After a few seconds, the vaccine was administered, the puncture site was sterilized, and a bandage was skilfully applied to the wound.
Madison and Tyler West had brought their 8-week-old daughter, Ruby, to Pediatric Associates of Greenwood for her regular checkup. As part of this visit, it was time for Ruby to get a round of vaccinations. Although the tiny newborn was crying at the needling, West knew it was too important to delay.
“I really just want her to be protected in any way possible,” said Madison West, a south Indianapolis resident. “Our family gets together a lot and we travel a lot, going to carnivals and reunions and all these places. And all those places have germs, she’s exposed to a lot of things. If it’s available and can help her in any way, I want to make sure it’s there.
Despite this importance, fewer young children in Johnson County and Indiana received the recommended vaccinations against diseases such as diphtheria, tetanus, polio and measles over the past three years.
Vaccination rates in the county have declined every year since 2019 as the COVID-19 pandemic wreaked havoc on regular pediatrician visits and disrupted established schedules for disease protection.
Doctors and local health officials are working to reverse this trend by working with parents through education and catch-up for children who have fallen behind.
“A lot of pediatricians weren’t seeing them for their regular checkups for a while during COVID,” said Dr. Mary Hodson, a pediatrician at Pediatric Associates of Greenwood and Ruby’s doctor. “It was several months before we were allowed to start seeing these children in our office again. People got out of their routine of coming every year for a check-up.”
Between the ages of 19 and 35 months, it is recommended that children receive a series of immunizations known as “4:3:1:3:3:1:4”. The number series refers to the doses of important vaccines against deadly diseases as set forth by the Advisory Committee on Immunization Practices, part of the Centers for Disease Control, made up of medical and public health experts who develop recommendations on how to use vaccines.
Vaccines included in this recommendation include those that protect against diphtheria-tetanus-acellular pertussis, poliomyelitis, measles-mumps-rubella, Haemophilus influenza B, hepatitis B, varicella, and pneumococcal disease.
“We’re starting to immunize kids at a young age because that’s when they’re most vulnerable to all these preventable diseases,” Hodson said. “When their bodies are vulnerable and they don’t have strong immune systems, ways to fight things, if we vaccinate, we can help them fight things if they have exposures.”
The Indiana Department of Health tracks the completion of these vaccinations through its state immunization registry.
As of 2020, the completion rate for these vaccinations in Indiana has dropped from 70% to 61% in 2021 to 58% this year. In Johnson County, during the same time frame, the completion rate rose from 76 percent to 67 percent to 59 percent, health department data show.
“Obviously a huge reason for that is COVID. It’s definitely a priority as people have stayed home and once people have been able to get out into the community, we’ve seen a drop in regularly scheduled immunizations,” said Lisa Brown, director of nursing for the Johnson County Health Department. “People were afraid not only to come here, but to go to doctor’s offices.”
The problem is not a local problem or an Indiana problem, but rather a worldwide problem. According to the World Health Organization and UNICEF, the COVID-19 pandemic has caused the largest sustained decline in childhood vaccinations in approximately 30 years.
“While a pandemic hangover was expected last year as a result of the disruptions and lockdowns of COVID-19, what we are seeing now is a continued decline. COVID-19 is no excuse. We need to catch up on immunization for the missing millions or we will inevitably see more outbreaks, more sick children and more pressure on already strained health systems,” said Catherine Russell, UNICEF’s executive director, in a report published in July 2022 .
The Johnson County Health Department offers all vaccines recommended by the Advisory Committee on Immunization Practices. They saw the decline in childhood vaccination rates and worked to correct that trajectory, Brown said.
“One thing we do is we use the immunization database registry that the state uses and we can run reports so patients that have been in our health department before, we can contact them if we see that they stand behind the vaccinations,” she said.
At Hodson’s office, the staff has always followed the American Pediatric Association’s recommendations to make sure their patients are up-to-date on their vaccinations, paying close attention to medical records and discussing vaccines with parents during well visits if their children are behind. from the schedule.
During the pandemic, that emphasis has become greater, Hodson said.
“In 2020, when practices were closing their doors and there was no one coming in at all, we continued to see all our children under 2 for their visits because we felt it was so important to get them up to date with these routine vaccinations,” said she. “So we continued to see these patients, even through the worst of COVID.”
As such, Hodson’s staff has not seen a significant decline in those patients under 2 years of age missing or behind on these vaccinations. But where she has seen a decrease is in vaccines for 5-, 11- and 16-year-olds — all ages where vaccines are recommended for various diseases.
Reinstating these routine doctor visits helped children become familiar with vaccinations.
“Fortunately, schools are on top, telling people they need to come in and get these vaccines. So it helps bring them back again. But we’re finding that some of those kids are a little behind,” Hodson said.
Still, the lag can be easily fixed.
“Go to your pediatrician, contact us here at the health department because we can look and see their records to see if they’re up to date. And if they’re not, we can usually schedule them in a week or so,” Brown said.
WITH THE NUMBERS
Percentage of completed vaccinations for children aged 19 to 35 months
Johnson County: 59%
Johnson County: 67%
Johnson County: 76%
Johnson County: 76%
Johnson County: 74%
Johnson County: 65%
— Information from the Indiana Department of Health