations have been shifted to telemedicine practice in many countries but vaccination requires an in-person visit. All vaccine-preventable diseases like Diphtheria, Pertussis, Tetanus, Polio, BCG, HiB, MMR, Typhoid should be given on time. Otherwise, there might be huge pressure of these preventable diseases on the healthcare system which is already stressed with the Covid 19 pandemic.
There is an urgent need to teach parents about the importance of regular immunization even in this pandemic. All the fears and queries need to be allayed. It should be emphasized that delaying immunization especially in first 2 years of life may put children at risk of many life-threatening infections owing to an immature immune system.
Necessary steps need to be taken to immunize children safely. Separate vaccination clinics, vaccination on the appointment, one caretaker with one child, proper hand hygiene, wearing a face mask can be done. All caretakers should be screened for fever or respiratory systems. Multiple vaccines can be given at one time like MMR and Typhoid conjugate vaccine can be given together.
There is a need to understand that though Covid 19 is an infectious disease, there are a lot more infectious diseases from which protection is a priority. Ensuring proper and timely vaccination needs to be carried out by both primary care physicians and pediatricians.
References
1.Ahuja Aastha(2020). “How to safely vaccinate Children during Covid 19 pandemic [Update 2020 November 11]”. Available from: https://swachhindia.ndtv.com/how-to-safely-vaccinate-children-during-covid-19-pandemic-52811/
2. The Times of Israel. “Vaccinations drop amid Covid-19 fears, raising the specter of fresh measles outbreak [Update 2020 April 24]”. Available from:http://www.timesofisraelcom/vaccinations-drop-amid-virus-fears-raising-specter-of-freshmeasles-outbreak/
4. Hart C. “Confessions of a pediatric practice management consultant”. The effect of COVID 19 on immunization rates. [updated 2020 April 6]. Available from: https://chips log.pcc.com/the-effect-of-covid-19-on-immunization-rates
Volume 2 Issue 4 April 2021
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