Childhood Vaccinations Fell During the COVID-19 Pandemic

Since at least 1998 when the U.S. enacted the nti vaccine, nti-vaccine sentiments had been simmering. Lancet, a prestigious medical journal, published—and later retracted—a fraudulent paper falsely linking childhood vaccines to autism. They’ve grown even stronger in the past two years, thanks to disinformation about the COVID-19 vaccines. Though the development of the COVID-19 vaccines happened at an unprecedented pace, they’ve been rigorously tested, and have proven both safe and effective. Nevertheless, falsehoods about them—that the vaccines contained microchips, that they would alter the DNA of recipients or cause them to become magnetic—have spread.

The public-health professionals feared that these inexplicable claims might increase distrust among vaccine-sceptical people or open the door to more vaccine doubt among people with no previous vaccine concerns. It seems that these fears were well-founded. In April, the U.S. Centers for Disease Control and Prevention (CDC) published a study showing that during the 2020-2021 school year, rates of routine vaccinations among the nation’s 3.52 million enrolled kindergarteners fell below the 95% level necessary to ensure herd immunity. Only 1% was the average decrease in vaccination rates from the 2019-2020 schoolyear. However, CDC scientists believe that this is sufficient to permit viruses to establish a foothold within the general community of children. Many of these kids may not be able to get vaccinated due to medical reasons.

Researchers cited several factors that could have led to lower vaccination rates. These included a lack of well-child visits at the peak of the pandemic, and closing of schools. Schools require students to be vaccinated. Many experts believe that anti-COVID-19 vaccine beliefs were a major factor.

“I think that segment of the community who’s already mistrusting of the medical community has been re-energized for sure,” says Dr. Gary Kirkilas, a Phoenix-area pediatrician and spokesman for the American Academy of Pediatrics. “We’ve had this politicization of the [COVID-19] vaccine that just leads to more mistrust.”

So far, the U.S. has been lucky that subpar vaccination rates haven’t yet triggered a rise in routine childhood illnesses. “We haven’t seen outbreaks, and that’s probably representative of the fact that families were staying home during the pandemic,” said Dr. Georgina Peacock, acting director of the CDC’s immunization services, and an author of the recent CDC study, at a press briefing when the findings were released. However, experts are now concerned about the possibility of an outbreak like that which erupted in 2019 with the nationwide measles epidemic.

Escalating anti-vaccine sentiments

California was a leader nationally in immunization requirements for schools. California lawmakers removed personal-belief exemptions in 2015 to allow parents to opt out of having their children vaccinated. Recent bills that would have required all businesses to provide COVID-19 vaccinations to their staff and added COVID-19 to the vaccine list for which students can be exempted from personal beliefs were not approved by the state legislature.

Christina Hildebrand is convinced that this may be the reason. Since years she has been fighting against California legislation mandating vaccinations as a prerequisite for public school enrollment. According to Hildebrand, legislators were resistant before the pandemic and became tired of her lobbying. Hildebrand said that since COVID-19 was released, legislators have been more open to her arguments. “I think it’s because prior to this, legislators didn’t have personal experience with the vaccine issue. Whereas now, every single legislator has had some experience.” She believes that the doubts people are feeling over the COVID-19 vaccine for kids (which studies have shown to be safe and effective) have spurred more people to rethink routine vaccinations in this age group.

That’s exactly what concerns experts like Dr. Gerald Harmon, president of the American Medical Association (AMA). “We’ve had three different pandemics,” he says. “The COVID-19 pandemic, the disinformation pandemic, and now the pandemic of distrust. So there is a substantial risk of giving more oxygen to the anti-vaxxer population.”

Falling vaccination rates

A recent CDC survey examined the changes in vaccination rates for three routine childhood shots, from 2019-2020 through 2020-2021.

  • Mumps, measles and rubella (MMR), where vaccination rates dropped from 95.2% down to 93.9%
  • Diphtheria and tetanus (DTaP) fell from 94.9% down to 93.6%
  • Varicella or chickenpox fell from 94.8% down to 93.6%

Even small deviations below 95% are concerning, particularly when it is measles. The disease is highly transmissible and even one point lower than the 95% herd immunity rate can spread the virus widely to those who have not been vaccinated. “Measles is an incredibly contagious childhood, which carries a serious risk of lifetime injury,” says Harmon. Some cases of measles in children can lead to damage to their central nervous systems up to 10 years later than the original infection. Despite being troubling, the state vaccine rates are worse. Maryland’s vaccination rates plummeted from 95% in 2019-2020 to 87.6% for MMR, DTaP and varicella respectively. Wisconsin suffered a 5.5% decline to approximately 87.2%, for all three shots. Idaho was the state with 86% vaccinations for this age group. This represents a drop of 3% from 2019-2020.

Since the CDC last tallied childhood vaccination rates in 2021, schools have reopened—with mandates for vaccinations in place—and visits to pediatricians have increased after a sharp decline. These two factors could mean that vaccination rates could rebound, but Harmon, Kirkilas and others worry that misinformation and distrust regarding COVID-19 vaccines may have an impact on other vaccines. Indeed, “routine immunization rates have been slow to rebound,” said the American Academy of Pediatrics in January 2022.

Francesco Pierri (postdoctoral student, Polytechnic University of Milan) is the principal author of an April paper published in Nature Scientific ReportsAccording to Twitter misinformation and surveys that showed negative views about shots due to COVID-19 vaccinations, low child vaccine rates could be linked with unfounded COVID-19 rumours.

“You can assume some spillover effect,” he says. “The activity around this kind of malicious content has increased, [leading to] an increase in the prevalence of misinformation of vaccines in general.”

Says Harmon, the AMA president, and a former Major General in the Air Force Reserve and the Air National Guard: “One of the things I learned in the military was that the way to overcome resistance is to maintain overwhelming competence. These people are vaccine-reluctant and I meet with them one to one. I try to answer their questions, to stay on the side of the science, and to not get emotional.” The most effective antidote for misinformation, he says, is more information—the genuine, scientific variety.

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