Schools Also Face Challenges With Routine Non-COVID Vaccinations

With safety measures arising from the COVID pandemic, many families skipped routine medical care including children’s vaccinations – what role is there for schools as students are welcomed back to the classroom?

The Center of Disease Control recently issued a report about “routine vaccinations” (non-COVID) affected by behavior changes during the coronavirus response.

Full report citation: Patel B, Murthy , Zell E, et al. Impact of the COVID-19 Pandemic on Administration of Selected Routine Childhood and Adolescent Vaccinations — 10 U.S. Jurisdictions, March–September 2020. MMWR Morb Mortal Wkly Rep 2021;70:840–845. DOI:

This summary from the CDC website encapsulates the issue:


What is already known about this topic?

Early reports during the COVID-19 pandemic documented a marked decline in pediatric vaccine ordering and administration, placing U.S. children and adolescents at risk for vaccine-preventable diseases.

What is added by this report?

Analysis of immunization information systems data from 10 U.S. jurisdictions indicated a substantial decrease in administered vaccine doses during March–May 2020 compared with the same period during 2018 and 2019. Although administered doses increased during June–September 2020, this increase was not sufficient to achieve catch-up coverage.

What are the implications for public health practice?

To prevent outbreaks of vaccine-preventable diseases, health care providers should assess the vaccination status of all pediatric patients, including adolescents, and contact those who are behind schedule to ensure that all children and adolescents are fully vaccinated.

An article in EducationWeek (limited free views available) extends those concerns to the schools – many of which (in Maryland and across the country) are preparing to return to largely in-person instruction in the fall of 2021:

“We and others are very concerned that a large number of kids have missed their routine vaccinations, to the point that we’re going to see outbreaks this fall [of] measles, mumps, and rubella,” said Richard Long, the executive director of the Learning First Alliance, a group of K-12 organizations including the national associations for school principals and superintendents, the country’s two largest teachers’ unions, and the National PTA.

In its report, the CDC warned that if students return under-vaccinated to schools this fall, it could lead to outbreaks and cause a “serious public health threat.”

That’s the more extreme scenario.

Another possibility is that, as more students return to in-person learning and schools step up vaccine enforcement, large numbers of students won’t be able to start school on time because they haven’t received their required immunizations.

Communication with families and guardians, the experts quoted in the article, will be a key element in avoiding either the public health risks, or the attendance delays, that seemingly could arise from this under-recognized concern.

Read the full article on the EdWeek website.

Thinking about how schools and public education will change in the years ahead, as we move beyond the pandemic? So is MACo, and so are our panelists for a General Session at the MACo Summer Conference, “Lessons Learned and Ways Forward with Virtual Learning.” Be there for that Saturday morning session, and all the content at the MACo Conference — we’ll be safe and productive as we return to our in-person offerings.

The MACo Summer Conference will be held August 18-21 at the Roland Powell Convention Center in Ocean City, Maryland. This year’s theme is “Resilient. Responsive…Ready.”

Learn more about MACo’s Summer Conference:


Michael Sanderson

Executive Director Maryland Association of Counties