Kindergarten vaccinations fall, serve as reminder to offer catch-up vaccine schedules

A lot of necessary care was disrupted by the SARS-CoV-2 pandemic, and the full effects are only now becoming evident.

It’s no secret the well-child visits and vaccination schedules were rescheduled, cancelled, or delayed during COVID lockdowns and in the months that followed. Efforts were made to catch children up on these visits as COVID restrictions eased, but a new report from the CDC highlights the ongoing challenges the pandemic caused to childhood vaccination schedules.

The report, released in early 2023, revealed a continued decreased in kindergarten vaccination rates compared to before the pandemic. According to the CDC, 93% of incoming kindergarten students had all of their required vaccines for the 2021-2022 school year, but this was a 1% drop from the prior school year, and a 2% drop from the 2019-2020 school year.1

CDC notes that among those kindergarteners that were not up-to-date with their vaccinations at the start of the school year, 2.6% had at least one exemption. On the other hand, 4% had no exemptions at all to recommended vaccines and were not even up-to-date on MMR vaccines. The CDC report notes that overall, MMR coverage rates were the lowest nationally since the 2013-2014 school year.1

Tochi Iroku-Malize, MD, MPH, MBA, FAAFP, president of the American Academy of Family Physicians, says this trend should be a reminder to all pediatricians and family physicians to use every patient encounter as an opportunity to review vaccine compliance. While a 1% drop each year might not seem like a lot, Iroku-Malize says that translates to a huge number of individual children who are now at an increased risk of infection.

“The study estimated that the US kindergarten population is about 3.8 million children. That translates to about a quarter of a million kids not getting the recommended vaccines,” she says. “These vaccines keep them in school and participating. This continuity helps improve their quality of life and their social and emotional development.”

Iroku-Malize says these vaccination trends aren’t only a concern for the children missing vaccines, either. It also presents challenges to establishing “a community of immunity” that can help protect children who are not able to be vaccinated.

The message healthcare providers need to get out following the release of this report is clear, says Iroku-Malize. First is to recommend vaccines to anyone who is eligible to receive them. Second, providers should stress the fact that vaccines are safe, effective, and save lives. Finally, she says pediatricians and family physicians need to remind patients and families that healthcare providers should be the first, most trusted stop for information about vaccination and disease prevention.

Although some states have blamed lingering impacts of the COVID pandemic for reduced health care access and vaccine compliance, Iroku-Malize says its important that providers help families understand that its never too late to get up to speed on preventive care. There is a catch-up schedule that can help resolve pandemic-related timing issues on the vaccination schedule, she adds, and modifications can be made to fit any situation.

“Our hope is that physicians will be able to have a better conversation with their patients and family members to remind them that vaccines are important, they are safe, and they do save lives,” Iroku-Malize says. “Patients should know we are there for them, we can answer questions, and they can catch up.”

Reference

1. Seither R, Calhoun K, Yusuf OB, et al. Vaccination coverage with selected vaccines and exemption rates among children in kindergarten — United States, 2021–22 school year. MMWR Morb Mortal Wkly Rep. January2023;72:26