HJAR Jul/Aug 2020

42 JUL / AUG 2020 I  HEALTHCARE JOURNAL OF ARKANSAS CHILDREN’S HEALTH As recommendations for social distancing relax, under-vaccinated children will be more vulnerable to vaccine preventable diseases such a meningitis, bacteremia, pertussis, and measles. Public health messaging regarding the importance of maintaining routine immunizations in children during the COVID-19 pandemic is essential to reversing falling vaccination rates. Health care providers and institutions can reduce parental concern regarding acquisition of COVID-19 by temporally or physically separating children being seen for vaccinations from those presenting for evaluation of illnesses, and by screening all children and their caregivers for signs or risk factors for SARS-CoV-2 infection. Use of catch-up vaccination schedules and drive-through immunization clinics offer ways to rapidly immunize children behind on their vaccinations, and increase access to vaccines. n REFREENCES 1 Santoli JM, Lindley MC, DeSilva MB, et al. Effects of the COVID-19 Pandemic on Rou- tine Pediatric Vaccine Ordering and Admin- istration — United States, 2020. MMWR. 2020:69;591–593. 2 McDonald HI, et al. Early Impact of the Coronavirus Disease (COVID-19) Pandem- ic and Physical Distancing Measures on Routine Childhood Vaccinations in En- gland, January to April 2020. Euro Surveill. 2020;25:2000848. 3 World Health Organization. Immunization, immunization coalition), and many committed partners and stakeholders have resulted in a sustained increase each year. By 2018, which is the year for which we have the most recent data, Arkansas’s immunization rate for the seven-vaccine childhood series had increased to 78.6 percent, and for the first time, surpassed the national average, raising Arkansas to the rank of 16 among all 50 states. The preliminary immunization numbers for 2019 look even more promising, so we are looking forward to those results, which will be available in the fall of 2020. Sadly, it is very unlikely that Arkansas will see a continued increase in our childhood immunization rates for 2020. As has been seen with national immunization data, there has been a marked decrease in the overall number of doses of childhood immunizations children have received over the past few months. In March and April this year, there was a 17 percent decrease in the number of vaccine doses (80,338 doses) given to children 2 years of age and younger, compared to the same months (96,825 doses) in 2019. This decrease is largely attributed to a marked decrease in office visits for primary care, as well as a decrease in immunization visits to ADH local health units as a result of the COVID-19 pandemic. José R. Romero, MD is a professor (tenured) of pediatrics in the department of pediatrics at the University of Arkansas for Medical Sciences (UAMS) in Little Rock, Arkansas. He has board-certification in pediatrics and pediatric infectious diseases. He is currently the chief medical officer at the Arkansas Department of Health (ADH). He was appointed as the interim secretary of health for Arkansas by Gov. Asa Hutchinson in May 2020, and will assume that role in July 2020. Jennifer Dillaha, MD , has played a leading role in the agency’s health promotion efforts, using a life stage approach that focuses on population-based interventions to improve the health and well-being of all Arkansans, since joining the Arkansas Department of Health in 2001. In March 2020, Dr. Dillaha was named state epidemiologist. This is in addition to her role as medical director for immunizations since November 2013, and medical director for outbreak response since August 2019. Her charge in the role of state epidemiologist is to provide leadership and guidance for addressing Arkansas’s most pressing infectious diseases, including COVID-19. She is also charged with improving Arkansas’s immunization rates, particularly among adults. She is uniquely prepared for that role as a physician with specialty training in internal medicine, and subspecialty training in infectious diseases and in geriatric medicine. She also serves on Immunize AR board of directors. Immunize AR is Arkansas’s statewide immunization coalition. Vaccines and Biologicals. https://www.who. int/immunization/diseases/measles/state- ment_missing_measles_vaccines_covid-19/ en/ Accessed June 5, 2020. 4 MMWR, May 07, 1982/ 31(17); 231-2 https:// www.cdc.gov/mmwr/preview/mmwrht- ml/00001091.htm accessed May 30, 2002. 5 7-Vaccine Series: 4 doses DTaP/Tdap/TD, 3 doses Hep B, 2 or 3 dose HIB series, 1 dose MMR, 4 dose PCV , 3 doses Polio, 2 doses Varicella. Vaccines Administered for Children 0-2 Years of Age in Arkansas, a 4 Month Comparison 2018-2020* Vaccination Month/Year 2018 2019 2020 January 49,607 54,189 55,607 February 40,296 45,373 44,739 March 45,566 47,756 41,818 April 42,242 49,069 38,490 Total 4 Months 177,711 196,387 180,654 *Provisional as of 5/28/2020 (Arkansas data source – WebIZ)