The COVID-19 Pandemic Is Causing Public Health Repercussions Beyond Those Who Get Infected With the Novel Coronavirus

The New York Times is reporting that New York City public health authorities are sounding the alarm on children missing their childhood vaccines because of the COVID-19 pandemic:

“During the height of the pandemic, from March 23 to May 9, the number of vaccine doses administered to children dropped 63 percent compared with the same time last year, and by 91 percent for children older than 2, according to the city health department.

The city is tentatively planning to reopen its 1,800 public schools in September, along with hundreds of day care sites. But children will not be able to start school and relieve their parents of home schooling and child care duties without shots to protect them against illnesses like measles and chickenpox.

In a typical year, about 98 percent of the city’s public school students are fully vaccinated.”

New York is not alone in this respect. The rest of the world has reassigned public health workers to the pandemic response. The World Health Organization has re-tasked its polio vaccine resources toward the pandemic. According to Wired magazine, this has resulted in a pause to polio vaccine efforts:

The pause benefits the fight against the coronavirus: Approximately 3,700 WHO employees, consultants, and lab personnel who staff the polio campaign in 55 countries have been loaned to the Covid-19 effort, according to Zaffran. But it is a serious operational hazard for the three-decade campaign. “Our community is concerned,” says Dr. John Sever, the vice chair of the International PolioPlus Committee of Rotary International, a partner in the campaign; its members have delivered more than 2 billion polio vaccinations. “But we recognize the importance of the Covid problem. We’re willing to take a pause in the immunization program with the idea we’ll return to it full throttle as soon as possible.”

The forced pause comes on top of a bad year for the polio campaign. After its inception in 1988, when approximately 350,000 children were paralyzed by the disease each year, the multinational effort had nearly wiped polio out of existence. In 2018, there were only 33 naturally occurring cases in the world, and an additional 25 in which a weakened virus used in some vaccine formulas reverted to virulence and caused paralysis.

But in 2019, polio began bouncing back, with 176 cases of the naturally occurring type, which spreads from child to child through fecal particles and contaminated water, and an additional 366 cases of what is called vaccine-derived polio. By May 13 this year, there had been 59 cases of wild polio and another 104 cases of vaccine-derived polio—and that’s with the tropical rainy season, traditionally the riskiest part of the year for infection, still to come.

Vaccinations are not the only healthcare service that has seen a slowdown. Many emergency departments in areas affected by the pandemic in the United States are reporting low numbers of patients for things like heart attacks and strokes, something that is being reflected in the excess mortality being reported around the country. As people are fearful of going to an emergency department and possibly being exposed to the novel coronavirus, they stay home even when their symptoms are serious. Some of them, unfortunately, are dying at home or arriving to the emergency department too late to be helped.

Number of laboratory-confirmed and probable COVID-19–associated deaths and total estimated excess deaths — New York City, March 11–May 2, 2020

The best public health recommendation right now is to not wait until it’s too late when it comes to any preventative medical care or medical condition. Physicians and other healthcare providers have been trained well in preventing the spread of disease, and their offices and workplaces are sure to be prepared to take care of patients as safely as possible. The same goes for vaccinations. We already saw last year what a low measles vaccination rate can do, especially in Samoa. The last thing the world needs is a pandemic of vaccine-preventable diseases on top of the COVID-19 pandemic.

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Author: René F. Najera, DrPH

I am the editor of the History of Vaccines site, an online project by the College of Physicians of Philadelphia. All opinions expressed on these blog posts are not necessarily those of the College or any of my employers. Check out my professional profile on LinkedIn: https://www.linkedin.com/in/renenajera Feel free to follow me on Twitter: @EpiRen

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