Michigan reports a sharp drop in child vaccinations after the CDC warned missed shots could lead to a measles resurgence across the US

• A new CDC analysis found that after the state of Michigan went into shutdown on March 23, vaccination rates fell.
• The CDC issued a warning to the public about a possible measles outbreak if children were not vaccinated properly.
• The data from Michigan shows an emerging trend in declining childhood vaccinations, both in America and abroad.
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Child vaccination rates have dropped dramatically in one US state, stoking concerns among public health officials that the lockdown could pose serious public health risks unrelated to the coronavirus pandemic.

According to a new CDC analysis on vaccinations in Michigan, around 66% of five-month-olds were vaccinated each year from 2016 to 2019. That dropped sharply to 49% in 2020.

Overall, the vaccination rate for Michigan children under 18 years old decreased by 21.5%.

It comes after the CDC issued a warning to the public about a possible resurgence of measles. The new report builds on data showing an emerging trend in the decline of childhood vaccinations, both in America and internationally.

While many doctors have transitioned to telemedicine during COVID-19, vaccinations still require an in-person doctor's visit, something many parents are leery of during a pandemic.

Michigan officially went into shutdown on March 23, and vaccination rates immediately fell. The only vaccine rate that did not fall was the Hepatitis B vaccine, which is typically administered after birth in the hospital.

For children on a government health insurance program like Medicaid, vaccination rates were even lower than for children on private insurance. Only 34% of Medicaid-enrolled children were up to date with their vaccinations, compared to 55% of children not enrolled in Medicaid.

The study authors advised doctors on strategies they could use to make in-person vaccination visits safer, from dedicating specific, separate rooms to sick visits and routine check-up visits, limiting the amount of patients in the office at one time, and having parents call to check-in and receive their vaccinations in the parking lot.

"The observed declines in vaccination coverage might leave young children and communities vulnerable to vaccine-preventable diseases such as measles," the study authors wrote. "If measles vaccination coverage of 90-95% is not achieved, measles outbreaks could occur."

Without widespread vaccination, everyone can be at risk

Proper measles vaccination is split into two different shots. The first measles vaccination shot is given at 12 to 15 months, and the second is given between the ages of four and six. Without both shots, the child has not been fully vaccinated against measles. During this pandemic, many children may be missing their final measles shot.

Without a vaccine to combat it, measles is one of the most contagious diseases there is, and according to the World Health Organization, over 117 million children all over the world are currently at risk of missing their vaccines.

Measles is an airborne disease, which means just entering the room of someone who is sick can spread an infection, and 90% of people who come in contract with measles will get infected, according to the CDC.

"Measles is way more infectious than COVID is, so it's something to be much more feared than being exposed to COVID," Dr. Lee Atkinson-McEvoy, chief of general pediatrics at UCSF, told ABC7.

One 2015 estimate shows that if vaccinations were stopped, 2.7 million people would die from measles. In 2018, thanks to a combination of anti-vaxxers and misinformation, as well as lack of access, over 140,000 people died from measles, most of whom were babies and young children. With proper vaccinations, most of those deaths could have been prevented.

Richard Mihigo, program manager for immunization at the World Health Organization's Africa office, says historically, measles outbreaks have occurred during epidemics, when people have neglected to vaccinate.

"We saw this during the [2013-2016] Ebola outbreak in West Africa, where we had an outbreak of measles at the same time," he told Medical XPress. "And recently we've seen in the Democratic Republic of Congo that an ongoing outbreak of measles has killed more people than the ongoing outbreak of Ebola. But all attention was on Ebola."

"Concerted efforts are needed to ensure rapid catch-up for children who are not up-to-date with measles-containing vaccines," the study authors wrote.

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