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In a pandemic, childhood vaccinations have never been more important

As a pediatrician, I know that vaccinations keep our children safe from preventable diseases like the measles. As a parent, I understand the apprehension — or perhaps, fear — some parents have in scheduling office visits during the COVID-19 pandemic to get immunizations and other primary care services for their children.

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By Dr. Paul Hain Blue Cross and Blue Shield of Texas

This parental anxiety is palpable in a new report that shows an average 44% drop in the number of doses administered in the Texas Vaccines for Children program during the early months of the pandemic. Correspondingly, childhood vaccinations plummeted across the country after COVID-19 was declared a national emergency in mid-March, according to a Centers for Disease Control and Prevention report.

The Texas and CDC findings are “incredibly worrisome,” said Sara H. Goza, president of the American Academy of Pediatrics (AAP). The data show that “from mid-March to mid-April, doctors in the Vaccines for Children (VFC) program ordered about 2.5 million fewer doses of all routine non-influenza vaccines and 250,000 fewer doses of measles-containing vaccines compared to the same period in 2019.”

Moreover, the CDC report found that the number of doses of measles-containing vaccine administered at Vaccine Safety Datalink sites also dropped in mid-March, especially among older children.

As school administrators across the state grapple with whether to hold in-person or virtual classes, or some hybrid of the two, there is no question that school-age children still need their vaccinations.

This is particularly true in Texas, because the state’s vaccination rates were low even before the pandemic. Last year, the state failed to meet minimal national goals for eight of 11 immunizations — and also experienced measles resurgence.

While the pandemic certainly has played a major role in the drop in immunizations, access is also an issue. According to the state report, more than 150 Texas Vaccines for Children program sites closed as of mid-May, due to personnel being shifted to help in the COVID-19 fight or inactivity. More than 40% were school-based clinics.

I am proud to be involved with The Caring Foundation of Texas, which like other organizations is stepping up to offer access to free immunizations for uninsured and medically underserved children and their families by collaborating with school districts in the Dallas and Houston. Blue Cross and Blue Shield of Texas is the lead sponsor of the Care Van Program, which administers the shots, and which has provided more than 1.3 million vaccinations since 1997.

To protect families as well as Caring Foundation staff and volunteers during the pandemic, the following health and safety protocols have been implemented for Care Vans:

  • All clinic attendees are required to bring and wear their masks during their visits. Additionally, each attendee will have their temperature checked and go through a medical screening.
  • One parent or legal guardian will be allowed to enter the clinic with children receiving care. Required appointments will limit the number of families at the clinic at any one time.
  • Volunteers will be screened prior to entering the clinic and will adhere to increased cleaning measures during clinic hours.
  • Attendees need to bring the proper intake form for each child to the clinic. Forms can be found here:
  • They also need to bring a copy of each child’s immunization record.

Understandably, the pandemic has led to parents delaying in-office wellness visits and vaccinations, but pediatricians statewide and across the country also have implemented measures to prevent the spread of COVID-19 both to themselves and their patients. Those measures are based on AAP guidance that recommends:

  • Scheduling well and sick visits at different times of the day;
  • Physically separating patients in different locations;
  • Rigorously sanitizing offices;
  • When appropriate, conducting some elements of the well exam via telehealth with in-person follow-up;
  • Continuing to make referrals for specialty care, and allowing telehealth visits for pediatric medical subspecialists and pediatric surgical specialists.

Vaccinations play a critical part in creating healthy communities. They have never been more important than at this moment in our history. With the flu season fast approaching and no rapid end to the COVID-19 pandemic, we must work together to protect our children from preventable diseases.