The Centers for Disease Control and Prevention say the number of vaccines being given to children for diseases like polio and hepatitis B has fallen dramatically during the coronavirus pandemic.
Montana’s public health departments and providers, seeing the same decline, are concerned it could lead to an outbreak of a vaccine preventable disease and pull resources away from the COVID-19 response.
The CDC reports the number of childhood vaccine orders coming through a program providing free immunizations to uninsured children has seen a significant decline since states issued stay-at-home orders in mid-March. The program, called the Vaccines for Children Program, provides vaccines to about half of children under five in the U.S.
While Montana has had one of the lowest COVID-19 case rates in the country, public health officials including Cindy Farr say the state is no exception. She said visits to the Missoula City-County Health Department’s immunization clinic have remained low even as the state opens up.
“Well, I can tell you that our immunization clinic use to see a steady flow of traffic, and enough to keep three nurses busy all day. And at this point, we’ve got only one nurse working and we’re only getting maybe half a dozen people a day coming in,” she said.
County health departments big and small, as well as private providers across the state, are seeing the same thing. The Montana Department of Health and Human Services has also seen a drop in vaccine orders. Public health officials hope families will get their kids caught up on their vaccines as the state eases social distancing directives. The state health department is conducting a statewide survey to get an idea of the capacity to get kids caught up.
Even a short-term decline in vaccine rates is concerning in a state like Montana, according to public health officials. The state has persistently fallen below the 90% mark required to gain herd immunity against diseases like measles. In recent years, Montana has seen outbreaks of mumps and pertussis, which broke out in Missoula’s school district last year. That’s the last thing the health department needs as it’s trying to focus its attention on COVID-19, Farr said.
“You know, we are pretty taxed on resources right now, and so trying to make sure that everyone is well cared for and that we’re able to get the contact investigation and contact tracing done for two outbreaks, and not just one, is also concerning,” she said.
By and large, state and county health officials expect most parents will get kids caught up on their vaccines in the coming months. But there’s concern the coronavirus pandemic could leave lasting marks on Montana’s vaccination rates. Janice Fordham is a physician at Laurel Family Medicine, located about 20 minutes outside Billings.
“Absolutely I think there’s a concern of people not finishing series, a three-part series, and not getting the last one, so not getting full immunity, or never getting an immunization series in the first place. I think we do have a fear of all of that.”
And then there’s concern about potentially long-lasting economic barriers created by the pandemic. Some families are facing job loss and, as a result, might have no medical insurance. They might not even be able to afford transportation to an immunization clinic.
Sophia Newcomer is an assistant professor of epidemiology at the University of Montana. In early April, she received funding for research looking at barriers to early childhood vaccines in Montana, including why some people are hesitant to get a vaccine.
“We're looking at data from before the pandemic, but in some ways it might be able to serve as a baseline for what vaccine coverage and barriers to vaccination looked like before COVID-19,” she said.
Newcomer hopes to adapt her work to look at data during and after the coronavirus pandemic to measure its long-term impacts. In the meantime, providers and public health officials are trying to get the word out that they’re open for appointments and in some cases walk-ins. That includes Farr and the Missoula City-County Health Department.
“I know that we’re doing everything we can here to make it a safe experience, and the medical clinics that we work with are too,” she said. “So if you’re concerned about it as a parent, please call your provider and talk to them about your concerns.”
Many providers and public health departments are making reminder calls to parents with children due for vaccines. They also want to Montana’s parents to make the call even if they don’t have insurance for their children. Many private doctors and public health departments are able to offer free vaccines to uninsured children.