WASHINGTON, D.C. – Today, U.S. Senators Mark R. Warner and Tim Kaine joined Senator Maggie Hassan and 14 of their colleagues in calling on the Centers for Disease Control and Prevention (CDC) to address the declining rate of routine child immunizations for measles and other dangerous viruses amid the COVID-19 pandemic.

“The administration of routine pediatric immunizations remains critical throughout the duration of this public health emergency,” wrote the Senators. “The decline in immunizations is largely attributable to efforts by families to adhere to social distancing guidelines to reduce both their exposure to, and the spread of COVID-19. But if this trend ofdecreased immunization rates among children continues, the United States could face yet another public health crisis: increased risk of outbreaks of vaccine-preventable diseases.”

The Senators continued, “Such outbreaks would put lives at risk, and place additional stress on our health care system and public health infrastructure at a time when these systems are struggling to respond to the COVID-19 pandemic.”

The Senators called for CDC to develop and execute a comprehensive plan to address the decline in immunization rates, including measures such as increased public outreach and education and best practices for parents and families to visit doctors while limiting their risk of contracting COVID-19. The Senators also asked for details on what CDC is doing to ensure sufficient supply of immunization doses and medical devices to administer them.

In addition to Senators Warner, Kaine, and Hassan, the letter was signed by Senators Patty Murray (D-WA), Bernie Sanders (I-VT), Jeff Merkley (D-OR), Tammy Baldwin (D-WI), Bob Casey (D-PA), Chris Van Hollen (D-MD), Mazie Hirono (D-HI), Richard Blumenthal (D-CT), Tina Smith (D-MN), Jacky Rosen (D-NV), Elizabeth Warren (D-MA), Amy Klobuchar (D-MN), Jack Reed (D-RI), and Doug Jones (D-AL).

Read the Senators’ full letter here or below. 

Dear Dr. Redfield,

We write to express significant concern regarding the recent decline in routine childhood immunization rates in the United States during the novel coronavirus (COVID-19) pandemic, and urge you to take immediate action to encourage and support routine pediatric immunizations through the duration of the COVID-19 pandemic.

According to recent data published by the Centers for Disease Control and Prevention (CDC), a decline in provider orders for non-influenza childhood vaccines, and measles-containing vaccines including the measles-mumps-rubella (MMR) vaccine, began one week after President Trump declared a national emergency on March 13, 2020 due to the COVID-19 pandemic. ^[1] In May, the Michigan Care Improvement Registry found a drastic decrease in vaccination rates among children across nearly every age group. The percentage of children five months and younger who remain up-to-date on recommended vaccines declined from 67.9 percent in 2019, to 49.7 percent in May 2020.^[2] The New York City health department reported a 63 percent drop in the number of vaccine doses administered to children between March 23 and May 9, including a 91 percent drop for children ages 2 and above.^[3]

The administration of routine pediatric immunizations remains critical throughout the duration of this public health emergency. The decline in immunizations is largely attributable to efforts by families to adhere to social distancing guidelines to reduce both their exposure to, and the spread of COVID-19. But if this trend of decreased immunization rates among children continues, the United States could face yet another public health crisis: increased risk of outbreaks of vaccine-preventable diseases. Such outbreaks would put lives at risk, and place additional stress on our health care system and public health infrastructure at a time when these systems are struggling to respond to the COVID-19 pandemic.

To avoid this potential crisis, we urge the CDC to immediately develop an action plan that incorporates targeted public outreach and education efforts on addressing vaccine hesitancy and emphasizing the importance of pediatric immunizations; resources for communities that have seen reductions in their immunization rates since the start of the COVID-19 pandemic; and guidance for parents and families on how to safely access pediatric immunizations during the COVID-19 pandemic, including best practices regarding personal protective equipment (PPE) use and other precautions to limit the risk of exposure to COVID-19 in health care settings; and necessary efforts to ensure rapid catch-up for children who are not up to date on critical pediatric vaccines.

In addition to developing the plans described above, we request that you respond to the following questions no later than July 1, 2020 to help us better understand how the federal government is working to address the alarming drop in pediatric immunization rates:

1. What specific steps is CDC taking to reverse the dramatic drop in vaccinations since mid-March?

1. How does CDC plan to capture accurate real-time data on pediatric immunization rates and identify potential solutions, particularly in vulnerable communities?

2. What outreach and education efforts are underway at CDC to address fears among parents and families related to bringing children into health care settings during the COVID-19 crisis? 

1. Is CDC planning a public information campaign to address vaccine hesitancy, and if so, how will CDC ensure that the necessary communication on the importance of routine immunizations is reaching parents and families?

2. How will CDC ensure that families receive guidance on safe access to care for children during the COVID-19 pandemic, including the appropriate use of PPE?

3. How will CDC communicate with health care workers, and provide the necessary tools to inform communities about the importance of receiving pediatric immunizations during the COVID-19 pandemic? 

4. What guidance is CDC providing to pediatricians and other health care workers on procedures to ensure that they can safely provide and promote routine pediatric immunizations?

5. Given the significant increase in unemployment due to COVID-19, many families are finding themselves uninsured. How will CDC raise awareness of the Vaccines for Children (VFC) program to ensure that families know their children can still access routine immunizations, and how does CDC plan to support participating VFC providers as they work to catch up VFC-eligible children on missed vaccinations, while also preparing for the upcoming flu season?

3. How will CDC monitor the ongoing availability and ordering of pediatric immunizations, including doses and other essential medical devices, PPE, and other supplies needed to store, transport and administer vaccines, and what plans are in place to address any supply chain disruptions?

1. Is CDC taking steps now to ensure that the availability of pediatric immunizations, and necessary medical devices and supplies, is not impacted when production and domestic distribution of a COVID-19 vaccine is underway?

4. Has CDC developed or reviewed modeling or projections that predict the potential impact on future vaccine-preventable outbreaks if the current pediatric immunization rate continues throughout the duration of the COVID-19 pandemic? 

5. Does CDC require additional resources from Congress in order to support efforts to reverse the decline in pediatric immunizations? If so, what level of funding would be sufficient?

We appreciate your timely response and look forward to working with you on this critical issue.

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