Vaccinations are declining in Virginia and pediatricians are worried about a new public health problem. What’s going on locally?

Vaccinations across the state have decreased amid the coronavirus pandemic, according to the Virginia Department of Health. (WYDaily/ Courtesy of Pixabay)

While many are finding new ways to protect themselves during the coronavirus pandemic, many children are going unvaccinated for other diseases across Virginia. 

Between March 15 and April 23, vaccinations in Virginia have decreased by 45.7 percent compared to the same time last year, according to data from the Virginia Department of health.

Dr. Sandy Chung, a pediatrician in Fairfax and president of the Virginia Chapter of the American Academy of Pediatrics, said the chapter’s data also shows there has been a 35 percent drop in vaccines for infants and a 75 percent increase for adolescents in the state.

While prior to the pandemic many children were vaccinated on time, the coronavirus has caused a decline in immunization services as parents opt out of taking their child to go to a pediatrician, said Christy Gray, director of the Division of Immunization for VDH.

Chung said parents are not coming to pediatricians out of fear for exposure in doctors’ offices, but many don’t realize the harm that can be caused by waiting for a vaccine.

“What we’re worried about is that there’s going to be a resurgence of other diseases that are normally prevented by vaccines,” Chung said. “So the message to parents is that while there is a risk out there because of COVID, COVID is not going away so delaying the vaccine puts the child in danger of other diseases.”

There isn’t a current prediction for when a resurgence of these diseases might occur because it depends on how many people remain without vaccinations, Chung said. As people start to go out and mingle with others, there could be a spike in preventable diseases.

“So it’s just a matter of time,” she said. “Once there is an exposure of these [diseases], a group of unvaccinated individuals is at risk.”

Many of the vaccines have to be completed before a student can attend school in the fall. For example, students are required to get the required age for the tetanus, diphtheria and acellular pertussis vaccine from 10 to 11 years old. 

“Immunization requirements for school enrollment and attendance are part of the Code of Virginia,” said Eileen Cox, spokeswoman for Williamsburg-James City County Public Schools. “Any change would require action at the state-level.”

At this time, there is no information from VDH or the Virginia Department of Education indicating there will be a change to the vaccination schedule, Cox said. 

Previous to the pandemic, students were able to receive waivers for immunizations based on medical or religious reasons. These exemptions are not for parents or guardians who simply do not want the child to be immunized, Cox added.

There were 194 students in WJCC in the current school year that were exempt from specific vaccinations for religious or health reasons. In the previous school year, there were 172 students exempt. 

WYDaily asked Katherine Goff, spokeswoman for the York County School Division, how many waivers were issued for vaccinations and what vaccinations were the waivers issued for the 2018-2019 and the 2019-2020 school years.

“The division does not track exemptions per school year, as an exemption is valid for the student’s entire enrollment in a school or school division,” she wrote in an email. “As of this year, there are currently 227 vaccine exemptions for students attending YCSD schools.”

Goff said the most common exemptions are for the Tdap booster, MMR, and Varicella vaccines.

WYDaily reached out to Goff for further comment regarding the division’s policy to not track vaccine exemptions by school year and if the division’s enrollment policy regarding immunizations was accurate.

Goff confirmed the enrollment requirements were correct but was unable to give a response about YCSD’s vaccination tracking policy.

She said Wednesday the department that oversees health services for the school division has not responded to the inquiry.

Students enrolling in the school division for the first time are required to provide a birth certificate, proof the student’s guardian lives in York County, a physical examinations and immunizations before pre-school and elementary school, according to the YCSD’s website.

While the division also provides enrollment requirements for students who are homeless, in foster care, are military children transferring to other schools or have been expelled due to weapon, alcohol or drug violations, most of the enrollment policy focuses on immunizations.

The division needed proof of the minimum vaccination requirements shown below:

  • Four doses of DTP or DTaP for all new students.
  • Four doses of Polio (OPV/IPV) for all new students.
  • Two doses of Measles.
  • One dose of Mumps.
  • Two doses Mumps.
  • Three doses of Hepatitis B vaccine.
  • Two doses of Varicella for susceptible students.

“All rising 7th graders are required to have a dose of Tdap regardless of the interval since the last dose of tetanus-containing vaccine,” the policy noted. “If there is documentation of receipt of a dose of Tdap prior to 7th grade, another dose is not necessary. All new students entering 7th through 12th grade will be required to have received one dose of Tdap.”

The measles, mumps and rubella required immunizations are “met” with two doses of MMR with the first dose on or after the 1-year-old and the second before the child enters kindergarten.

There is some flexibility for parents and guardians.

Students with incomplete immunizations can still enroll, provided the parents create a timeline for getting the remaining doses within 90 days, except for the Tdap vaccine.

Parents who do not wish to immunize their children can be exempt from vaccinations.

“A medical exemption is a physician’s written statement that immunizations would be detrimental to the child’s health at that time and future immunization compliance is planned,” according to the enrollment policy. “A religious exemption is a parent signed and notarized document entitled “Certificate of Religious Exemptions,” Form CRE-1.”

But with this decline, there are concerns for children’s wellbeing going into the next school year.

“If everyone waits until August to get their shots to go back to school, there won’t be enough capacity at doctors’ offices to handle the influx,” Chung said. “So  we need to spread that out now.”

Chung said while parents are concerned, they should feel safe coming to a pediatrician. Most offices are taking measures to ensure the safety of patients, such as splitting up rooms and hours between visits from sick patients and those needing wellness check-ups.

Most are also cleaning surfaces more frequently and wearing personal protective equipment.

“I would say the doctor’s office is safer than the grocery store,” Chung said.

But as Virginia starts to reopen and residents creep back into normal activities, Chung said there’s no way of knowing if people will continue to be scared of coming to health care facilities for vaccinations.

“The question about opening up and will there have to be more mitigation strategies to keep people at home is difficult to determine,” she said. “It’ll be a waxing and waning situation. But just waiting until it’s safe to go out is not a good plan for parents to rely on when it comes to preventative care.”

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