本文摘譯自MASSDEVICE?2020年5月12日新聞

以下為詳文

根據美國疾病控制和預防中心（CDC）研究人員的數據，由于COVID-19大流行，社區采取強制執行的隔離保護措施，使父母和孩子遠離醫生辦公室，這種情況促使了美國兒童常規疫苗接種量急劇下降。

3月13日宣布全國緊急狀態后，小兒疫苗接種量急劇下降，這表明某些兒童患上其他嚴重傳染性疾病（例如麻疹）的風險可能會增加。

CDC截

研究人員把2020年1月6日至4月19日聯邦資助疫苗的每周訂單與2019年的同期訂單進行了比較。

他們特別提到，到研究期結束時，CDC免疫實踐咨詢委員會推薦的兒童常規小兒非流感疫苗訂單，COVID-19相關的累積劑量下降了250萬劑，此外，麻疹疫苗訂單的累積劑量下降了25萬劑。

CDC發言人Richard Quartarone表示，研究期間的疫苗接種，總體下降幅度較大。上述數字的下降，顯然與COVID-19大流行有關。

在2020年3月16日開始的一周內，為≥24個月的孩子訂購的麻疹疫苗周數量急劇下降到500份左右；在3月23日開始的一周內，進一步下降到約250份；直到4月13日開始的那一周，一直保持這個水平。相比之下，宣布緊急狀況之前，即在3月2日開始的一周內，訂購了2500多份。

對于2歲以下的兒童，下降幅度明顯較小。從3月23日開始的一周內，這些孩子的訂單下降到約750份左右，不過，3周內略有上升。相比之下，在3月2日的那一周，這些孩子的疫苗訂單大約是2000份。

5月8日在線發表在《CDC發病率和死亡率周報》上的這項調查結果，來自對聯邦兒童疫苗計劃（VFC）訂購數據的分析，以及來自CDC疫苗追蹤系統和疫苗安全協作數據鏈（VSD）的疫苗管理數據。

CDC截圖

對于18歲或18歲以下的，VFC為他們大約有一半的人數免費提供聯邦購買的疫苗。VSD與CDC免疫安全辦公室和全國八家大型醫療機構在疫苗覆蓋率方面進行合作。疫苗接種覆蓋率是評估疫苗使用情況的常用指標，提供方的指令和給藥劑量是兩個替代措施。

來自CDC免疫服務部門、國家免疫和呼吸系統疾病中心的研究人員強調，在大流行期間保持定期接種疫苗非常重要，并指出：“常規的兒童疫苗訂購和使用劑量的確定下降數據可能說明，美國兒童及其社區面臨著疫苗可預防疾病爆發的風險增加。”因此，應該提醒父母，必須保護自己的孩子免受疫苗可預防疾病的侵害。

研究人員預測，隨著社區隔離的緩和，未接種疫苗的兒童將更容易感染其他嚴重疾病。他們總結道：“地方、州、聯邦各級的醫療保健提供者和公共衛生官員之間，需要繼續協調努力，有必要實現快速補種疫苗。”

原文：

COVID-19 Fears Tied to Dangerous Drop in Child Vaccinations

Medscape Medical News? ? ?Diana Swift? ? ?May 12, 2020

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

The social distancing and sheltering in place mandated because of the COVID-19 pandemic are keeping parents and kids out of their doctors' offices, and that has prompted a steep decline in recommended routine vaccinations for US children, according to Centers for Disease Control and Prevention (CDC) researchers.

Pediatric vaccinations dropped sharply after the national emergency was declared on March 13, suggesting that some children may be at increased risk for other serious infectious diseases, such as measles.

The researchers compared weekly orders for federally funded vaccines from January 6 to April 19, 2020, with those during the same period in 2019.

They noted that by the end of the study period, there was a cumulative COVID-19–related decline of 2.5 million doses in orders for routine noninfluenza pediatric childhood vaccines recommended by the CDC's Advisory Committee on Immunization Practices, as well as a cumulative decline in orders of 250,000 doses of measles vaccines.

Although the overall decrease in vaccinations during the study period was larger, according to CDC spokesperson Richard Quartarone, the above figures represent declines clearly associated with the pandemic.

The weekly number of measles vaccines ordered for children aged 24 months or older fell dramatically to about 500 during the week beginning March 16, 2020, and fell further to approximately 250 during the week beginning March 23. It stayed at that level until the week beginning April 13. By comparison, more than 2500 were ordered during the week starting March 2, before the emergency was declared.

The decline was notably less for children younger than 2 years. For those children, orders dropped to about 750 during the week starting March 23 and climbed slightly for 3 weeks. By comparison, during the week of March 2, about 2000 vaccines were ordered.

The findings, which were published online May 8 in the CDC's Morbidity and Mortality Weekly Report, stem from an analysis of ordering data from the federal Vaccines for Children (VFC) Program, as well as from vaccine administration data from the CDC's Vaccine Tracking System and the collaborative Vaccine Safety Datalink (VSD).

The VFC provides federally purchased vaccines at no cost to about half of persons aged 18 years or younger. The VSD collaborates on vaccine coverage with the CDC's Immunization Safety Office and eight large healthcare organizations across the country. Vaccination coverage is the usual metric for assessing vaccine usage; providers' orders and the number of doses administered are two proxy measures, the authors explain.

"The substantial reduction in VFC-funded pediatric vaccine ordering after the COVID-19 emergency declaration is consistent with changes in vaccine administration among children in the VSD population receiving care through eight large US health care organizations," write Jeanne M. Santoli, MD, and colleagues, of the CDC's Immunization Services Division, National Center for Immunization and Respiratory Diseases. "The smaller decline in measles-containing vaccine administration among children aged ≤24 months suggests that system-level strategies to prioritize well child care and immunization for this age group are being implemented," they state.

Santoli, who is an Atlanta-based pediatrician, and associates stress the importance of maintaining regular vaccinations during the pandemic. "The identified declines in routine pediatric vaccine ordering and doses administered might indicate that US children and their communities face increased risks for outbreaks of vaccine-preventable diseases," they write. "Parental concerns about potentially exposing their children to COVID-19 during well child visits might contribute to the declines observed." Parents should therefore be reminded of the necessity of protecting their children against vaccine-preventable diseases.

In 2019, a Gallup survey reported that overall support for vaccination continued to decline in the United States.

The researchers predict that as social distancing relaxes, unvaccinated children will be more susceptible to other serious diseases. "In response, continued coordinated efforts between health care providers and public health officials at the local, state, and federal levels will be necessary to achieve rapid catch-up vaccination," they conclude.