Staying Up to Date with Vaccinations During the COVID-19 Pandemic Is Critical
Jun 01, 2020

This guest post was written in May 2020 by VYF Board Member Mary Koslap-Petraco DNP, PPCNP-BC, CPNP, FAANP, an adjunct clinical assistant professor at Stony Brook University School of Nursing and a pediatric nurse practitioner in New York.

Nurse practitioner discusses vaccination during COVID-19

Mary Koslap-Petraco with her grandchildren

Life During the Pandemic

Life is so tenuous these days, and to be able to enjoy each other’s company is a pleasure that I really miss. I feel like I am in a cocoon that is warm and safe watching the world go by, and I’m doing what I can, while staying at home, to help my colleagues during this terribly stressful time. I really miss seeing my patients in person. The schools are closed so no school physicals. Telemedicine is not bad, but there is something special to be able to reach out and physically touch someone.

I miss my children and grandchildren. I was able to see my younger son’s two children today. My five-year-old granddaughter lost her two lower front teeth, which she pulled out herself (aggg!), so I dropped off the envelope the “Tooth Fairy” left at our house. I was able to visit with her and her brother through the glass storm door. What a day brightener! I miss my nurse friends and church friends, and I miss traveling, but social distancing is a small price to pay to keep everyone safe. As my husband and I are considered to be at higher risk for serious illness from COVID-19, our children do a lot of the shopping for us. Although I do make occasional trips to the local grocery store for fresh fruit and vegetables in the late afternoon when I know the store is empty, wearing a mask and gloves, and carrying disinfectant wipes. And then I scrub everything when I get home. Who would have thought?!

When I worked for the county health department, we used to talk about a pandemic, but the reality of it is really sobering. I keep up with all the health department’s updates on coronavirus. I am the point person for the most current evidence-based information on coronavirus for my colleagues who do not have the time to sit and watch TV. Yes, you must have guessed by now that I am one of those nurses whose health would be put at risk if I went back to work in the hospital. And yes, I do feel a sense of guilt, but I know if I did go back to the hospital, I would most likely be a burden to my colleagues who would then be looking for a bed for me. So, I am a behind-the-lines nurse doing all I can do to keep people healthy.

If we do not vaccinate on time, every time, we are going to start seeing these vaccine-preventable diseases come back, causing unnecessary heartache once again.
Vaccination Rates are Down

While everyone is on high alert over coronavirus, another danger is lurking. The Centers for Disease Control and Prevention recently published data indicating that there has been a big drop in routine childhood immunizations since the start of the pandemic. I see that in my own practice because fewer children are keeping appointments for vaccines.

I cannot tell you how dangerous this is! If we have children who are not vaccinated and they get sick, then it becomes more difficult to make a diagnosis in the era of a pandemic. If the child has a rash, could it be measles, rubella (German measles) or coronavirus? What about a cough? Is it pertussis (whooping cough) or coronavirus?  Or if the child has difficulty breathing and pneumonia. Is it pneumococcal pneumonia or coronavirus? A terrible headache —  Is it meningitis or coronavirus?  Muscle weakness. Is it polio or coronavirus? People may not realize, but there is still polio in some areas of the world, and due to the pandemic, the polio vaccination programs have been suspended.

Mary's Grandchildren Are we ready to see epiglottitis again, which causes a swelling of tissues in the throat, making it impossible to breathe? Most pediatricians educated in the last 20 years have never seen this disease because children receive Hib vaccinations. And let us not forget chickenpox (varicella) and hepatitis B vaccinations. If we do not vaccinate on time, every time, we are going to start seeing these vaccine-preventable diseases come back, causing unnecessary heartache once again. Have we forgotten that chickenpox can cause encephalitis or a bacterial infection from an infected chickenpox lesion? And do we really want anyone to develop liver cancer because they didn’t get all of the recommended doses of the hepatitis B vaccine?

Suppose someone develops a fever along with a vaccine-preventable disease and has coronavirus at the same time. I do not even want to think about what the possible cost to a child would be. And for adults and children, what about influenza (flu) vaccine? This year was a particularly bad influenza season — at least 179 children died between October 1 and May 29. This was one of the deadliest flu seasons for children in recent years. We have excellent data that indicate those who receive influenza vaccine and still get the flu (no vaccine offers 100% protection) rarely develop severe complications from influenza or need to be hospitalized. Do we want to have to face people getting the flu and coronavirus at the same time? Or perhaps be in a weakened state from influenza, only to get coronavirus at a later date? Will our immune systems be able to withstand another severe viral infection after recovering from influenza? Or vice versa?

We Need to Protect Our Children, Our Families and Our Communities

Bills have been introduced in some states to suspend vaccine requirements for children entering school for the next school year. Why would we want to do that now? Proposed legislation like this flies in the face of good public health practice at any time, and it would be even worse right now. Our public health workers are now stretched to the limits, and they would never have the legions of additional workers needed to track individuals in the case of a vaccine-preventable disease outbreak. The result will be uncontrolled vaccine-preventable diseases in our communities, causing additional untold complications and death.

Imagine the danger to our families and friends who had underlying medical conditions, which puts them at greater risk from vaccine-preventable diseases (and coronavirus). Many of these people have conditions such as autoimmune disorders or cancer and cannot be vaccinated against vaccine-preventable diseases. They rely on herd immunity (also known as “community immunity”) for protection. To have herd immunity against most infectious diseases, a community needs to have 80-90% of the people vaccinated to stop vaccine-preventable diseases from entering the community.

After working for a county health department for 30 years, I thought I could contribute to fighting this virus safely by being a contact tracer. I just received a call to ask if I wanted an interview. You bet I do! But along with that work, I will still be working to make sure all individuals are fully vaccinated right now. A pandemic is no time to let our guard down by postponing immunizations. Public health and healthcare providers must ensure that both children and adults can safely receive all the vaccines that are indicated for their age and health conditions, as long are there are no true contraindications.

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