File photo
Bartholomew County health officials are growing increasingly concerned with low pediatric vaccination rates for childhood diseases, including measles, one of the most infectious. One infected person can pass it on to between 12 and 40 others if they haven’t been vaccinated, according to the CDC.
Routine childhood vaccinations have fallen drastically in the Columbus area during the coronavirus pandemic, raising concerns among local health officials that the decline could make the community vulnerable to outbreaks of diseases that have not been seen locally in decades.
Records from the Indiana Department of Health show that an estimated total of nearly 1,800 children ages 19 to 35 months in Bartholomew, Jackson and Jennings counties had missed some or most of their recommended shots for vaccine-preventable illnesses as of March of this year, including measles, polio, whooping cough, among several others.
That is more than double the 765 children in that age group in the three-county area who were behind on their routine vaccinations at the same point in 2019, the year before the COVID-19 pandemic struck.
Bartholomew County has seen a significant drop in immunization rates for several diseases over the same period — including declines of 21 percentage points for hepatitis B, 13 percentage points for pneumococcal disease and 8 percentage points for chickenpox.
In addition, polio and DTaP (diphtheria, tetanus and acellular pertussis) vaccinations each fell 7 percentage points compared to 2019, and MMR (measles, mumps and rubella) immunizations declined 5 percentage points.
Overall, just 54% of Bartholomew County children this year completed all of their recommended vaccinations by their third birthday, down from 74% in 2019.
The declines were even more steep in the surrounding area.
In Jackson County, 46% of children in that age group were up to date on their vaccinations this year — tied for the fourth lowest rate in the state and a 35-percentage-point decrease compared to the same period in 2019. Jennings County recorded a drop of 26 percentage points since 2019.
Similar trends were seen across Indiana, with 58% of children in that age group in the state receiving all of their recommended shots this year, down from 70% in 2019.
Local officials say they are concerned that the downward trend could make several illnesses that were once thought to be eradicated become more common.
“As long as our local rates remain this low, then the potential for cases in our community definitely exists,” said Bartholomew County Health Officer Dr. Brian Niedbalski.
Pandemic fallout?
The decline in routine childhood vaccinations is being attributed to a variety of factors, including the pandemic, which overwhelmed the health care system and disrupted routine health care for children.
As COVID-19 swept across Indiana, some medical providers temporarily closed their doors, while others halted wellness visits, officials said. Even after appointments were available, many parents put off taking their children to doctor due to the virus.
“I think there (are) a number of reasons why vaccination rates are low,” Niedbalski said. “First, some parents choose against vaccinating their children for one reason or another. Secondly, the pandemic has played a role. Children weren’t at school in person, so enforcement of required vaccinations may have dropped off a bit. Plus, I feel that some parents were rescheduling wellness visits due to COVID-19. This prevented the opportunity for children to get vaccines.”
Northside Pediatrics in Columbus, however, has not seen a decline in vaccination rates in that age group, though officials there said the county-wide declines could indicate that “large numbers of patients and families are not seeking regular care.”
“Many of the families we see are motivated to stay up to date on vaccines and well visits because of school or daycare rules,” said Dr. Tami Stone Iorio, a pediatrician at Northside Pediatrics. “When families were not using school or daycare as much during the early months of the pandemic, there was one more missing layer of reminders to be up-to-date.”
At the same time, local health departments, where many children get vaccinated, were instructed to focus all their attention on combating the pandemic that, at times, was overwhelming hospitals across the country, including Columbus Regional Hospital.
“The pandemic played the largest role in the decrease in all other vaccines,” said Amanda Organist, director of nursing at the Bartholomew County Health Department.
“I am concerned but also trying to do our very best to educate and inform parents on the need of vaccines for all ages,” Organist added.
Mistrust of vaccines
Some officials also pointed to trends in other parts of the country where COVID-19 vaccine hesitancy and misinformation may be spilling over into routine immunizations.
Currently, it is hard to say for certain the extent to which the local decline in childhood vaccination rates can be attributed to mistrust of COVID-19 or other vaccines. Statewide data suggests that more parents are choosing to not vaccinate their children on religious grounds.
The number of Indiana kindergartners who were granted religious exemptions to required school vaccinations more than tripled over the past seven school years on record, according to the Indiana Department of Education.
During the 2021-22 school year, 1,347 kindergartners had religious exemptions, up from 420 during the 2014-15 school year. Similarly, religious exemptions reported for Indiana sixth graders increased from 557 to 1,315 over the same period.
That comes out to about 2% of kindergartners and 6th graders in the state.
It is unclear what is driving the increase. While many parents have been hesitant to vaccinate their children against the coronavirus, COVID-19 vaccines are not currently required to attend public K-12 schools, meaning parents wouldn’t need to request an exemption for them.
“I think in some areas of the country, the growing distrust of medicine, of doctors and of the COVID vaccine has led some families to abandon any and all vaccines and maybe most traditional medical care,” Stone Iorio said.
However, Stone Iorio said the issue doesn’t appear to be significant in Bartholomew County.
“I do not believe this is a big issue locally, as most, if not all, of our local pediatricians take a strong stand on vaccines as a necessary part of public health,” Stone Iorio said.
‘Terrible pediatric illnesses’
The concerns among local health officials and doctors come as illnesses once thought to be eradicated in the United States have started to pop up once again.
Last month, the U.S. reported its first case of polio in nearly a decade after an unvaccinated young adult in New York contracted the virus and developed paralysis, The Associated Press reported.
Just a few weeks later, New York state and federal officials confirmed that the virus that causes polio had been detected in New York City’s wastewater in another sign that the disease is quietly spreading among unvaccinated people, according to wire reports.
Polio was once one of the nation’s most feared diseases, with annual outbreaks causing thousands of cases of paralysis.
There have been sporadic outbreaks of measles in the United States in recent years. In 2019, there were 1,274 cases of measles in 31 states — the highest total since 1992, according to the Centers for Disease Control and Prevention.
In addition, local officials said pertussis (whooping cough) cases in the U.S. have risen.
Local officials are urging parents to get their children vaccinated. Stone Iorio advised that parents whose children are behind in their vaccinations contact a doctor to talk about catching up, as the schedule for some vaccines does change when children are behind.
During the 20th century, Bartholomew County was not spared from outbreaks of these diseases.
In 1957, the National Foundation for Infantile Paralysis said there were 52 polio victims living in Bartholomew County, according to CRH.
In 1910, there were “three or four deaths” from measles in Bartholomew County in a matter of days, The Republic reported at the time.
In 1992, the Jackson County Board of Health declared a two-week “measles emergency” after two Seymour High School students contracted the disease.
During the emergency, officials held a mass vaccination clinic at the high school, inoculating about 950 students. The outbreak eventually crossed county lines, with at least one case reported in Bartholomew County.
“As a pediatrician who has been in practice for over 20 years, I fear that low childhood vaccination rates could lead to the reemergence of some of the terrible pediatric illnesses that I saw during my pediatric training in the 1990s that we rarely see today,” Stone Iorio said.
