Delayed Vaccinations for children due to Covid 19


The lockdown forced by the novel coronavirus has taken a toll on the immunisation of children in Andhra Pradesh. Most toddlers had missed the scheduled vaccinations in the first phase of the lockdown during coronavirus pandemic, leading experts to warn that such delays could cause out breaks of preventable disease later in the year. Their parents are worried and online paediatric queries have multiplied manifold.
A 36-year-old woman in MVP Colony, mother of a 17-month old girl, is looking for a paediatrician who can administer the Varicella vaccine, also known as chickenpox vaccine, to her daughter. “The vaccine was due in April. The doctor who administered the previous vaccines has shut his clinic. When I called, he said he would not start the clinic before the lockdown is officially lifted,” said the woman, who teaches in a girls’ school. The doctor is above 70. He said he was taking “extra precaution because he was in the vulnerable age group”. 
Still there is fear and anxiety that you might be exposed to COVID-19 while visiting your primary care physician or paediatrician. A 29-year-old mother in Seethammadhara is worried because her 10-month-old daughter is yet to get the MMR-I vaccine, for protection against measles, mumps and rubella. The vaccine was due in April. She takes her daughter to a private hospital for vaccinations but the schedule has gone haywire because of the Covid-19 crisis. “Going to the hospital is a problem. Also, I cannot discount the risk of infection at the hospital. But the doctor has said she would not resume her private clinic before May 21,” she said.
Disruption of immunization services, even for brief periods, will result in increased numbers of susceptible individuals and raise the likelihood of outbreak-prone vaccine preventable diseases (VPDs) such measles said Dr. Kandula Radha Krishna,  paediatrician of Omni RK Hospital and Past President of the Indian Academy of Paediatrics (IAP) AP Chapter. The vaccines for lungs and the respiratory tract — for protection against influenza and pneumonia — should also be ideally not delayed because weak lungs would make a baby more vulnerable to Covid-19 added Dr. Krishna.
Many aspects of life have recently changed or been put on hold due to COVID-19. “We know these are scary and uncertain times and many families aren’t sure whether they should bring their child to see their paediatrician for routine visits,” shared  Dr. Ch. Vishnumurthy, Paediatrician and owner of SVR Nursing Home in Amalapuram. But, It is important that infants and toddlers should receive primary vaccines like BCG, OPV without any fail before they are released from the hopistal. Such inoculations ward off serious conditions such as rotavirus, pertussis (AKA whooping cough), tetanus and polio. The vaccines like triple antigen, polio and rotavirus vaccines, due in periodic intervals over the first few months, are also non-negotiable added Dr. Vishnumurthy.
Worried about their children’s immunity being compromised amid the coronavirus pandemic, the parents are calling their family doctors for advice.  “Cough and cold in babies and the impact of delayed vaccination during the lockdown were among the top queries, said Dr. Srikant, Consultant Paediatrician and Immediate Past president of Indian Academy of Padiatrics of AP, who runs Sree Nursing Home in Vizianagaram. Added to this, due to the travel restrictions, rural patients are unable to come to towns to seek medical advice.
The IAP had issued an advisory in the middle of April, including some “general instructions for vaccination clinics” in the wake of the Covid-19 crisis. This was after a first advisory postponing the vaccinations till March 31. The new guidelines recommend that “a polyclinic/ nursing home/ hospital should have segregated vaccination areas with separate entrance and exit” and “it is essential to stager appointments to avoid crowding at the clinic”. Doctors who have resumed vaccinations said they were working according to the IAP guidelines.

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