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

Childhood immunization during the COVID-19 pandemic in Texas

Affiliations

Childhood immunization during the COVID-19 pandemic in Texas

Tasmiah Nuzhath et al. Vaccine. .

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.

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Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Percent of children up-to-date with recommended childhood vaccines at 1 May between 2010 and 2020, by age group – Texas, ImmTrac2, May 2010 to May 2020.
Fig. 2
Fig. 2
Percent of 5-month-old children up-to-date with recommended childhood vaccines at 1 May between 2010 and 2020, by vaccine – Texas, ImmTrac2, May 2010 to May 2020. Abbreviations: DTaP, ditheria-tetanus-acellular pertussis vaccine; MMR, measles-mumps-rubella vaccine; Hib, Haemophilus influenzae B; PCV13, pneumococcal conjugate-13 vaccine.
Fig. 3
Fig. 3
Percent of 16-month-old children up-to-date with recommended childhood vaccines at 1 May between 2010 and 2020, by vaccine – Texas, ImmTrac2, May 2010 to May 2020. Abbreviations: DTaP, ditheria-tetanus-acellular pertussis vaccine; MMR, measles-mumps-rubella vaccine; Hib, Haemophilus influenzae B; PCV13, pneumococcal conjugate-13 vaccine.
Fig. 4
Fig. 4
Percent of 24-month-old children up-to-date with recommended childhood vaccines at 1 May between 2010 and 2020, by vaccine – Texas, ImmTrac2, May 2010 to May 2020. Abbreviations: DTaP, ditheria-tetanus-acellular pertussis vaccine; MMR, measles-mumps-rubella vaccine; Hib, Haemophilus influenzae B; PCV13, pneumococcal conjugate-13 vaccine.

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