The number of adolescents getting routine vaccinations in Mecklenburg County dropped significantly during COVID-19, along with a drop in regular wellness visits statewide, experts say.
About one in five seventh-graders in the county have missed some required routine immunizations, state data show.
A N.C. Department of Health and Human Services’ annual report shows that the percentage of N.C. seventh-graders who had not obtained their required immunizations increased from 7.4% in 2019-2020 to 9.6% in 2020-2021. In Mecklenburg County, the rate increased from 8.1% to 20.6%.
All adolescents enrolled in childcare facilities or schools are required to be vaccinated against certain preventable diseases, including measles, mumps and chickenpox. Vaccination records are checked twice, once before students enter seventh grade and again before university entry.
A federal health report published in May also noted that many children and adolescents nationwide are behind on their shots.
The lag in catch-up vaccinations could pose a “serious public health threat,” especially when schools return to in-person instruction, the Centers for Disease Control and Prevention said in the report.
North Carolina has gradually opened public K-12 schools for in-person instruction since March. DHHS guidelines issued Wednesday said that masks are no longer required for vaccinated students and faculty in public high schools, since children aged 12 and above, including most seventh-graders, are eligible for COVID-19 vaccines.
The potential risks of not getting routine vaccinations include an increase in both illness and deaths from vaccine-preventable diseases, said Dr. Catherine Ohmstede, a pediatrician at Novant Health.
For example, all N.C. adolescents are required to receive one dose of meningococcal vaccine by age 12, or seventh grade, and a booster dose by age 17 or 12th grade. The vaccine prevents diseases caused by bacteria called Neisseria meningitidis, which could lead to infections of the membranes covering the brain and spinal cord, particularly among younger age groups.
While the infection is rare, the disease can be “very fatal”, Ohmstede said. The CDC recommends getting vaccines as the best defense against the illness.
In older age groups, whooping cough and chickenpox are among contagious vaccine-preventable diseases, said Dr. Amina Ahmed, an infectious disease physician at Atrium Health. Parents should consider have children getting influenza vaccines, she added, because respiratory diseases like the flu will spread more going into the fall school season.
The CDC also recommends getting vaccinated against human papillomavirus (HPV), which can cause cervical cancer in women and other kinds of cancer among men and women. Ohmstede said that an estimated 80% of people will be infected with the virus at some point in their lifetime. Over 35,000 cases of cancer are caused by HPV each year, CDC said.
While recommended and available, HPV vaccines are not required for adolescents in North Carolina.
“It’s very important for people to remember to get children caught up on those vaccines, especially if you delayed or spaced them out a little bit during the pandemic,” said Ahmed.
‘No reason to feel uneasy’
The drop in routine vaccinations is seen across all adolescent age groups, Ohmstede said. She said that families’ concern over non-essential visits to healthcare facilities during the pandemic, out of fear of COVID and other health risks, was an important reason for the decrease in vaccination compliance rates.
“We really recommend that children should have a doctor’s visit every year, and that visit is to monitor physical development, psychosocial maturation, and observation for both physical and mental wellness,” she said.
To relieve patients’ anxiety, hospitals since last year have made a priority of cleaning protocols and providing adequate personal protective equipment, Ohmstede said. This year, Novant staff are all vaccinated, and its physician practices have been operating with caution.
“There should be no reason for anybody to feel uneasy going through their annual examinations,” Ohmstede said.
She also recommended that parents schedule their children’s annual wellness visits as soon as possible. As the school year approaches, healthcare facilities are getting busier, she said.
Last year, students were not asked to complete physical examinations if they wanted to participate in sports – another reason why students did not visit the doctor and get routine vaccinations, Ohmstede said. N.C. schools will require the examinations for the 2021-22 school year.
Routine shots can be taken with COVID vaccines
When teens aged 12-15 became eligible for COVID-19 vaccines in May, concerns were raised over whether COVID vaccines could be taken at the same time as routine vaccinations.
CDC guidelines issued in May suggested that COVID-19 and other vaccines can be administered without regards to timing — including receiving vaccines on the same day and within 14 days. The center said that data has shown that does not lead to unusual adverse effects.
A full list of required vaccines for adolescents in North Carolina:
▪ Pertussis (whooping cough)
▪ Varicella (chickenpox)
These vaccines are recommended by the CDC but not required in the state: