Pediatric vaccinations decline in Minnesota amid COVID-19, parent hesitancy

Immunizations declined among kindergartners entering Minnesota schools last year, when concerns about COVID-19 vaccines carried over into hesitancy about shots to protect kids against measles and other infectious diseases.

Only 89% of Minnesota kindergartners were vaccinated for measles, mumps and rubella in the 2021-2022 school year, below the national rate of 93.5% — the lowest in a decade, the Centers for Disease Control and Prevention reported on Thursday. At least 3.7% of Minnesota parents filed vaccine exemptions for kindergartners, which exceeded the national average and was nearly a full percentage point higher than the 2020-2021 school year.

"This is alarming and should be a call to action for all of us," said Dr. Sean O'Leary, chair of the American Academy of Pediatrics' Committee on Infectious Diseases. He noted that the nation's weakened vaccination shield has allowed measles outbreaks in Minnesota and other states and the emergence of the polio virus in New York.

The decline in pediatric vaccinations is another indirect impact on Minnesota of the pandemic that has now caused more than 14,000 COVID-19 deaths in the state, according to Thursday's weekly state COVID-19 update.

COVID-19 numbers haven't surged after the holidays as feared, but the coronavirus has remained persistent in Minnesota. COVID-19 hospitalizations have remained above 500 each day since mid-November in Minnesota, though Tuesday's total of 524 was below the recent peak of 633 on Dec. 7.

On this date in 2022, more than 1,600 people were hospitalized for COVID-19 — with cases caused both by the fast-spreading omicron variant and the delta variant that had been harsh on people across age groups.

The COVID-19 death rate has slowed since that time — it took 35 days for Minnesota to go from 11,000 to 12,000 deaths in January 2022, but then it took more than 160 days each to reach the next two milestones. The remaining risk is concentrated in Minnesota's seniors, who accounted for 247 of the state's 266 COVID-19 deaths since Nov. 27.

State health officials are planning publicity campaigns to increase COVID-19 vaccinations and boost immunity levels. Even among seniors, less than 60% are considered up to date with COVID-19 vaccines plus recommended booster shots. The up-to-date COVID-19 vaccination rate is only 7.1% in grade-school children age 5 to 11.

Federal health officials believe hesitancy over COVID-19 vaccines is only part of what has reduced broader pediatric immunizations, though. Some schools during the pandemic weren't checking children or requiring parents to file exemptions, especially during periods of online learning.

"We know that the pandemic really had a disruption to health care systems," added Georgina Peacock, director of the CDC's Immunization Services Division. "So I think part of it is, well, child visits maybe were missed and people are still trying to catch up."

MN Community Measurement on Wednesday reported similar trend data — with clinics in the state reporting only 53% of children up to date on 10 recommended vaccinations by age 2. That rate had peaked at nearly 60% in 2017.

Seasonal influenza vaccinations have declined this fall and winter alongside the pediatric vaccinations in Minnesota, but the flu season surged before many people would normally seek their shots. Nearly 600 flu-related hospitalizations were reported each week in mid-November, but only 75 were reported in the week ending Jan. 7, according to Thursday's weekly update.

In a typical flu season, viral exchanges over the holidays would be causing infection levels to surge right now. But Minnesota was reporting minimal flu activity at the end of December when most states were reporting high to very high levels.

Not all vaccination trends worsened. A separate CDC database showed a higher rate of vaccinations by age 2 in U.S. children born in 2018 and 2019 than in those born in 2016 and 2017.

Preliminary data for 2022-2023 suggests that vaccination rates in Minnesota are returning to pre-pandemic levels for kindergartners and adolescents, said Jennifer Heath, a supervisor in the state Health Department's vaccine preventable disease section. Minnesota's lower vaccination rates last year, compared to the U.S., could have been exaggerated by the small sample size of the surveys, she added.

"So while there are concerning drops in immunization coverage ... there are some good signs on the horizon," she said in an emailed statement.