This article is from the source 'nytimes' and was first published or seen on . It last changed over 40 days ago and won't be checked again for changes.

You can find the current article at its original source at https://www.nytimes.com/2020/05/18/health/vaccinations-rates-coronavirus.html

The article has changed 30 times. There is an RSS feed of changes available.

Version 0 Version 1
Vaccinations Fall to Alarming Rates, C.D.C. Study Shows Vaccinations Fall to Alarming Rates, C.D.C. Study Shows
(14 days later)
As states across the country relax stay-at-home orders and people return to more normal routines, some researchers worry about a spike in vaccine-preventable diseases in addition to the coronavirus’s spread.As states across the country relax stay-at-home orders and people return to more normal routines, some researchers worry about a spike in vaccine-preventable diseases in addition to the coronavirus’s spread.
During the pandemic, the rates of childhood vaccinations have dropped significantly as many parents have been reluctant to schedule well-child visits at their doctors’ offices, for fear of contracting the coronavirus. As a result, children have fallen behind on vaccinations for diseases like measles and pertussis, better known as whooping cough.During the pandemic, the rates of childhood vaccinations have dropped significantly as many parents have been reluctant to schedule well-child visits at their doctors’ offices, for fear of contracting the coronavirus. As a result, children have fallen behind on vaccinations for diseases like measles and pertussis, better known as whooping cough.
According to a new study released by the Centers for Disease Control and Prevention, the vaccination rates in May for children under 2 years old in Michigan fell to alarming rates, including fewer than half of infants 5 months or younger.According to a new study released by the Centers for Disease Control and Prevention, the vaccination rates in May for children under 2 years old in Michigan fell to alarming rates, including fewer than half of infants 5 months or younger.
Angela Shen, a research scientist at Children’s Hospital of Philadelphia and the co-author of the study, said the falling rates in Michigan were concerning and quite likely representative of trends throughout the country.Angela Shen, a research scientist at Children’s Hospital of Philadelphia and the co-author of the study, said the falling rates in Michigan were concerning and quite likely representative of trends throughout the country.
“Now, you’re not just dealing with Covid,” she said, referring to Covid-19, the disease caused by the coronavirus. “Now you’re contending with common vaccine-preventable diseases.”“Now, you’re not just dealing with Covid,” she said, referring to Covid-19, the disease caused by the coronavirus. “Now you’re contending with common vaccine-preventable diseases.”
Over the past two months, the risk of infection for diseases like measles might have been mitigated because most people, following stay-at-home orders, were not in proximity to one another. Now that some states are easing restrictions and allowing people to move about in their communities, there is a fear of outbreaks for diseases like influenza and especially measles.Over the past two months, the risk of infection for diseases like measles might have been mitigated because most people, following stay-at-home orders, were not in proximity to one another. Now that some states are easing restrictions and allowing people to move about in their communities, there is a fear of outbreaks for diseases like influenza and especially measles.
“You are prone to potentially seeing measles outbreaks as communities and jurisdictions in Michigan — and arguably in other parts of the country — open up,” said Dr. Shen, a retired captain in the U.S. Public Health Service. “This is a big week for opening up, and public health wants you to come in and get your shots.”“You are prone to potentially seeing measles outbreaks as communities and jurisdictions in Michigan — and arguably in other parts of the country — open up,” said Dr. Shen, a retired captain in the U.S. Public Health Service. “This is a big week for opening up, and public health wants you to come in and get your shots.”
The study used data from the Michigan Care Improvement Registry, which tracks immunizations within the state. It compared vaccination rates for children 5 months or younger on a typical day in May from 2016 to 2019, with the same day this year. It showed that before the pandemic, roughly two-thirds of children in that age group were up to date with their vaccinations; this year, the rate fell to 49.7 percent.The study used data from the Michigan Care Improvement Registry, which tracks immunizations within the state. It compared vaccination rates for children 5 months or younger on a typical day in May from 2016 to 2019, with the same day this year. It showed that before the pandemic, roughly two-thirds of children in that age group were up to date with their vaccinations; this year, the rate fell to 49.7 percent.
The study also showed that Michigan children on Medicaid were even less likely to be current on their immunizations. The largest disparity was seen among those 7 months or younger. The researchers found that only 34.6 percent children on Medicaid were up to date, compared with 55 percent of children in Michigan who were not on Medicaid.The study also showed that Michigan children on Medicaid were even less likely to be current on their immunizations. The largest disparity was seen among those 7 months or younger. The researchers found that only 34.6 percent children on Medicaid were up to date, compared with 55 percent of children in Michigan who were not on Medicaid.
Dr. Shen said the falling rates could jeopardize the herd immunity that communities have built up against a disease like measles. Public health officials estimate that a community vaccination rate from 93 percent to 95 percent is necessary to prevent a widespread outbreak of measles.Dr. Shen said the falling rates could jeopardize the herd immunity that communities have built up against a disease like measles. Public health officials estimate that a community vaccination rate from 93 percent to 95 percent is necessary to prevent a widespread outbreak of measles.
Recent measles outbreaks in the United States have raised fears that the disease could become endemic here again. It was declared eliminated in the United States in 2000.Recent measles outbreaks in the United States have raised fears that the disease could become endemic here again. It was declared eliminated in the United States in 2000.
Dr. Matthew L. Boulton, a professor of epidemiology and preventive medicine at the University of Michigan, who did not take part in the Michigan study, said the results were not surprising considering the suspension in preventive care in recent weeks. People were not able, or did not want, to visit doctors for routine checkups.Dr. Matthew L. Boulton, a professor of epidemiology and preventive medicine at the University of Michigan, who did not take part in the Michigan study, said the results were not surprising considering the suspension in preventive care in recent weeks. People were not able, or did not want, to visit doctors for routine checkups.
It is vital, though, that parents and guardians catch up on their children’s vaccinations as soon as possible, he said, because these lapses can become magnified over time; with so many more children unprotected, outbreaks may occur.It is vital, though, that parents and guardians catch up on their children’s vaccinations as soon as possible, he said, because these lapses can become magnified over time; with so many more children unprotected, outbreaks may occur.
“I think the implications for childhood immunization are long term,” he said, “because it will take a substantial amount of time to make up for this.”“I think the implications for childhood immunization are long term,” he said, “because it will take a substantial amount of time to make up for this.”
Updated June 1, 2020
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
More than 40 million people — the equivalent of 1 in 4 U.S. workers — have filed for unemployment benefits since the pandemic took hold. One in five who were working in February reported losing a job or being furloughed in March or the beginning of April, data from a Federal Reserve survey released on May 14 showed, and that pain was highly concentrated among low earners. Fully 39 percent of former workers living in a household earning $40,000 or less lost work, compared with 13 percent in those making more than $100,000, a Fed official said.
Yes, but make sure you keep six feet of distance between you and people who don’t live in your home. Even if you just hang out in a park, rather than go for a jog or a walk, getting some fresh air, and hopefully sunshine, is a good idea.
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
Charity Navigator, which evaluates charities using a numbers-based system, has a running list of nonprofits working in communities affected by the outbreak. You can give blood through the American Red Cross, and World Central Kitchen has stepped in to distribute meals in major cities.
Dr. Boulton said the problem was global, too. He said that he does immunization work and research in China, India and some African countries, and that his partners there had said they were seeing the same phenomenon.Dr. Boulton said the problem was global, too. He said that he does immunization work and research in China, India and some African countries, and that his partners there had said they were seeing the same phenomenon.
“It’s a really scary thought,” he said. “We’ve made tremendous progress around the world, especially in many low-income countries. This literally could set us back years in our control of vaccine-preventable diseases, in both high- and low-income countries.”“It’s a really scary thought,” he said. “We’ve made tremendous progress around the world, especially in many low-income countries. This literally could set us back years in our control of vaccine-preventable diseases, in both high- and low-income countries.”
In the United States, state health departments and pediatricians use immunization registries to monitor vaccinations. The information can be used to contact the families that have fallen behind on vaccinations and urge them to follow up as soon as possible.In the United States, state health departments and pediatricians use immunization registries to monitor vaccinations. The information can be used to contact the families that have fallen behind on vaccinations and urge them to follow up as soon as possible.
The Michigan study also noted that doctors could employ strategies to reduce the potential for coronavirus infection by creating separate rooms for healthy children and even by administering vaccinations to children in cars in parking lots. Those efforts could alleviate the fears among parents and improve the likelihood they catch up on their children’s vaccinations.The Michigan study also noted that doctors could employ strategies to reduce the potential for coronavirus infection by creating separate rooms for healthy children and even by administering vaccinations to children in cars in parking lots. Those efforts could alleviate the fears among parents and improve the likelihood they catch up on their children’s vaccinations.
“We already had challenges keeping kids up to date,” Dr. Boulton said. “This two- or three-month gap will definitely exacerbate that.”“We already had challenges keeping kids up to date,” Dr. Boulton said. “This two- or three-month gap will definitely exacerbate that.”