Update on childhood COVID-19 and routine vaccination trends heading into winter and as respiratory viruses rise

Update on childhood COVID-19 and routine vaccination trends heading into winter and as respiratory viruses rise

In recent weeks, cases of respiratory syncytial virus (RSV) have been reported in younger children. aroseand the Centers for Disease Control and Prevention (CDC) have reported seeing early increases in seasonal flu cases. the CDC grades that the last two years have seen low flu activity, which likely means reduced population immunity heading into this year’s flu season, especially among young children who have never been exposed or vaccinated against the flu. Winter could also bring a spike in COVID-19 cases as the weather turns colder and activities move indoors. While cases of COVID-19 in children are often mild, this is not always the case. case, and children are particularly vulnerable to influenza and RSV. The combination of all three could have more serious ramifications for children and also has the potential to overwhelm hospitals. Vaccination against COVID-19 and the flu can provide protection; however, COVID-19 vaccination rates have plateaued and remain low for younger children, and the pandemic may have affected other routine vaccination rates. This policy watch outlines recent trends in children’s routine and COVID-19 immunizations and explores strategies to increase vaccination rates among children as we head into the winter season.

Uptake of the COVID-19 vaccine among children has stalled, and vaccination rates remain low for young children. As of November 2, 2022, 3.2% of children under the age of five and 31.8% of children ages 5-11 had completed their primary series, which are initial doses of a COVID-19 vaccine, most commonly two injections of an mRNA vaccine, but can vary based on age, immune status, and vaccine product (Figure 1). Acceptance is greater among those between 12 and 17 years old, with 61.1%. Some of this variation in uptake reflects the amount of time since the FDA authorized COVID-19 vaccines for different age groups. The vaccine was first licensed for children 16 and 17 years of age in December 2020 and for children 12 to 15 years of age in May 2021. It was licensed for children 5 to 11 years of age in November 2021 and eventually for children under five in June 2022. However, some reflects the views and concerns of parents. KFF COVID-19 Vaccine Monitor September 2022 report that more than half (53%) of parents of children under five and more than a third (35%) of parents of children ages 5 to 11 said they would “definitely not” vaccinate their children. their children. KFF surveys July 2022 found that parents of young children were concerned about the newness of the vaccine and insufficient evidence or research, side effects, and concerns about the general safety of vaccines.

Bivalent boosters were recently authorized for children five years and older, but it is not clear how many children will receive the new booster. Vaccination rates of children for the first booster (no longer authorized) were low. Starting November 2North Dakota5.3% of children aged 5 to 11 years and 18.2% of children aged 12 to 17 years had He received your first booster dose. It is required to complete the primary series at least two months before to receive the new bivalent booster; therefore, the low rates of the primary series, especially among children aged 5 to 11 years, mean that fewer children are eligible for the new booster. Starting November 2North Dakota0.5% of children aged 5 to 11 years and 2.6% of children aged 12 to 17 years have He received an updated booster dose (bivalent). Although children often have milder cases of COVID-19, some children do not develop serious illness and some have shown prolonged COVID symptoms after diagnosis. Boosters combat decreased immunity and can help reduce the risk of infection and subsequent transmission.

The pandemic has also caused a decline in flu vaccinations for children, although the impact of the pandemic on other routine vaccinations remains uncertain. while the children flu vaccination rates of last year’s flu season (2021-2022) were similar to those of the previous year (2020-2021), they were almost 6 percentage points lower than in 2019-2020, just before the pandemic began. Influenza vaccination rates among children vary widely by state and appear to be correlated with COVID-19 vaccination, meaning that states with higher uptake of influenza vaccination last season also have higher flu vaccination rates. increased acceptance of the COVID-19 vaccine, and vice versa (Figure 2). Some public health leaders have expressed concern that COVID-19 vaccine hesitancy may be spreading to routine childhood vaccinations, and one to study Factors found to affect COVID-19 vaccine uptake could be affecting flu vaccine uptake. In addition, vaccination rates for other routine childhood immunizations are also refused early in the pandemic, and the CDC reports vaccination coverage for all state-required vaccines for children in kindergarten (MMR, DTaP, and varicella) refused slightly by 1% in the 2020-2021 school year (the first full pandemic school year) compared to the previous school year. Some state Y local areas have more recently reported seeing reduced childhood immunization rates. However, CDC data for the most recent two school years is not yet available, and the overall impact on routine childhood vaccination rates is still unclear at this time.

There is a specific policy considerations to vaccinate young children, and some states have developed successful strategies to increase vaccination rates among children. States with the highest COVID-19 vaccination rates among children ages 5-11 use incentives, school vaccination clinics, parent-friendly websites and the media to encourage parents to vaccinate their young children. School immunization mandates can also be used as a tool to increase COVID-19 vaccine uptake among children, but at this time, only a few state have COVID-19 vaccination mandates for school staff or students. Preventive Care Appointments Are Important Too component when addressing routine vaccination rates, as some parents may not find an offer of a vaccine until they go for a well-child visit to a pediatrician and the pediatricians are I consider highly reliable sources of information for parents. Recently, the CDC’s Advisory Committee on Immunization Practices (ACIP) voted add COVID-19 vaccines to the recommended pediatric immunization schedule that includes the other routine childhood immunizations based on age. This is part of a regular annual process in which the ACIP meets to vote on the addition of newly recommended vaccines to childhood and adult immunization schedules.

Because Medicaid covers four out of ten children in the US, the program can play an important role role to facilitate access to COVID-19 and other routine vaccines for children, especially those with low incomes. To increase acceptance of the COVID-19 vaccine, state Medicaid programs and Medicaid managed care plans have undertaken several initiatives, including financial incentives for managed care plans that meet vaccination goals. Other recent federal actions may help increase routine vaccination rates more broadly. Data for children enrolled in Medicaid and CHIP showed a 9% decrease in all routine immunizations when comparing the COVID-19 public health emergency (PHE) period (March 2020 to April 2022) with a period prior to PHE (January 2018 to February 2020), with the largest decreases for HPV, Hepatitis A, and flu vaccines. Provisions included in recent legislation to strengthen the Medicaid Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) benefit can help more children covered by Medicaid receive all recommended screenings and services, including routine immunizations. In addition, the Children’s basic set The measures, designed to improve the quality of care for children in Medicaid and CHIP, will be required to report in 2024 and clue Statewide immunization rates for children and adolescents.

Children will still be able to access needed COVID-19 vaccines for free after the end of the COVID-19 PHE and even when federal vaccine supplies run out. Although the end of the PHE, as well as the exhaustion of the supply purchased by the federal government, could restrict access to some COVID-19 countermeasures, such as tests and treatments, COVID-19 vaccines, including boosters, will continue to be available free of charge to all the children even when there are no longer any federally purchased supplies or PHE protections in place. Once the supply of government-purchased vaccines runs out, the Vaccines for Children (VFC) program will provide access to COVID-19 vaccines to children who have Medicaid, are uninsured, or are underinsured, or who identify as American Indian or Alaska Native. Although immunizations are free through the VFC program, participating health care providers can collect an administrative fee. Children who do not have insurance can be eligible for the administration of free or reduced-price vaccines through a community health center.

As we head into the winter season, RSV and other respiratory viral infections are on the rise in young children, flu infections are higher than usual for the time of year, and COVID-19 cases are also expected to increase. At the same time, childhood vaccination rates against COVID-19 have plateaued and remain low, and other routine childhood immunizations may also have declined since the pandemic began. While most children have mild cases of COVID-19, vaccines can offer protection for children and families as travel and gatherings increase for the holiday season. Various tools, including incentives, outreach, and the media, can be used to increase vaccination rates for children against COVID-19, as well as routine vaccinations in general.

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