Recent Drop in Children's Immunizations May Result in the Rise of Certain Highly Contagious Diseases

Pharmacy Times® interviewed Jason Kay, PharmD, MS, the director of pharmacy programs at Blue Cross Blue Shield Association, on how the recent drop in immunizations among children in the United States may cause the country to lose protection against highly contagious diseases, such as measles, whooping cough, and polio.

Alana Hippensteele: So Jason, what could be a potential result to the decline in immunizations among children in the United States this year?

Jason Kay: Well that's a good question, Alana. First of all, I think it's a very timely topic that you bring up right now because, as we're all focused right now on the COVID-19 vaccines being distributed as we speak throughout the whole country and really throughout the whole world, which is you know rightly so on the top of everybody's mind, it is more critical now more than ever to really hone in and not lose the ball on the importance of getting children vaccinated on time, on schedule, and up to date, because what could potentially happen is, as we start getting out of the pandemic, hopefully as early as in 2021, and we'll start getting back to some sort of normalcy, and we'll start gathering in groups again, particularly in schools and day care centers, if the vaccination rate continues to drop as it has been so dramatically in 2020, for example our BCBSA Health America Report estimates that by the end of this year, so in a couple of weeks, up to 9 million missed childhood vaccination doses could occur, which is a significant drop from 2019 of 26%. If that continues to happen, as we break out of this pandemic and get back into normalcy with getting into groups, in particular in schools and daycare centers, we could really see you know potential outbreaks of preventable but really serious infectious diseases such as pertussis, polio, diphtheria, and measles. Things that we thought decades ago were out of our lives and eradicated in this country could really come back and really bite us in a way that we have not seen in our lifetimes.

Alana Hippensteele: Yeah. Is the COVID-19 pandemic the main cause of the decline in immunizations among children?

Jason Kay: Yes, definitely for sure. For this year, in a recent survey we did from the association of up to 2000 parents, up to 40% responded that COVID-19 was the main reason they did not have their children vaccinated because they're afraid to go into the doctor's office or pharmacies to get the children vaccinated in the fear that they could get infected with COVID-19.

Other reasons behind that includes worries about having children vaccinated multiple times in one visit, and also some general concerns about the overall side effects related to vaccines, as well as general scheduling conflicts. What we're actually pleased to see is that what was not on as a reason was overall objection to vaccines, so we were always very worried about parents being very skeptical and very negative towards vaccinations, but we did not see that in the survey that we did back in September, so we were at least very happy to see that.

Alana Hippensteele: Yeah, absolutely. When will we see the effects of this decline in immunizations start to appear among patient populations?

Jason Kay: It could typically happen at any time, but the risk will more likely occur when the pandemic starts to subside, and again hopefully later in 2021, when the great majority of Americans are vaccinated with the COVID-19 vaccine and we return to some sort of normalcy, as we gather in crowded events, and in particular when the state lockdowns and restrictions subside and schools are allowed to reconjugate in person, and also in day care centers, that is when the risk could most likely be at its highest, as kids gather round and start socializing again in person, that's when we could potentially see the highest rate for potential outbreaks.

Alana Hippensteele: Right. What is the potential impact on health systems if the worst-case scenario result of the decline in immunizations among children comes to pass?

Jason Kay: Great question. It could be extremely significant. It could be, on the lower end, it could be sporadic outbreaks in communities across the country. In more severe cases, people widespread across the country, where communities are ravaged by outbreaks of measles, which is a serious enough disease, but also, we could see the return of a disease that has been eradicated for over 40 years in the United States, and that's polio. It was extremely debilitating, and it could lead to paralysis amongst kids, and that could be in its most severe nature, one of the main results of coming out of these significant decreases in the lack of childhood immunization rates.

In terms of the health care system, which is already being hammered by the COVID-19 pandemic, handling cases of these could be much more challenging because they're already dealing with COVID-19 patients. Also, economic distress, as parents may need to take off work and miss out on work days and getting paid because they’ll need to take care of the kids at home with either measles, whooping cough, or maybe even polio, in a severe case, and that could really damper families and directly impact families personally.

Alana Hippensteele: Yeah. Is there any way pharmacies can diminish the impact of the decline in immunizations now?

Jason Kay: Absolutely. I mean pharmacies for decades now have been really the go-to source to get vaccinated. Every year, the great majority of patients get their flu shot at the pharmacy. In prior decades, it used to be the doctor's office or a clinic, but now really pharmacists have really take a step up to the plate to become the primary source to get vaccinated, not just with flu and pneumonia shots, but with childhood vaccinations, with MMR vaccines, and HPV. So you only need to make the appointment, you go to your local retail pharmacy, the large chain pharmacy, and just step right up and ask to get vaccinated for your child, and usually you get in and out within 5 to 10 minutes, or even less than that. So, it is extremely accessible to get vaccinated, particularly with kids, at your local pharmacy.

Alana Hippensteele: Yeah. Highly contagious diseases such as measles, whooping cough, and polio have not been a part of American lives for so long that many may not understand the severity of these diseases. Is there anything that can be done to remedy this lack of awareness among patient populations?

Jason Kay: Absolutely, and I strongly think we could, if we haven't done a great enough job in the past, I think that's starting to turn around, and we're doing much better job overall as a health care system to promote the awareness and the importance of really getting vaccinated because, as you've mentioned, the majority of us haven't lived in a time where measles, polio, and whopping cough were really widespread, and so we have to get that message out and really hammer down that it is extremely important to keep up to date with children's vaccination schedules.

Pharmacies, I believe, do a decent job already one-on-one with families when they see them at the counter. But in terms of wide-scale type of promotion, we at the Blue Cross Blue Shield Association are really supporting our plans to get the word out, and already we've seen some excellent examples that's happening. Blue Cross Blue Shield Alabama is really working locally with their communities to promote this via a text messaging system to remind their members to get vaccinated for certain diseases, so they keep up to date and don’t forget to get vaccinated.

Also, Blue Cross Blue Shield Kansas City is taking another approach in terms of really directing their focus on folks of minority status and folks in underprivileged communities by developing a health equities dashboard to analyze data on a really significant detailed scale to prioritize and direct their attention as best they can to promote and really encourage folks in the minority status and the underprivileged status to get vaccinated.

Then also, across all of our plans, they work directly with the large scale and independent pharmacies to work together to promote and bring awareness in their member communities, really also promote public confidence to get vaccinated, and really stress that importance to do that, and also the fear and the potential significant risks if they don't get vaccinated.

Alana Hippensteele: Yeah, absolutely. Do you have any closing thoughts on these topics?

Jason Kay: You know, again, I thank you very much for bringing up this timely topic right now because, as I mentioned, the very beginning as we're all focusing on the COVID-19 vaccination front and how important that is and critical it is, we can't lose our eye on the ball on our regular scheduled immunizations, particularly with children.

So it is more important now than ever to get, if you haven't had your children’s vaccination schedule caught up, to get caught up now, and the sooner the better as always.

If you have any questions, please go out to your local pharmacies and ask any questions you need or just get vaccinated, we're always there to help.

Alana Hippensteele: Absolutely. Thank you so much for taking the time to speak with me today, Jason. Now let’s hear from some of our other MJH Life Sciences brands on their latest headlines.