Children still need to get their vaccines on time, even during the COVID-19 pandemic, health experts say.
And they typically can, as many clinics have taken safety precautions to keep kids from being exposed to the novel coronavirus.
But it seems some families have been staying away. The Washington State Department of Health has noticed a significant drop in the number of children being vaccinated over the past two months.
Kripal Kavi and Parvati Patil are among those who've been wary. Their daughter had been on schedule to receive all her recommended inoculations during her first year -- but they've wondered whether a pandemic-induced lockdown is the right time to take the now 11-month-old to the doctor.
"We were playing the waiting game to see how it would play out and evolve, to see whether the situation would improve," Kavi said.
Patil and Kavi's daughter isn't alone. About 30% fewer children were vaccinated in March, and about 40% fewer in April, compared to the average number of childhood vaccinations administered during those months between 2015 and 2019, according to the state Department of Health.
That's got health officials concerned that babies and kids won't be properly protected against diseases such as measles and pertussis (whopping cough), said State Health Officer Dr. Kathy Lofy.
"Decreasing vaccinations increases the risk that we could see an outbreak of a vaccine-preventable disease," Lofy said.
People don't normally see the effects of diphtheria or measles because they have long had vaccines, said Dr. John Dunn, Kaiser Permanente Washington's director of preventive care. Not having seen these diseases firsthand is no reason for parents to think vaccinations for them can be skipped during a health crisis like the COVID-19 pandemic, Dunn said.
A disease once thought eradicated can come roaring back if not enough people are vaccinated against it.
The most recent example in Washington state: a measles outbreak that sickened more than 70 people last year in Clark County, where only 85% of kindergartners had received the measles, mumps and rubella (MMR) vaccine. Nearly all that county's cases were in children -- 93% involved patients between the ages of 1 and 18 -- and people who weren't immunized. In King County, a dozen people contracted measles last spring, including unvaccinated students at Bothell's North Creek High School and at Issaquah High School. Measles had been declared eradicated in the United States in 2000.
Now, as parents are surrounded by news of a coronavirus that doesn't yet have a vaccine or proven treatment, they're worried that taking their child to be immunized against one illness could just lead to another.
"It's been interesting to see who hasn't come in for vaccinations. It's often been families that we would normally expect to be right there, right on time," Dunn said. The health-care system at large could have done more at the outset of the pandemic to work with families, he said.
Health-care providers are trying to cut through the noise and let parents know they're making doctor visits -- whether for checkups or vaccinations -- as safe as possible.
For example, Kaiser clinics are being regularly deep cleaned, Dunn said, and ill patients are seen in a separate area away from where kids are getting shots. That follows guidance from the Centers for Disease Control and Prevention (CDC), which also recommends health-care providers limit the number of patients in a clinic and do drive-thru vaccinations.
The recent drop in child vaccinations isn't unique to Washington.
Orders for pediatric vaccines have dropped since late January and fewer doses have been administered in the United States than had been by this time last year, according to a CDC report published this month.
Meanwhile, 25 countries around the world have put off measles vaccination campaigns, and most countries with polio vaccination programs have suspended them, according to the Measles and Rubella Initiative, a group that includes the CDC, the American Red Cross and the World Health Organization.
Not being vaccinated poses a real risk to children, especially children younger than 2 years old, Dunn said, because many of the vaccinations for that age group are for diseases that don't have effective treatments or are highly contagious.
As parents navigate the pandemic of a still-mysterious virus, they find themselves struggling with both an overload of information and not enough information.
Researching how COVID-19 affects children and infants has been difficult, said Kavi, who is a product manager at Microsoft. He has been reading any study he can find about the coronavirus and infants to try to get a better handle on the risk to his daughter.
Kavi and Patil plan to speak with their daughter's pediatrician soon to find out what precautions their office has taken.
"Were it not for COVID, it wouldn't even be a question in our mind," Kavi said.