COVID-19 Is Impacting Vaccination Rates of All Ages, Including Adults

New data shows a sharp drop-off in non-flu vaccination rates during the COVID-19 pandemic, leading doctors and major medical organizations to speak out and encourage routine vaccinations— for children and adults.

Childhood vaccinations plunged in the middle of March after COVID-19 was declared a national emergency, according to a May 15 report from the Centers for Disease Control and Prevention (CDC).

The decreased rates aren't limited to children. A data analysis from doctors at VaxCare, a company that provides vaccine management tools for physicians, health systems, and public health departments, shows at least a 49% drop across all age groups in weekly vaccines given during weeks in late March through mid-April. The company recently conducted an analysis of its own data across 1,146 ambulatory care offices and 231 health departments, finding a significant year-over-year decline in non-flu vaccines given at ambulatory care offices from 2019 to 2020.

Doctors are discouraging people from delaying a routine immunization any further.

“There’s a reason why vaccinations are given on a certain schedule,” Juan C. Salazar, MD, MPH, physician-in-chief and executive vice president of academic affairs at Connecticut Children’s Medical Center, tells Verywell. “If you don’t give certain vaccines in a timely fashion or if you give it delayed, you may lose that window of opportunity to prevent a serious illness.”

Childhood Vaccines

In its May report, the CDC analyzed data on vaccines ordered through the Vaccines for Children (VFC) program, a federally-funded program that provides free immunizations to children who may not otherwise be vaccinated because of their family's inability to pay.

The data shows that, from the middle of March to the middle of April, doctors in the VFC program ordered approximately 2.5 million fewer doses of all routine non-flu vaccines compared to the same period in 2019. That includes vaccinations against serious illnesses like measles, meningitis, and whooping cough.

The number of doses of measles-containing vaccines ordered, specifically, decreased by 250,000, with the largest drops found among older children. The report found vaccine rates started to increase among children ages 2 and under in mid-April, but still remained lower than they were before COVID-19 was declared a national emergency.

VaxCare data supports this trend. During the week of April 6, for example, non-flu vaccination rates were down 31% for 0- to 24-month-olds, 71.6% for 2- to 10-year-olds, and 76.3% for 11- to 18-year-olds compared to the same time last year. But by April 20, they were only down by 19.8%, 61.8%, and 73.2%, respectively.

AAP and CDC Response

The American Academy of Pediatrics (AAP) issued a statement after the data was released, calling the report “very worrisome.”

“Immunizing infants, children and adolescents is important, and should not be delayed,” Sally Goza, MD, FAAP, president of the American Academy of Pediatrics, said in the statement. “We do not want to return to a time when parents had to worry their infant could die of meningitis—especially when we have a vaccine to prevent it.” 

Now, the AAP and CDC are urging parents to vaccinate their children on schedule rather than delay during the pandemic. The CDC vaccine schedule recommends infants, for example, receive doses of multiple vaccines every few months for their first 18 months:

• Hepatitis b (HepB): At birth; between 1-2 months; between 6-18 months
• Rotavirus (RV): 2 months; 4 months; 6 months
• Diphtheria, tetanus, & acellular pertussis (DTaP): 2 months; 4 months; 6 months; 15-18 months
• Haemophilus influenzae type b (Hib): 2 months; 4 months; 6 months; 12-18 months
• Pneumococcal conjugate (PCV13): 2 months; 4 months; 6 months; 12-18 months
• Inactivated poliovirus (IPV): 2 months; 4 months; 6-18 months

Can You Delay Childhood Vaccines During the Pandemic?

The CDC also has a “catch-up” immunization schedule for children between the ages of 4 months and 18 years who start their vaccines late or who are a month behind the standard schedule. Is delaying a trip to the doctor's office for these shots permissible during COVID-19?

Doctors don't think so.

Delaying vaccines can lead to outbreaks of vaccine-preventable illnesses, including measles, whooping cough, rotavirus, and chickenpox, Joseph Schwab, MD, an associate professor of pediatrics at Rutgers New Jersey Medical School, tells Verywell. “Any delay in vaccination can undo the benefits of widespread immunization that took a long time to accomplish,” he says. “We encourage all patients to seek immunizations as soon as they are eligible for a dose and as soon as they can safely get an appointment.”

Gina Posner, MD, a pediatrician at MemorialCare Orange Coast Medical Center in Fountain Valley, California, tells Verywell that she’s been encouraging her patients to stay on schedule. “We can’t prevent COVID-19 from being in communities at this point,” she says. “What we can prevent are those deadly illnesses that we vaccinate against. If you delay vaccinations, those kids have a chance of getting something we can actually prevent.”

Experts stress that doctors and care providers are doing what they can to limit potential exposure to COVID-19 in their offices and to make patients feel as safe as possible.

“Many offices, including our own, have [arranged patient appointments] to allow for social distancing as well as aggressive cleaning regimens for the office and the use of personal protection equipment by both patients and staff,” Hanan A. Tanuos, MD, director of pediatric primary care at the Rutgers New Jersey Medical School, tells Verywell. At her office, staff and patients have their temperatures taken as soon as they arrive. "Everyone is given a face mask,” Tanuos says. People are also asked to answer screening questions about their COVID-19 risk.

Doctors aren’t taking concerns about potential COVID-19 exposure lightly. “It’s a scary time and people don’t want to go into any medical facility. We get that,” Salazar says. “Reassuring patients of the measures in place to protect them and their children is important, as is answering all their questions regarding their safety prior to the visit."

Adults Vaccination Rates Are Also Decreasing

While much of the attention—and government data—focuses on childhood vaccines, experts say the pandemic has likely caused a drop-off in adult vaccinations as well.

During the week of May 11—the most recent week of available VaxCare analysis data—non-flu vaccine rates were 30.1% lower than the same week in 2019. The largest percentage drop with respect to age group occurred among 19- to 49-year-olds and was twice as large, at 60.5%. Among 50- to 64-year-olds, vaccine rates were down 56%, and adults 65 and older showed a 46% drop.

Can Adults Delay Vaccines?

There is often a lesser national focus on vaccinations for adults, but they’re important, too, Susan Besser, MD, a primary care physician at Mercy Medical Center in Baltimore, tells Verywell. The human papillomavirus (HPV), Tdap (which can prevent tetanus, diphtheria, and pertussis), and pneumococcal (which protects against pneumonia) vaccines “are important to protect yourself and to protect others from that illness,” she says.

When it comes to which adult vaccines can be delayed and which are essential, Besser said it depends on the patient and their health. “That is actually an individual discussion between doctor and patient,” she says. “It partially depends on a person’s own health and their risks, as well as the risks of others around him/her.”

However, Besser says the flu vaccine is especially crucial this year as the U.S. faces an expected overlap of flu and COVID-19 season. "The flu vaccine should be mandatory this year," she says.

Global Impact of Delayed Vaccinations

Vaccine delays aren’t just happening on an individual level. The pandemic is also disrupting immunization programs in lesser-developed countries, according to an April analysis by Gavi, The Vaccine Alliance, a global health partnership that strives to increase access to immunization in poor countries.

Delays to vaccination campaigns mean that at least 13.5 million people in 13 of the world’s least-developed countries will not be protected against diseases like measles, polio, and HPV, the organization says. That number is expected to rise and impact more populations with time.

A Word From Verywell

You may be hesitant to go to the doctor’s office now, but experts say getting vaccinated is as important as ever. “Vaccinations have been protecting billions of people around the world for generations by preventing the infection and spread of dangerous diseases,” Schwab says. “They are most effective when most people receive vaccines on time and get all the doses they need. Offices and other vaccine programs can provide vaccines safely, even during this pandemic.”

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.