Vaccine Access and Hesitancy: The Public Health Importance of Vaccines

Well before the coronavirus pandemic, measles, polio, and other vaccines were out of reach for 20 million children below the age of 1 every year, said Nandy. He described the unique challenges of vaccine uptake among four populations — people in remote rural areas, the urban poor, people in conflict-affected areas, and women. In addition to these challenges are persistent shortages of health workers, the displacement of refugee populations, gaps in data on who has and hasn’t been vaccinated, and long transport distances.

Getting Back on Track with Childhood Vaccinations

Vaccinations have also plummeted during the pandemic, as parents have postponed well-child checkups, fearing the risks of in-person visits. One-third of U.S. children are not vaccinated on schedule as it stands.

“We need to explicitly state it’s safe to go for well-child visits. The message is simple: Call your health care provider and get back on schedule,” said Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Disease. “Vaccinations are just one reason why we need to get kids back to the doctor’s office.  It’s an opportunity to check on their emotional well-being and how they are coping with this health emergency.”

Messonnier described some of the precautions doctors’ offices are taking, such as using separate waiting rooms for well-child visits and sick-child visits. Pharmacies, clinics, and other providers may also need to get creative and establish drive-up clinics — popular with COVID-19 diagnostic tests — for childhood vaccinations. School nurses and administrators will also need more guidance in the coming months.

Preparing for a COVID-19 Vaccine

“As we prepare for a future COVID-19 vaccine — in the hopes it will be available in the fall or winter — CDC is working to identify priority groups for outreach,” said Messonnier. “We need to look at disparities in vaccination at the state and county level — by race, ethnicity, and insurance status.”

Experts are also working to understand public perceptions around possible candidates for a COVID-19 vaccine. The idea that vaccines are rushed to the market without enough scrutiny is a tenet of the anti-vaccine movement. Language such as “operation warp speed” (in reference to the administration’s search for a COVID-19 vaccine) can be problematic, and dismissive of the extensive safety and effectiveness testing that vaccines must undergo.

Lessons from the Polio Eradication Program
COVID-19 might set the world back in immunization goals by several years. But it’s also an opportunity to reimagine childhood vaccination as a core function of the primary care system.

In low- and middle-income countries, polio vaccinators have walked from door to door, and they’ve traversed conflict zones and remote villages to ensure no child misses the opportunity to get vaccinated. Similar outreach tactics will be needed when a COVID-19 vaccine becomes available, and they will continue to be crucial for other childhood vaccinations.

“We have to be mindful of where the unvaccinated kids are, especially in the post-COVID-19 world,” concluded UNICEF’s Nandy. “We’ll have to coexist with COVID and continue to deliver vaccine services.”

Stephanie Miceli is a media relations specialist with the National Academy of Sciences, Engineering, and Medicine. The article was originally posted to the National Academies website.