Routine children’s vaccinations delayed out of fear of COVID-19 risk at doctor’s

Parents are delaying or skipping vaccinations altogether, fearing a trip to the doctor’s office may put them or their children at risk for contracting the COVID-19 virus.

But pediatricians are worried that even a slight dip in inoculation could jeopardize herd immunity for all the diseases routine vaccines protect against. What the population may see in a few months is an increase of these diseases and that there needs to be a good system in place to play catch-up.

“I would be comfortable now saying that the risks to children from these vaccine-preventable diseases are quite a bit higher than COVID, in terms of hospitalization or being in the ICU and dying,” said Dr. Shaun Morris, an infectious diseases physician at the Hospital for Sick Children.

“We’ve never had a situation where it’s possible a huge cohort of children may have gaps in their immunization. We don’t have a plan right now to fix that when COVID-19 goes away.”

Morris said there should be other ways of delivering the vaccinations as safely as possible in a clinic without making families wait around with sick people. One way could be staggering times — similar to grocery stores that allow only seniors to shop in the mornings — so that only healthy infants and children are coming in for vaccinations at certain times.

The New York Times reported the pediatric ambulatory department at Boston Medical Center began sending vaccination mobile units into city neighbourhoods last week. Part of that included a dedicated van for vaccines and well-baby checkups in front of the hospital.

Another way of easing parents’ fears of contracting the virus is what they’re doing in the U.S. — drive-through vaccinations. Toronto pediatric clinic Kindercare, in the Eglinton Ave. and Spadina Rd. area, is allowing its patients to pull up to the alley behind the clinic by appointment twice a week. Once assessed there are no risk factors — such as COVID-19 symptoms — the parent and child sit on a disinfected plastic chair outside of the office while the doctor gives the injections.

A Toronto Public Health-approved mini fridge is plugged in with an extension cord in order to maintain the vaccine’s temperature storage requirements. The clinic plans to administer vaccines for up to 60 children a week.

“The idea is when a patient comes into a regular practice, they touch the handle of the door, elevator button, they sit in the chair and sit in an exam room where the child may be slobbering on things — it’s 30 to 40 mins. of exposure, whereas in this model, it’s two minutes of extremely low exposure,” said Dr. Daniel Flanders, who is administering the vaccinations.

“Both the physicians and patients were both concerned that 30 patients a day — 60 humans — coming in and out of our clinic creates a COVID-19 spread, so parents were very afraid to come in and physicians were concerned it wasn’t safe. Layered on that, if kids aren’t getting their vaccines, the immunity infrastructure could crumble not only in Toronto, but globally.”

The clinic has a computer that will automatically update the child’s vaccine records, so parents don’t need to bring their paper copies.

The World Health Organization said Thursday that when immunizations are disrupted, even briefly during emergencies such as this pandemic, then the risk for measles and polio outbreaks increases.

In 2019, Congo experienced a deadly measles outbreak which killed more than 6,000 people in a country already facing its largest Ebola outbreak, which marks the importance of keeping up to date with immunizations, WHO said.

Toronto Public Health spokesman Dr. Vinita Dubey said other local measures clinics could adopt include limiting one adult to accompany their child to a visit, screening, conducting the assessment, and vaccinating and completing the 15-minute post-immunization wait in the same clinic room and having patients wait in their vehicle and calling them when it is their clinic time.

Morris said even children aren’t going outside during the pandemic — and even with daycares and schools closed — it’s important to get them vaccinated.

“A lot of the diseases being immunized, particularly in the first year of life, those are bacteria that already live on your body,” he said.

“You’re not so much trying to prevent getting it from another person, so much as you’re trying to prevent the bacteria that live in your nose, for example, getting into your body and causing invasive disease. So a child could still be at risk without ever going outside.”

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