Doctor Appointments Amid Coronavirus: Should You Delay Your Child's Vaccines?
Across the nation, parents are canceling their children's routine checkups and vaccination appointments because they worry about a more imminent concern — having their child get infected with the coronavirus at their pediatrician's office. Some parents have even delayed the first-time vaccines for their infants for fear of COVID-19 contraction. For them, it's a logical concern: why put my otherwise healthy baby in harm's way?
But to most doctors, this is just solving one short-term problem by creating another, much larger crisis down the road.
"Even though our attention has been on COVID-19, there are many other infections still out there. They haven't gone away just because we're preoccupied with a new infection."
"In the long run, delaying vaccines is inviting disaster for everyone," Dr. Roy Benaroch, a pediatrician and a professor at Emory University in Atlanta, told POPSUGAR. "Now is not the time to let our guard down and allow another epidemic of disease to strike."
That's because delaying immunizations during this pandemic could lead to an outbreak of vaccine-preventable illnesses like pertussis, a respiratory infection more commonly known as whooping cough that, Benaroch noted, would "be a nightmare" in this current climate.
"Even though our attention has been on COVID-19, there are many other infections still out there," said Benaroch, who recently released a Great Courses presentation that outlines the rise, spread, and dangers of the coronavirus. "They haven't gone away just because we're preoccupied with a new infection. In fact, measles is still present all over the world and far more contagious than COVID."
Dr. Natasha Burgert, a board-certified pediatrician, agreed: "To be blunt, delaying vaccines is a foolish decision based on irrational fear rather than our evidence-based reality."
So what are concerned parents, desperate to keep their young ones safe and healthy, to do?
Parents Should Not Delay Their Children's Vaccinations
The Centers For Disease Control and Prevention have long recommended that children be vaccinated against 14 illnesses — from chicken pox to polio — in their first three years of life. Yet long before the coronavirus made the news, pediatricians have had a difficult time keeping parents from delaying their children's vaccine schedules. In fact, the CDC noted in a study released this past February that one-third of children between 19 and 35 months didn't receive vaccines on time. And often, once parents were off their child's schedule, it was much harder to get back on it.
"Although it's possible to get caught up later on vaccines, that's not the best idea," Benaroch said. "Being late means you've left children vulnerable and allowed time for children to be able to spread infections to other people. That's especially dangerous when our hospitals and healthcare workers are already strained."
Some apprehensive parents assume that the risk of their babies contracting, say, measles during this time of sheltering in place is extremely low. So why not wait?
"To be blunt, delaying vaccines is a foolish decision based on irrational fear rather than our evidence-based reality."
"Although social distancing has decreased the spread of all bacterial and viral illnesses, vaccine-preventable illnesses are slippery and tricky, just like novel coronavirus," Burgert told POPSUGAR. "They can be passed from people who feel well, they need very few particles to cause infection, they can linger on surfaces for extensive time, and they harbor silently for weeks before showing up. If any family member is still gathering groceries, running to the drug or hardware store, or continuing essential work, vaccine-preventable illnesses will continue to spread within family units."
Not only that, but when life eventually normalizes, "there will be times of increased susceptibility for those who are catching up," Burgert said.
Doctors are also urging parents to consider those beyond their child, as the success of vaccines is dependent on community protection rates. "The whole community has been put at risk," Benaroch said. "Families should be able to rest easy knowing that their children are as protected as possible, and that they're not putting elderly people, those with immune problems, and babies too young for vaccines at risk."
The American Academy of Pediatrics has also advised that babies and young children should still be brought in for vaccines amid the coronavirus outbreak. However, some experts suggest that parents with children at least 2 years of age — or older kids in need of a booster shot — could put off those appointments temporarily.
Benaroch, however, still recommends sticking to the vaccine schedule.
"Consider vaccines specific for older children," he said. "Tdap includes pertussis. Meningitis vaccines are also given then, and meningitis is spread by respiratory droplets and cause a very serious infection that typically has to be treated in an ICU — which would be a problem if ICUs are overwhelmed with COVID. The HPV vaccine is also given, which very safely and effectively prevents cancer. These three are usually given together at the 11- or 12-year visit, and I would not delay or split them up."
He added that the HPV booster, typically given one year later, could be delayed but that the 16-year meningitis booster shouldn't be postponed.
Parents Should Still "Attend" Well-Child Appointments
It's not only missed vaccinations that are a concern. Pediatricians track growth and development at all well-child visits and can spot underlying issues to address.
"I worry that for parents who skip checkups out of fear or misunderstanding, their children may suffer from an undiagnosed heart defect, hip dysplasia, developmental or growth delay, neurological issues, or a problem with puberty," Burgert said. "These are things parents do not come to the office worried about but are caught during routine visits. If not discovered, missing these issues can lead to lifelong problems."
"I worry that for parents who skip checkups out of fear or misunderstanding, their children may suffer from an undiagnosed heart defect, hip dysplasia, developmental or growth delay, neurological issues, or a problem with puberty."
These exams are particularly important for newborns, as doctors are also looking out for signs of jaundice, congenital diseases, and weight loss — issues that could be much more dangerous than the coronavirus at this point.
"Avoiding well visits also removes a lifeline for mothers and fathers to disclose mental-health challenges, both for themselves and their children," Burgert added. "And worse, avoiding routine visits will not offer the opportunity to discover evidence of emotional or physical abuse — a very real issue as our physical-distancing orders continue."
When possible, telemedicine appointments are ideal, but for some concerns, a physical exam is crucial.
"Different offices are approaching this in different ways," Benaroch said. "We're typically doing our exams in their vehicles, out in the parking lot, when that's practical. We've also set aside a completely separate time for only children coming in for well checks and immunizations and noncontagious concerns. Those children can come into the office during the morning hours, when no children with any contagious symptoms are allowed."
In the event you will need to go into the pediatrician's office, it's worth noting that national data shows a 45 percent decline in patient visits since stay-at-home measures began. Burgert hopes parents recognize that "it has never been safer to come to my pediatric office for care" because of all the safety protocols they have put into place.
Still, Benaroch recommends the fewer people attending, the better. "Only one parent should come in, with no siblings, if possible." His office has removed all magazines, shared toys, and even pens, so be prepared with your own if you plan to take any notes. He also advises parents coordinate with their pediatric office on the visit timing, "so you spend fewer minutes in the waiting room and fewer minutes in the hallway and reception area doing paperwork."
Above all, he said parents should try to remain calm: "Pediatricians are especially aware of the need to keep our offices safe for everyone, even the youngest and most vulnerable."
Burgert echoed that sentiment: "COVID-19 is going to be in our lives for many, many months. Parents will have to seek care for their children well before this pandemic is over. Now is the time to understand what measures your child's pediatric office has taken to accommodate this new normal. Keep routine visits as much as you are able. Vaccinate on time. Keep essential visits essential. And ask your pediatrician for options to determine which type of visit is best."
POPSUGAR aims to give you the most accurate and up-to-date information about the coronavirus, but details and recommendations about this pandemic may have changed since publication. For the latest information on COVID-19, please check out resources from the WHO, the CDC, and local public health departments.