Could vaccine-preventable diseases surge as Alberta reopens?

Some Alberta pediatric infectious disease experts worry the pandemic may have led to a drop in the number of children who are vaccinated against serious childhood illnesses.

Alberta's public health clinics offering routine immunizations remained open even as other health services shut down.  But it's unclear if kids are being vaccinated on time at the same rate as usual.

Children under the age of two are supposed to receive vaccines at two, four, six, 12 and 18 months. The shots are given on a set schedule and protect against illnesses such as measles, whooping cough, pneumonia and meningitis.

Dr. Jim Kellner, pediatric infectious disease physician at the Alberta Children's Hospital and professor at the University of Calgary, suspects fewer Alberta kids are getting those routine childhood immunizations.

"It's pretty apparent — not just here in Calgary and southern Alberta but across the country — that visits that infants and children make to have vaccines, either in public health clinics or in physician's offices, are down quite a bit because children and families have stayed away from the offices to adhere to distancing recommendations," he said.

"I don't want to be too alarmist about it on the one hand, but on the other hand — certainly in the pediatric world — there's been a lot of discussion about whether we should be preparing ourselves to see a bit of a surge in some of the vaccine-preventable infections … after things start to open up."

Dr. Joan Robinson, a pediatric infectious disease physician at the Stollery Children's Hospital in Edmonton and editor of Paediatrics & Child Health, the journal of the Canadian Paediatric Society, has similar questions.

"The bottom line is we really do not know for sure at all what has happened with routine childhood immunizations during this pandemic," she said.

"The vaccines given especially at two, four and six months are to prevent some really severe diseases like sepsis, meningitis, pneumonia and so it's certainly possible that children who don't get those vaccines could end up getting severe disease, getting admitted to hospital. There's even a small chance they could die from those infections."

Robinson said there's also a risk of an outbreak of diseases, such as measles.

Data unclear

According to Alberta Health Services, the percentage of children who are up to date by age two on their vaccinations for illnesses including measles, whooping cough and polio remained roughly the same during the first five months of 2020 compared to the same time period last year.

But that data doesn't tell the whole story, according to Robinson​​​​​.

"If you look at kids who are fully immunized by age two, that's going to include all the kids who got their 18-month immunization prior to the pandemic," she said.

"Most of those immunizations would have been given prior to the pandemic no matter what."

A better indicator, she said, would be data indicating the number of children vaccinated at two, four, six, 12 and 18 months during the pandemic compared to the same time period last year.

CBC News requested that data from AHS but was told it is not available.

AHS did provide a breakdown of visits to public health clinics — which include routine childhood immunizations and a number of other health services.

Those visits are down.

There were 19,354 visits to these clinics between February and May of this year compared to 20,766 during the same period in 2019 — a drop of nearly seven per cent.

In a statement emailed to CBC News, an AHS spokesperson said it is possible some parents may be delaying their children's immunizations because of concerns relating to COVID-19, "but our data to date does not reflect that." 

"As always, we strongly encourage parents to make appointments to ensure their children are up to date. It is especially important now as Alberta is opening up again and there will be more opportunities for children to be exposed to these vaccine-preventable diseases as a result," the statement reads.

AHS said it is aware that some parents chose to delay non-essential visits to public health clinics — including appointments to check baby weights — during the pandemic.

"All routine childhood immunization appointments have continued to proceed as booked, and new appointments continue to be taken," the statement reads.

School-aged children have been impacted by the pandemic as well. School vaccination programs were halted during when schools shut down.

According to AHS, the majority of Alberta's roughly 50,000 Grade 6 students had their second dose of HPV and hepatitis B vaccines postponed when school was cancelled.

A smaller number of Grade 9 students would have had a different set of vaccinations cancelled.

AHS said those will be completed when school resumes.