Childhood immunization during the COVID-19 pandemic in Texas

Tasmiah Nuzhath; Kobi V Ajayi; Qiping Fan; Peter Hotez; Brian Colwell; Timothy Callaghan; Annette K Regan

doi:10.1016/j.vaccine.2021.04.050

Childhood immunization during the COVID-19 pandemic in Texas

Vaccine. 2021 Jun 8;39(25):3333-3337. doi: 10.1016/j.vaccine.2021.04.050. Epub 2021 Apr 27.

Authors

Tasmiah Nuzhath¹, Kobi V Ajayi², Qiping Fan³, Peter Hotez⁴, Brian Colwell³, Timothy Callaghan³, Annette K Regan⁵

Affiliations

¹ Texas A&M School of Public Health, College Station, TX, USA; Hagler Institute for Advanced Study at Texas A&M University, College Station, TX, USA.
² Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA; Laboratory for Community Health Evaluation and Systems Science (CHESS), Texas A&M University, College Station, TX, USA.
³ Texas A&M School of Public Health, College Station, TX, USA.
⁴ Hagler Institute for Advanced Study at Texas A&M University, College Station, TX, USA; Texas Children's Hospital Center for Vaccine Development and Center for Medical Ethics and Health Policy, Departments of Pediatrics and Molecular Virology & Microbiology, National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, USA; Scowcroft Institute of International Affairs, Bush School of Policy and Government, Texas A&M University, College Station, TX, USA; Department of Biology, Baylor University, Waco, TX, USA; James A Baker III Institute of Public Policy, Rice University Houston, TX, USA.
⁵ Texas A&M School of Public Health, College Station, TX, USA; School of Nursing and Health Professions, University of San Francisco, San Francisco, CA, USA; UCLA Fielding School of Public Health, Los Angeles, CA, USA. Electronic address: akregan@usfca.edu.

Abstract

In 2020, the state of Texas implemented coronavirus disease 2019 (COVID-19) social distancing guidelines in order to prevent surges at Texas hospital emergency rooms and in intensive care units. As noted in other states, an unintended consequence of these activities was significant declines in childhood immunizations. After analyzing state-wide immunization register data for Texas, we observed a 47% relative decline in immunization rates between 2019 and 2020 among 5-month-olds and a 58% decline among 16-month-olds. We observed a small decline (5%) among 24-month-olds, and no decline in vaccines received at birth (Hepatitis B). Declines were larger in rural counties compared to urban. These declines are superimposed on increases in state vaccine exemptions over the last five years due to an aggressive anti-vaccine movement in Texas. There are concerns that continued declines in childhood immunization coverage due to COVID-19 could lead to co-endemics of measles and other vaccine preventable diseases.

Keywords: COVID-19; Childhood immunization; Immunization programs; SARS-CoV-2 pandemic; Texas; Vaccine-preventable diseases.

MeSH terms

COVID-19*
Humans
Immunization
Immunization Programs
Infant, Newborn
Pandemics*
SARS-CoV-2
Texas / epidemiology
Vaccination