The Effect of COVID-19 On Immunization Rates

We've shared the unequivocal data - visits are down significantly for pediatricians across the country.  Although Well Visits have slowed less than sick visits, they aren't much behind.  What does this mean for vaccination?

I shared some quick immunization data last week on the webinar, but the spaghetti chart was a distraction so I am going to simplify.  Please note: these reduced immunization rates are not (yet) a reason to panic.  Many of them are for second and subsequent boosters - important but not vital at this moment.  The social efforts to reduce COVID will also help with measles, chicken pox, etc.  And we don't yet know how long COVID will impact immunization opportunity.  For now, though, this is what we're looking at.

I want to be clear: I am specifically looking at immunization CPT codes.  I'm not pulling clinical data and I'm not looking at immunization rates among our clients.  We might do that in a few weeks if we don't see an improvement or opportunity to catch up.  For the uninitiated, measuring true vaccine coverage is tricky for a variety of reasons and I'm trying to keep it simple.

My first thought was to look at the MMR vaccine.  Why?  Measles are a problem (again) in the US.  Measles is particularly contagious and we've had a few outbreaks.   Their timing is also easy to measure.   I don't want to see a measles outbreak as a result of COVID.

My second thought was to look at one of the "older" vaccines - namely, the HPV.  There is already powerful clinical evidence that the vaccine, even with its poor administration rates, has had an important impact on rates of HPV infection in children.  I don't want to see us slide backwards and allow HPV to recapture some deadly territory.  

I presumed that the HPV rate would fall further as pediatricians prioritize vaccines for younger children.  I then picked two more shots just to confirm what I think is common sense is true.  Let's look at the results.


Sure enough, there it is.  I've set the week of 02/24 (Monday start) to be the baseline for immunization volume.  That's very much pre-COVID here in the US.  The next week, due to normal variations in volume (and, I expect, teenagers returning from school break), HPV volume and Flu volume increase slightly while MMR and Hep A decrease slightly.  

By the week of March 16, however, we fall off the table.  At the end of last week, we are looking at MMR volume that is off by 53%, HepA volume off by 51%, HPV by 73%, and Flu down a whopping 83%.  

Is anyone surprised by these numbers?  I know I'm not.

To answer an immediate incoming comment: flu rates were already in steep decline in the weeks preceding this analysis, although they weren't going to drop to their present level without COVID.