Some families behind on routine childhood vaccinations during pandemic, says Fraser Health

Fraser Health is hoping that shifting focus onto childhood vaccination against COVID-19 is going to have a dual benefit—of reminding parents to get their kids caught up on other, routine vaccinations as well, which they may have fallen behind on during the pandemic.

Last week, the health authority announced that nine sites across the region—including a clinic at Bonsor Recreation Centre in Burnaby—will provide childhood immunizations like the MMRV, diphtheria, and whooping cough vaccines alongside the COVID vaccine.

Fraser Health director of COVID testing and immunizations Sarah Siebert told Burnaby Beacon last week that her team has noticed that some families haven’t gotten around to getting their kids vaccinated against some of those illnesses over the past two years.

“Whether that has been that parents haven’t had the time, or haven’t been able to, or have been hesitant to leave the home—we have noticed that there is a bit of catch-up work to do. And the resources of public health have been busy with COVID,” she said.

“They haven’t been able to keep up as much with some of their immunization clinics in the school. So they’ve been able to do some, but there’s some catch-up for us to do.”

The Beacon requested provincial data on childhood immunizations since the pandemic began from the Ministry of Health last week. The ministry did not provide that by time of publication.

However, studies from Ontario and the United States have shown that the pandemic did have an impact on families keeping up to date on childhood immunization.

Researchers in Toronto found that the odds of vaccination delay of more than 30 days in the first wave of COVID (between March 17 and May 31, 2020) were nearly four times higher than they were before the pandemic was declared. Their paper, published last month in the Canadian Journal of Public Health, looked at children 0-2 years old in the Toronto area and also found that the median time that parents took to get their kids vaccinated increased from five to 17 days after the declaration of emergency.

The authors of that paper acknowledged the limited time window in which they conducted their research and said more study would be needed to ascertain whether families eventually caught up on delayed vaccinations. They also didn’t look at whether parental perspectives on vaccinations played a role in delays.

They did, however, express concern that if delays in vaccination were widespread, it could lead to an increased risk of catching vaccine-preventable diseases.

Another paper published last October in the Journal of the American Medical Association found that while vaccine administration rates in the US eventually returned to pre-pandemic levels, the proportion of younger children with up-to-date vaccinations has declined over time.

The problem was more pronounced among some racialized groups in the US, researchers found—and in fact, “differences in proportion of [up-to-date] vaccinations at age 18 months between Black children and children of other races may have increased through the COVID-19 pandemic,” they wrote.

Both papers cited the need for public health interventions to get children up to date on their immunizations—possibly by increasing the frequency of routine check-ups over the next year, or by promoting vaccinations when a child visits a doctor due to illness.

While Burnaby-based primary care physician Dr Birinder Narang told the Beacon he didn’t have access to data showing similar trends in BC, he said the pandemic undoubtedly had an effect on pediatric healthcare—and the impact went much further than childhood immunization.

“We have had difficulty bringing people in as well. Usually when you’re doing childhood vaccinations, at the same time you’re doing developmental assessments and milestone tracking for children. So it’s an important time for physicians and families to get together to read what’s happening with children,” he said.

“So there’s very obvious access problems. Because there’d been a lack of ability for patients to come in, there’s sort of been increased fear of coming into the clinic, due to the risk of exposure from COVID. There’s [also] been, probably, an impact of all the vaccine hesitancy that’s been going on with regards to the COVID vaccine that has spilled over into these well-established, well trusted programs.”

Narang said he’d seen anecdotally that misinformation about vaccines had been spreading with a vengeance as the COVID vaccine became available. False and long-debunked claims that vaccines had a link to autism in children became even more prominent, for instance.

And he said as misinformation spread, trust in science and healthcare professionals simultaneously dropped, potentially discouraging hesitant patients from seeking advice on vaccines from physicians.

Narang feels a top-down approach to COVID vaccination may have contributed to that. In BC, COVID vaccinations have been given out at mass immunization clinics and, later on, pharmacies.

But Narang said studies have repeatedly shown patients trust their own family physicians much more than they trust health authorities and governments, because they have relationships and rapport with their own doctors.

“And so I absolutely understand why [COVID vaccination] was important on a mass scale, to have it operational in a public health manner, … but when we got down into the general public much later into the campaign [with] people who were still very hesitant, there was not much impact on the public health campaigns in actually swaying them,” he said.

“What it was coming down to, and what it is still coming down to, was individual conversations, the trust, for people who are waiting for science to evolve, for consistency in it.”

Narang called it a “disservice” that the populations that would have been most helped by easy access to a family physician who could administer the COVID vaccine themselves would have been marginalized populations, like racialized groups or those experiencing other systemic barriers to healthcare.