August is National Immunization Awareness Month. The American Academy of Pediatrics recently posted a news piece on the disturbing state of affairs for childhood vaccines due to the pandemic and urged parents to make sure their children’s routine vaccines were up to date, along with their vaccination against COVID-19. Data published by UNICEF and WHO note that, worldwide, “23 million children missed out on basic childhood vaccines through routine health services in 2020, the highest number since 2009 and 3.7 million more than in 2019.” The resurgence of vaccine-preventable diseases is a real concern. The reason for the drop in vaccinations among children is likely multifactorial.

 

Fear of COVID-19

The decline in the vaccination rates among children during the pandemic can’t be blamed solely on one issue. However, the most obvious source likely stemmed simply from the fear of contracting COVID-19. Parents limited their families’ travels and just did not visit the doctor or clinic to receive routine vaccines or well-child care. But, there have also been supply chain issues, with which vaccines were not readily available in certain areas of the world, and there were healthcare workforce issues that limited the distribution of the vaccines. Personally, I witnessed closures of clinics and limited hours of operation of facilities that likely hindered the ability for families to obtain proper healthcare for their children as well. With that said, another obstacle has been the rampant spread of misinformation on communication mediums, especially on social media.

The Infodemic

The medical community has been fighting a pandemic on one front and an infodemic on the opposite front. This infodemic can be described as “too much information including false or misleading information in digital and physical environments during a disease outbreak.” With this infodemic, we observed vocal opponents to basic public health measures that were meant to slow the spread of the pandemic and save lives, such as utilizing masks, social distancing, and the COVID-19 vaccine when it became available. When it comes to the COVID-19 vaccine, an intervention that literally turned the tide of the pandemic, it is important to emphasize that much of the infodemic of misinformation was targeted at creating vaccine hesitancy.

Vaccine misinformation is not a new phenomenon, but it certainly reached a fever pitch when the COVID-19 vaccine was developed. Parental concerns and fears about the COVID-19 vaccine were welcome opportunities that were seized by anti-vaccine groups to fan the flame of more hesitancy for general vaccinations, as well as the COVID-19 vaccine. The Center for Countering Digital Hate identified 12 individuals who have been responsible for up to 65% of antivaccine content online, labeled the “Disinformation Dozen.”

 

Pushing Things in a Good Direction

With the identification of misinformation super-spreaders, the responsibilities of social media and online companies to limit the access for these individuals and many others who spread misinformation on their platforms became a widely discussed topic. The US Surgeon General further emphasized this in an advisory to build a healthy information environment to reduce the spread of misinformation. There have been some efforts to combat these misinformation super-spreaders, but it may have been too little too late. The misinformation messages have already influenced and caused harm to the health of our communities. Nevertheless, these limited efforts to support the healthcare community to control the spread of the infodemic have resulted in curbing the influence of some major anti-vaccine groups, such as the recent removal of Robert F. Kennedy Jr’s Children’s Health Defense from Facebook and Instagram. The awareness and actions of the healthcare community are pushing things in a good direction, albeit incrementally small at times.

While August is National Immunization Awareness Month, it is critical to incorporate the awareness and importance of vaccines with the knowledge that there is also a movement that opposes this most crucial public and personal health measure. The drop in vaccinations among children during the pandemic is likely multifactorial, but the spread of misinformation has likely played a bigger part than most would like to admit. Having a month to spotlight immunizations is nice, but we have to continue to educate and advocate for immunizations beyond the month of August, not only for the sake of children’s health, but also for the health of our entire community.