Cover Story by Casey L . Penn
The Importance of Regular Vaccinations During a Pandemic
To understate it by a catastrophic mile ,
nothing has been routine about 2020 . Immunizations being no exception , it ’ s especially important right now to encourage your patients to get scheduled vaccinations . This month , we discuss the current immunization situation here in Arkansas to assist you in providing care to patients amid flu season and the continuing pandemic .
Bridging the Immunization Gap Attributed to the Pandemic
The development of a gap in scheduled immunizations during a pandemic year is cause for alarm , and recent data showed that is occurring for Arkansas children . Data presented by the Arkansas Department of Health in July revealed that from January to March 2020 , vaccination numbers were consistent with those from the same period last year . However , from March to May 2020 , the number of vaccinations for young children went down considerably in number compared to the same period in 2019 . Roughly one-third of that number was attributed to privately insured patients and about twothirds represented children covered by the Vaccines For Children program .
“ The health department ’ s latest data * shows that since the COVID-19 outbreak , around 75,000 immunizations have been missed for Arkansas children compared to this time last year ,” explained Anna Strong , executive director of the Arkansas Chapter of the American Academy of Pediatrics . “ We are concerned about this gap , a national trend . The last thing we need during a pandemic is an outbreak of another , preventable disease .”
ANNA STRONG
photo Courtesy of Heather Hazzan , SELF Magazine
Strong focused on the example of measles and the MMR vaccine ( Measles , Mumps , Rubella ). “ We know that measles is approximately six times as contagious as coronavirus according to the last numbers I ’ ve seen ,” she said . “ It ’ s highly concerning that there was a huge drop in the MMR vaccine during the scheduled periods of between 12-15 months and between 4-6 years of age .”
Pediatrician Laura Williams , MD , practices at PrimeCare North Little Rock and serves as medical director for the nonprofit vaccination awareness organization Immunize Arkansas . She has seen the reduction in vaccinations firsthand and is concerned . While her clinic has tried to continue aggressive immunizations as usual , she has seen fewer patients coming for vaccinations , she believes due to the " patient fear of coming to doctor ( thinking we were closed , you could get sick , etc .), an increase in vaccine hesitancy brought about by distrust of the medical establishment ,” and parents of children not currently going to in-person school feeling that the usual vaccine rules don ’ t apply to them .
“ If we can get the patients in the office , we are generally successful in giving immunizations , especially to the under-two-year-old group ,” said Dr . Williams . “ We have tried calling , reminders when children come in for illness or COVID testing , and advocating on social media .”
Dr . Williams noted that , on top of the work involved in getting patients into the clinic , giving vaccines is expensive and poorly reimbursed . “ In this era of severe business constraint to pediatricians ,” she explained , “ it becomes a fine line between appropriate , effective medical care and staying afloat . I think immunization is part of the ‘ pediatric religion ’ as it were ; however , most of us feel hamstrung in trying to deliver . I am especially worried about the upcoming influenza season . Many people do not think of influenza as a ‘ big deal ’ and are more than usually concerned about unfounded side effects . The overall suspicion of big pharma , of governmental medical oversight , and general fatigue over the pandemic all seem to lead to not following through with preventative health care .”
Reimbursement worries aside , Dr . Williams has remained resolute during the extra stress of the pandemic . “ We are here for the health and well-being of children and that has to be our focus ,” she said . “ The service we provide is essential to the future of society . In general , government has not been very supportive of pediatric efforts , to include immunizations . Most of my colleagues feel that we are just treading water and are being asked to do more with a lot less . We will persevere … the kids are worth everything .”
To help bridge the pandemic ’ s vaccination gap and the financial burden on physicians who provide vaccinations to Arkansas children , ARAAP and other Arkansas stakeholder groups
* as of 9 / 1 / 20 102 • The Journal of the Arkansas Medical Society www . ArkMed . org