© Fred Squillante, Fred Squillante
Kayden Pittman, 5, gets a vaccination shot from Morgan Roby RN, left, as his grandmother, Jennifer Mance, comforts him on Thursday, October 8, 2020 at Columbus Public Health.
Economic shutdowns implemented to slow the spread of the coronavirus may indirectly lead to outbreaks of other deadly diseases in the coming months, health experts are warning.
With more people staying home, fewer children got their vaccines for dangerous diseases such as the measles, mumps, rubella and pertussis this year, said Dr. Sara Bode, director of Nationwide Children's Hospital's Care Connection School-Based Health and Mobile Clinics.
"Everyone should think about this and be concerned and pay attention to this," Bode said. "It's really opening us up to being at risk of having a potential outbreak."
At this point, Bode said, it could be a question of when an outbreak of one or more of these childhood diseases occurs rather than if one will happen.
More than 90% of people need to be vaccinated for a disease to establish herd immunity and prevent an outbreak. Bode said Nationwide Children's estimates its patients are currently below that critical threshold. The patients of several other health care systems are likely behind on their vaccines as well because of the pandemic, she said.
In April, pediatric vaccines dropped by more than 45% across Ohio compared to April 2019, according to the state’s Immunization Registry.
A survey of 1,000 independent pediatricians nationwide by PCC, a pediatric electronic health records company, found that administered doses of measles, mumps and rubella (MMR) shots had fallen by 50% during a week in April when compared to a week in February.
The declines, Bode said, are the equivalent of a "ticking time bomb."
© Fred Squillante, Fred Squillante
Kayden Pittman, 5, gets a vaccination shot from registered nurse Morgan Roby on Thursday at Columbus Public Health.
"I'm in awe of our public health departments," Bode said, "but they are stretched to capacity. If we added on another outbreak on top of (COVID-19), it would be challenging."
Although diseases like the measles and mumps have been mostly eradicated in the U.S., they can spread quickly once introduced into an unvaccinated community, said Dr. Bill Miller, senior associate dean of research and professor of epidemiology at Ohio State University’s College of Public Health.
The measles may be the most concerning because every person who catches the measles could potentially infect up to 18 others, Miller said.
By comparison, Miller said, the flu and the mumps can infect between four and seven.
"All of these childhood illnesses, if you get them as adults, they're much worse," Miller said. "They aren't trivial, and there's a reason why we put so much effort into finding vaccines for them."
If outbreaks of measles or other diseases occur, Ohio and its health departments could be at a disadvantage financially and manpower-wise, said Amy Bush Stevens, vice president at the Health Policy Institute of Ohio (HPIO).
Health departments in Ohio receive less state and federal funding for emergency preparedness than nearly every other state and the District of Columbia, according to an analysis from HPIO. The state ranks 48th for emergency preparedness dollars per capita, according to the Columbus-based institute.
Ohio also ranks near the bottom when it comes to the size of its public health workforce, coming in at 45th out of 50 states, according to HPIO.
"I think our local health departments and our state health department are stretched really thin right now," Stevens said. "We just don't have a large enough public health workforce."
Stevens said recent history shows that if health departments mobilize a quick response, an outbreak can be quashed. She pointed to the 2009 H1N1 swine flu pandemic and recent outbreaks of mumps and measles in Ohio as examples of such containment.
In 2014, central Ohio saw a mumps outbreak and Amish communities across the state were hit with a measles outbreak, according to Dispatch reports at the time.
In all, 484 mumps cases were reported in the central Ohio outbreak that year — 46 more than the total reported in the United States throughout 2013. It was the largest mumps outbreak in Columbus in 35 years.
The mumps typically causes a swollen jaw or salivary glands, fever, headache and fatigue, according to the Centers for Disease Control and Prevention.
This article originally appeared on The Columbus Dispatch: COVID shutdowns may lead to outbreaks of measles, mumps as childhood vaccinations decline