Prioritize Vaccines Now -- Before We Have One for COVID-19

Sandra Adamson Fryhofer, MD


July 07, 2020

Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

This transcript has been edited for clarity.

Here's the topic of this edition of Medicine Matters:

Operation Warp Speed is a national program to accelerate the development, manufacturing, and distribution of COVID-19 vaccines. Several vaccine candidates are under study. The Advisory Committee on Immunization Practices (ACIP) has convened a dedicated COVID-19 vaccine workgroup.

But recent studies have me worried. The World Health Organization reported that as many as 80 million children worldwide are missing out on routine childhood vaccinations because of COVID-19. At least 68 countries are having problems with their immunization programs due to strain from the COVID-19 pandemic, and there are many reasons. People are scared — many are afraid to go to a clinic for fear of becoming infected with SARS-CoV-2. They are concerned for themselves, for their children, and for healthcare workers.

In some cases, the healthcare workers who usually administer the vaccines have been reassigned to respond to the COVID-19 pandemic. Many clinics don't have enough personal protective equipment and have had to limit the number of patients they see, which means fewer appointments are available. Travel restrictions also play a role. Some people may not be physically able to get to a clinic during a pandemic. Travel restrictions, including cutbacks in air travel, can also affect vaccine delivery to the clinic. You can't vaccinate if no vaccine is available, leading some clinics to cancel appointments.

Two other studies from the CDC have hit closer to home. Even now, during the pandemic, the CDC says it's important to prioritize vaccination of newborns, infants, and young children under the age of 2 years. But a new study in MMWR finds that from mid-March to mid-April, doctors in the Vaccines for Children program ordered 2.5 million fewer doses of vaccines and 250,000 fewer doses of measles-containing vaccines as compared with the same period in 2019.

As social distancing rules become more relaxed, children who have not been vaccinated are at greater risk of getting diseases like measles. Pockets of unvaccinated children led to a surge of measles in 2019, with the highest number of cases seen across the United States in more than 20 years. Another recent study looking at child vaccination in Michigan shows declines in vaccination rates for children of all ages, with coverage below 50% for some diseases.

These drops in immunization are occurring at a time during which we need strong immunization networks and programs, so that when a COVID-19 vaccine is available, we have mechanisms in place to get people vaccinated and protected quickly and efficiently.

Many experts predict a second surge of COVID-19 in the fall, right as flu season begins. Everyone aged 6 months and older needs a flu vaccination every year, especially this year.

The pandemic presents new challenges to routine vaccination. Many routine visits are going virtual, but vaccinations require an in-person visit. But during a telehealth visit, there is still much we can do to promote vaccination. We can reinforce the importance of vaccination and assess which vaccines a patient needs. We can administer vaccines during an in-person visit for another purpose. We can also give more than one needed vaccination during the same visit. We can even consider setting up a drive-thru flu vaccination clinic.

Physician recommendation is a strong motivator for vaccination. Physicians are trusted sources of information when making vaccination decisions. We need to use that power to strengthen our immunization programs so that when we have a COVID vaccine, we will be ready.

For Medicine Matters, I'm Dr Sandra Fryhofer.

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