KENDALLVILLE — Hoosier children are required to be immunized against a variety of communicable diseases before they can enter school. Yet health agencies such as the Centers for Disease Control and Prevention and the Indiana Department of Health are seeing a decline in the number of children who have completed their vaccines before age 3 since the pandemic began March 2020 in Indiana.
In its annual Indiana Kids Count 2021 Data Book, the Indiana Youth Institute reports a decrease in the numbers of children getting their vaccines during the pandemic.
The change was immediate. The IYI writes:
“The decline began the week after the national emergency declaration. The decrease was particularly prominent for children older than 2 years old. The CDC did not indicate if this trend would continue throughout the course of the pandemic or if rates would resume pre-pandemic levels. This trend could lead to a decrease in the number of older Hoosier children who are inoculated against preventable diseases in the next few years.”
The decrease also threw a red flag up on another issue: getting parents to take their children for wellness checks and check-ups. The IYI notes that:
“Though no data were reported about rates of preventive services during the pandemic, it is likely that wellness visits and check-up rates have similarly fallen during the pandemic. If children are not visiting the doctor for vaccinations, they could also miss on preventive screenings for such issues as mental health problems or developmental delays and warning signs for autism, lead poisoning, child abuse or neglect, or malnutrition.”
The Indiana Department of Public Health said this:
“Many children missed routine healthcare appointments at which childhood immunizations are administered during the COVID-19 shutdowns and have fallen behind schedule. We continue to work with healthcare providers and schools to ensure that children catch up on missed vaccinations.”
Barriers
The Indiana Youth Institute reports that fear and distrust are the reasons that parents and caregivers didn’t follow through with vaccines on schedule. The IYI writes:
“Potential reasons for the decrease in vaccination rates during the pandemic include access issues, fear of being exposed to COVID-19, and distrust of vaccines. Lower vaccination rates during the pandemic could create a second healthcare crisis, specifically for lower-income children. The identified declines in routine pediatric vaccine ordering and doses administered indicate that U.S. children and their communities will face increased risks for outbreaks of vaccine-preventable diseases. The CDC indicates that susceptibility to and contracting of measles may become more prevalent.”
Vaccination Rates by County
The Indiana State Department of Health, Immunization Division, has issued a 30-page immunization rates assessment by county.
Vaccines For Children program is funded through the Centers for Disease Control. The program provides free vaccines for eligible children in Indiana. A VFC provider is enrolled in the VFC program and given permission to order and administer vaccines covered under the program to eligible persons.
A look at vaccination rates from 2019, the most recent figures available, shows that Indiana has an average completion rate of 70% for children’s vaccinations. Northeast Indiana fares poorly in vaccination rates, with three counties among the 10 counties with the lowest vaccination rates in the state.
The northeast Indiana counties of LaGrange (55% with five VFC providers), Wells (56% with two VFC providers), and Allen (60% with 28 VFC providers) are included on a list of 10 counties with the lowest rates when adjusted for population assessment and Vaccines for Children providers. Daviess County had the lowest vaccination rate of 49% with seven VFC providers.
The 10 highest rates by county are Spencer, Pike, Monroe, Owen, Greene, Gibson, Cass, Lawrence, Shelby and Warrick counties, which ranged between 81% and 85% and two to nine VFC providers.
Playing catch-up
Amy Lash, the school nurse for Prairie Heights Community Schools, is aware of the lag in vaccines for students in K-12. Like other school nurses, Lash’s duties include checking immunization records to make sure all students are up-to-date on their required shots.
Lash is proactive about making it easy and convenient for Prairie Heights’ families to catch up with vaccines that have been missed. They can take advantage of an in-school immunization clinic this week.
She has contacted families who have vaccination gaps and encouraged them to get their students vaccinated at school.
Lash collaborated with the LaGrange County Health Department to coordinate an immunization clinic for students and the public on Friday, Sept. 17, from 10 a.m. to 2 p.m. at Prairie Heights Middle School, 455 S. C.R. 1150E, LaGrange.
An Angola school district had a similar shot clinic in early August, and that inspired Lash to try one at Prairie Heights.
“I’m so excited to see how it turns out,” Lash said.
The Indiana Immunization Coalition will administer all required state vaccines to children of any age (see chart). Lash said there are additional vaccines required for sixth-graders and seniors.
The COVID-19 vaccine is not among the immunizations required by state law, Lash said, but students age 12 and older and adults may request a COVID-19 vaccine when they register for the Prairie Heights Clinic.
The clinic accepts all forms of insurance (private, Medicaid or Medicare) and there is no charge for those individuals who don’t have health insurance. The exception is the shingles vaccine for adults, which carries a cost.
“Anyone can register to get the state required vaccines,” Lash said. “For some vaccines, call ahead or request it when registering.”
Vaccines prevent diseases
Vaccines today prevent the contagious diseases that were common in the first half of the 20th century. Eliminating these diseases also eliminates the risk of serious complications.
Chickenpox: Varicella vaccine protects children from the complications of infected blisters, bleeding disorders, brain swelling and pneumonia infection in the lungs.
Diphtheria, Pertussis and Tetanus: DTaP vaccine is a combination vaccine that provides immunity for all three of these diseases. Diphtheria’s complications are swelling of the heart muscle, heart failure, coma, paralysis and Death. Pertussis, called whooping cough, has complications of pneumonia and death. Tetanus, which enters the body through cuts in the skin, carries the risk of broken bones, breathing difficulty and death.
Mumps, Measles and Rubella: The MMR combination vaccine provides immunity to these diseases. Mumps carry the risk of meningitis (infection of the covering of the brain and spinal cord), brain swelling, inflammation of testicles or ovaries and deafness. Measles can cause complications of brain swelling, pneumonia and death. Rubella is especially serious for pregnant women with complications of miscarriage, stillbirth, premature delivery and birth defects.
Polio: The IPV vaccine prevents polio, a fear-inspiring disease in every community in the early 20{sup}th{/sup} century. Polio’s complications include paralysis and death. President Franklin D. Roosevelt was a victim of polio in 1921, when he was 39. He often hid the fact from the public that he used legs braces, crutches and a wheelchair in various settings, but later he founded the National Foundation for Infantile Paralysis which led to the development of the polio vaccine.
Pneumococcal: The PCV13 provides immunity for pneumonia infection in the lungs. Complications from pneumonia can include blood infections, meningitis in the covering of the brain and spinal cord, and death.
Rotavirus: The RV vaccine prevents the complications of severe diarrhea and dehydration that happen when this virus enters the body through the mouth.
Hib (Haemophilus influenza type b): The Hib vaccine provides immunity from the medical complications or meningitis infection of the covering of the brain and spinal cord, intellectual disability, epiglottitis (life-threatening infection that can block the windpipe and cause severe breathing problems), pneumonia infection in the lungs, and death.
Hepatitis A: The Hep A vaccine provides immunity for the complications of liver Failure, joint pain, and disorders of the kidney, pancreas and blood.
Hepatitis B: The Hep B vaccine prevents the complications of chronic liver infection, liver failure and liver cancer.
Influenza: The Flu vaccine provides immunity for pneumonia infection of the lungs.
Vaccines have also improved in the evolution of their development by scientists and medical professionals. For example, the DTaP vaccine produces fewer side effects and is a safer version of an older vaccine called DTP, which is no longer used in the United States.
Tdap vaccine is licensed for people 10 years through 64 years of age. Tdap contains a lower concentration of diphtheria and pertussis toxoids than DTaP. Tdap is given at 11-12 years.