Some children across the country have fallen behind on their routine immunizations during the COVID-19 pandemic, with vaccination rates dropping by several percentage points in some provinces.
Pediatricians and other health officials say the decline in routine immunizations is worrisome as cases of polio, a vaccine-preventable disease, emerge in other parts of the world.
“As we move through the pandemic, we really need to focus on children maintaining and receiving these routine immunizations that we otherwise took for granted,” said Dr. Sloane Freeman, a pediatrician at the St. Hospital Michael and Assistant Professor. in the Department of Pediatrics at the University of Toronto.
Some experts say there can be a number of reasons why someone isn’t vaccinated, but don’t think hesitance is the main culprit. Those who spoke to CBC News suspect school closures during the pandemic, reallocated public health resources and staff and a greater focus on COVID-19 vaccines may be behind the drop.
“It’s a good wake-up call that we need to be more diligent and probably provide additional resources to catch this group of kids because we know they were missing,” said Julie Bettinger, a professor of pediatrics at the University of British Columbia and a scientist at vaccine safety. at the BC Vaccine Evaluation Centre
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Drop in vaccination rates
Pediatricians across Canada said they are seeing more unvaccinated children this time of year than usual.
This week, Dr. Fatima Kakkar, an infectious disease pediatrician and professor of pediatrics at the University of Montreal, saw children who had never been vaccinated against tetanus. He says it’s “shocking to see how many” are unprotected.
“For the most part, it’s the younger kids who missed their regular appointments during the peak of the pandemic and have never caught up.”
Doctors at South Hill Family Health Center provide flu shots to their patients in the underground parking lot in Vancouver on October 16, 2020. (Ben Nelms/CBC)
Recent data provided by Alberta and Saskatchewan government officials show a drop in vaccination rates for many of the routine immunizations.
In Alberta, most vaccination coverage rates were down compared to 2020. These include the second dose of measles, mumps and rubella vaccine among seven-year-olds, with provincial coverage that it went from 79.2% to 75.8% in 2021.
In Saskatchewan, data from June 2021 compared to data through this June shows that immunization coverage dropped among two-year-olds. While 76.4% of two-year-olds were vaccinated against whooping cough with four doses in June 2021, only 73.4% were vaccinated against the disease by the end of this June.
Provincial pertussis immunization rates among seven-year-olds also declined over the same time period in that province.
The decline in vaccination coverage may not seem like much, but one pediatrician says the changes are striking.
“You’re actually looking at hundreds of kids who are now behind or unvaccinated. And that can make a big difference in terms of seeing some of the diseases that we have vaccinations for that they shouldn’t be seeing,” said Dr. Ayisha Kurji. , a Saskatoon pediatrician and assistant professor at the University of Saskatchewan.
Freeman said Ontario is seeing “very, very low coverage” of school-based immunization programs.
The number of 12-year-old children in Ontario who were vaccinated against meningococcal conjugate (MCV4), human papillomavirus (HPV) and hepatitis B at school decreased significantly when comparing school year data 2019-2020 with 2020-2021.
During the 2019-2020 school year, about 70% of 12-year-olds had started but not completed the HPV vaccine series. This percentage of coverage was reduced to around 20% the following year.
“We really need to make sure that they get caught and that these immunization programs continue and are well-resourced to move forward,” Freeman said Wednesday during an online event hosted by the Ontario Medical Association.
Why the drop?
Last month, UNICEF said about 25 million children worldwide routine immunizations against common childhood diseases have been missed, calling it a “red alert” for children’s health.
Bettinger says that in Canada, school-aged children were the most affected, as they typically received their routine immunizations at school. But because of the pandemic that affected deployment to schools, vaccination did not always occur.
“We probably have at least two years of children who have potentially missed these vaccines,” he said.
He added that the COVID-19 immunization programs rolled out across the country were also demanding on the system.
“The resources that were required are mind-boggling, to be honest. And certainly that was the priority for public health over the last couple of years, so a lot of the other routine public health activities didn’t have such good resources.” she said.
A Quebec spokesman says fewer routine vaccines were distributed to schools because nurses were redeployed for COVID-19 vaccinations, schools were closed for parts of the pandemic and students were absent due to outbreaks .
But they added that regional health authorities were trying to catch up with students who missed school vaccinations in 2020 and 2021.
Ontario and Manitoba government spokespeople say the redeployment of public health staff during the pandemic has also affected data collection.
Freeman says families also didn’t access the health care system like they would have before the pandemic.
Some parents also postponed routine vaccinations because they were worried about interactions with the COVID-19 vaccine, Kurji said. That’s why she says guardians should address their concerns with a health care provider.
“If you have questions, be sure to ask … who is giving the shots, what to do and how to help them answer your questions and all your fears,” she said.
Health care providers with the Southeast Toronto Family Health Team held a COVID-19 vaccine clinic for children under the age of five at East Lynn Park in Toronto on Dec. 12. August (Evan Mitsui/CBC)
Bettinger added that vaccinating enough children against diseases like measles and polio is something Canadian public health officials have struggled with for years.
Seconds 2017 federal datalast available, all provinces and territories failed to meet the national vaccination target of 95% for many of the routine childhood vaccines.
But Bettinger cautions that not assuming lower vaccination rates among some children is due to vaccine hesitancy. That may exist, he said, but it’s a smaller proportion of people compared to those who may not have their children vaccinated because of access.
“The pandemic really disrupted services,” he said.
“We know there are mountains of evidence showing that the easier it is for a parent to vaccinate their child, the more likely the child will be vaccinated.”
Vaccines against covid-19
As families prepare for the return to school in the coming weeks, Freeman wants guardians to also think about getting their child vaccinated against COVID-19.
A nurse provides a band-aid after giving a child a vaccine against COVID-19 on August 4. (Ben Nelms/CBC)
Federal figures show that 42.44% of children aged five to 11 have completed their primary series. In the 12-17 age group, almost 19 percent have completed their primary series and received a booster.
“If the [COVID-19 cases] Step up, we really want our kids to be protected,” Freeman said.
How can more children be vaccinated?
Freeman said public health units need to think of creative solutions to administer routine vaccines, especially to reach underserved or marginalized populations.
Facilitating this is key, with school vaccination recommended since children are already in school and are much easier to access, according to Freeman and Bettinger.
“The easier we make it, the more likely people are to do it,” Bettinger said.