Pediatricians Push for Routine Vaccinations

A vaccine administrator, a Black woman with long, black hair wearing blue gloves, is giving a shot to a young Black child with curly hair who is pulling up their t-shirt sleeve.
A 2021 COVID vaccine clinic at Waterview Recreation Center held by the Philadelphia Department of Public Health | Courtesy of Philadelphia Department of Public Health

In April 2020, routine vaccinations among children dropped to below 40,000, with total routine vaccinations in the city dropping more than 60% at the pandemic’s inception, according to a September report from the Philadelphia Department of Public Health.

“It’s really impossible to overstate how important getting and maintaining, staying on schedule for routine vaccines is for children,” PDPH Communications Director James Garrow said.

Despite COVID’s toll on pediatric routine vaccination rates, the tides are starting to turn: Immunizations have risen back to near their pre-COVID rates, with about 50,000 children getting their shots in June 2021, compared to about 60,000 in June 2019, according to the report.

However, some area Jewish pediatricians still have concerns. They believe there’s work to do to get those numbers back to what they were before the pandemic, and questions remain about how growing vaccine skepticism due to COVID vaccine misinformation has impacted attitudes toward routine vaccines.

Dr. Paul Offit, director of the Children’s Hospital of Philadelphia’s Vaccine Education Center, estimates that about 15% of parents he encounters have some form of hesitancy about getting their children vaccinated. He’s able to sway about 85% of them.

However, Offit is worried about the low COVID vaccine uptake in children over 5. Since Pfizer-BioNTech’s use for children 5-11 was approved by the Food and Drug Administration on Nov. 3, only 30% of parents nationwide have taken their children to be vaccinated, Offit said.

Dr. Paul Offit is a white man with short, grey hair and thin, rectangular glasses. He is wearing a blue button-up shirt and purple patterned tie.
Dr. Paul Offit | Courtesy of Children’s Hospital of Philadelphia

A large part of the undervaccination of children is due to growing partisanship around vaccination, he said.

“Twenty years ago, the anti-vaccine movement did not have a political cast to it,” Offit said.

Parents also report not wanting to have their child receive the COVID vaccine due to the speed at which the vaccine was produced, which made it seem untrustworthy, Center City Pediatrics Dr. Craig Barkan said.

“I generally try to explain to them that there’s an incredible amount of research that has demonstrated safety,” he said. “The process that went into making this vaccine has been as thorough as any other vaccine. It’s just been done in a more timely way.” 

Reasons for not giving children routine vaccinations differ from skepticism toward the COVID vaccine.

“There are some parents who argue the now-completely and utterly defunct fear of autism,” Barkan said. “And people sometimes are just afraid that there is responsibility for a child, and they’re afraid that they’re going to make a bad decision.”

Offit added that a lack of education about vaccines also adds to skepticism. 

“There’s always a hesitancy to inject the child with a biological agent because everyone considers a child to be more vulnerable, even though they’re not,” Offit said. “Or they view not-vaccinating as the safer, less risky thing to do, which is not true.”

For parents with inflexible, negative beliefs about vaccines, though they make up only a small fragment of Offit’s patients, convincing them of the benefits of vaccines is challenging.

“When people make a decision, they generally stick by that decision, no matter how much evidence there is that they’ve made the wrong one,” Offit said.

However, vaccine attitudes likely aren’t the driving force behind routine vaccine under-uptake among Offit’s and Barkan’s patients. In the early days of the pandemic, parents were especially wary of taking their kids to the doctor, and children potentially missed important opportunities to receive their routine shots.

Dr. Craig Barkan is a white man with short, brown hair and thick-rimmed glasses wearing a button-up shirt with a stethoscope around his neck. He has his hands in his pockets and he is smiling at the camera.
Dr. Craig Barkan | Courtesy of Center City Pediatrics

“People have avoided going to the doctor out of fear of being in a place where they might get infected or get sick,” Barkan said.  

As more people have received COVID vaccinations, numbers of visits to the doctor have increased and returned to pre-pandemic numbers at Center City Pediatrics,
Barkan said.

If anything, parents of his patients have become even more willing to vaccinate their kids: “For the most part, there has been a strong eagerness for the vaccine.”

Though hesitant parents remain few and far between, professionals have warned against the harm lack of vaccination can cause. According to Offit, 75-100 children die each year from chickenpox, a vaccine-preventable disease. 

Though COVID hospitalization rates for children remain low, there remains a risk that is preventable with vaccines.

“What people don’t realize is that still you have thousands of children between five and 11 years of age who’ve been hospitalized; you have about 100 children of that age group who have died of this virus,” Offit said.

Increased hospitalizations have the potential to overwhelm the system, forcing patients to delay elective surgeries, according to Garrow. Though elective surgeries are often thought to be mostly cosmetic, they also include surgeries for cancer patients, which may be put on hold indefinitely.

“There are people out there right now who do need surgery, lifesaving surgery, but can’t get it because hospitals have been so overwhelmed by people who haven’t been vaccinated,” Garrow said.

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