‘Recipe for disaster’: COVID-19 leads to kids’ vaccine rates falling, risking other outbreaks

The number of children getting vaccinated in Florida is declining and COVID-19 may be to blame.

Numerous doctors and even the state health department have noticed an alarming trend of parents not bringing their children in to get vaccinated due to coronavirus fears.

Dr. Maria Milla, a pediatrician at Nicklaus Children’s Hospital, said she has noticed parents growing skittish about taking their children for routine vaccinations in the last few months. Since her practice is located in a hospital, Milla said she thinks parents are afraid to bring their children into a place associated with being sick.

The decline in vaccinations is occurring across all ages, Milla said. The only vaccination rate that hasn’t gone down is the Hepatitis B vaccine, which is given to newborn babies in the hospital before they are taken home.

In May, the U.S. Centers for Disease Control and Prevention published a study reporting that routine vaccinations for children across the country have declined as a result of the coronavirus pandemic, as compared to the same time period in 2019.

Most notably, up-to-date vaccines for children aged 5 months went from approximately two-thirds of children being vaccinated from 2016-2019, to fewer than half — 49.7 percent — in May 2020, well into the pandemic, according to the CDC’s May 22, 2020, Morbidity and Mortality Report.

In Miami-Dade County in April, there was an approximate 60 percent decline in children’s vaccines administered as compared to 2019, according to data from statewide immunization registry Florida SHOTS. In May, there was about a 40 percent decrease.

But, now more than ever, it is important that children receive their vaccine and flu shots before returning to school in-person, Milla said.

“Vaccines cannot be put on the back burner at this point,” Milla said. “They definitely still need to be a priority despite the fear.”

Vaccine preventable diseases can be more deadly than COVID-19 for children, Milla said. While most children who get COVID-19 typically have mild symptoms or none, this would not be the case for diseases like measles, mumps, pertussis or whooping cough — diseases immunized by the vaccines.

She is trying to assure parents that it is safe to come into her office and that her practice is following strict infection control practices. Regular check-ups are set for morning hours, while sick patients can only come into the office during the afternoon. Milla is also not seeing any patients that have COVID-19 symptoms in person.

To help address this issue, the University of Miami Miller School of Medicine is running free vaccine drives through its UHealth pediatric mobile clinic. The doctor’s office-on-wheels goes across Miami-Dade County to neighborhoods where many children are uninsured and under-vaccinated.

Dr. Lisa Gwynn, a UM professor of pediatrics and medical director of the mobile clinic, said she is concerned about the spread of preventable diseases that could happen if children do not get their routine vaccinations, specifically to vulnerable populations like the elderly and immunocompromised.

“People will start getting these diseases,” Gwynn said. “So here we are in the middle of a pandemic and then we’re going to have all these comorbidities of other vaccine preventable diseases on top of that. It’s a recipe for disaster.”

The mobile clinic will work with the Florida Department of Health and Miami-Dade School District to help get local children vaccinated, Gwynn said. She said UM nurses are working with school districts to call parents with children behind on vaccines and give them information on how to get free vaccines, especially if they don’t have a doctor they regularly see. The clinic is working with the state health department to identify hots pots for low vaccine rates.

“We’re really working toward identifying schools and areas that have lower immunization rates and really trying to target those areas,” Gwynn said. “Just encouraging parents to go back to their pediatrician, they’re waiting with open arms.”

The Florida Department of Health said in a statement to the Miami Herald that it acknowledges parents have been hesitant about taking their children to the doctor’s office, but reiterated that going in for vaccines and check-ups is safe.

“The less children are vaccinated and brought up to date on childhood immunizations, the greater risk they pose to themselves, their families and their communities,” the FDOH said. “An outbreak of a vaccine preventable disease could have devastating effects on communities.”

The FDOH formed a work group with pediatricians, educators and public health employees to address the decline in immunization rates in Florida.

Miami-Dade County Public Schools said it is working with the FDOH to inform families about mandated vaccine requirements and that the district will be announcing where students can get free vaccines before the start of the school year.

Even before COVID-19, South Florida counties ranked poorly on its immunization of students compared to other counties in the state.

In the 2018-19 school year, Monroe County, home to the Florida Keys, had the second fewest amount of kindergartens up to date on their vaccinations in the state at 90.1 percent, according to the Florida Department of Health. Palm Beach and Miami-Dade counties were ranked slightly better, coming in at 51st place (93.5 percent) and 52nd place (93.3 percent), respectively.

Broward County ranked the best in South Florida — coming in at 42nd of the state’s 67 counties with 94.2 percent of its kindergartens up to date with vaccinations.

Among rates of seventh grade students properly immunized during this period, Miami-Dade ranked 63rd out of the state’s 67 counties (94.8 percent), Monroe 62nd (94.9 percent), Palm Beach 57th (95.9 percent) and Broward 53rd (96.3 percent).

The statewide average of kindergarten students up-to-date with their vaccines is 93.8 percent, while for seventh graders it is 96.3 percent.

Dr. Audrey Ofir, a UM pediatrics professor and director of the Pediatric Comprehensive Care Clinic at Holtz Children’s Hospital at Jackson Medical Center, said public education is essential, and parents must know that it is safe to take their children to the doctor. She said it is important schools are very strict about vaccine requirements and should even consider offering vaccines on-site.

“We have to reassure families that it is safe and really necessary right now to get back on track,” Ofir said, “and to get their kids checked out and make sure that they catch up on their vaccine before it’s too late and we end up with an additional crisis.”

Vaccine Information

To contact the Florida Department of Health in Miami-Dade County, call 305-324-2400.

To contact the University of Miami pediatric mobile clinic, call 205-243-6407.

To contact Nicklaus Children’s Hospital, call 1-800-432-6837.