Why Routine Immunizations are a Must—Even During a Pandemic

June 11, 2020|3:54 p.m.| Angela K. Shen, ScD, MPH

Anglea K. Shen, ScD, MPHThe public health response to COVID-19 is vital to saving lives. However, among the many disruptions of this novel virus as we practice social distancing is the disruption of important, "everyday" health services, including declines in immunization coverage. While receiving a routine vaccination last month, it made me think about the many provider practices that have not been able to stay open, and the health systems scrambling to temporarily transform their practices into functional telehealth machines—even though some services, like immunizations, require face-to-face visits.

The biggest takeaway from two recent studies on trends in vaccination uptake (here and here) is that coverage for childhood vaccines have gone down, leaving children under- and un-vaccinated. Missing visits for young children mean not only missing the primary series, but also vital childhood developmental screenings. Vaccines are an essential part of the well-child visit and must continue while local and state public health departments implement measures to manage COVID-19.

Vaccination uptake will certainly rebound, albeit slowly, and the ways providers see patients and how health systems operate have changed, with more strict infection control practices and new ways patients and providers interact. Primary care providers have worked to make their practices a safe place to receive medical care during the COVID-19 outbreak, including scheduling well visits and sick visits at different times of the day, separating sick and well patients, and collaborating with other community primary care providers.

It is important to maintain services and to reassure parents that it is both safe and important to get timely vaccinations. In preventing illness, routine vaccinations also prevent unnecessary medical visits and hospitalizations down the road, which prevents additional burden on the already-strained health care system. The concern is that there is now a population of disease-susceptible children, and as the country reopens, they will need to make up those appointments to get their shots. Once children fall behind on the primary immunization series, it’s hard to catch up. This message becomes even more pertinent as we approach the fall, a time traditionally associated with back-to-school shots, sports physicals, and influenza vaccination season. It is also more critical than ever to emphasize the importance of getting the flu vaccine to reduce the impact of respiratory illness in the population, particularly those at high risk of respiratory illness. Older adults and adults with underlying medical conditions are at particular risk for vaccine-preventable diseases and complications. Reducing strain on the health care system by preventing the flu, and associated respiratory illnesses, will be key if there’s a second wave of COVID-19.

Public health is facing an unprecedented time. As the country emerges from various degrees of hibernation, it is important for healthcare providers to review recommended vaccination practices for children, adolescents, and adults, including pregnant woman. Resources on strategies to maintain routine immunizations and to promote immunizations during the COVID-19 pandemic are available to public health, providers, professional societies, immunization coalitions, and advocacy groups. At this time, the public health community is working hard to continue to contain the spread and mitigate the risks of COVID-19 while promoting and sustaining other essential public health services like immunizations to reduce the incidence of vaccine-preventable diseases and prevent community outbreaks.


Angela K. Shen, ScD, MPH is a retired Captain in the U.S. Public Health Service and a Visiting Research Scientist in the Vaccine Education Center at Children’s Hospital of Philadelphia.