At Dr. Alyssa Goodwin’s pediatrics practice in Brunswick, a few families have been so fearful of coronavirus exposure that they refused to come into the building for their infant’s checkup.

But Goodwin’s staff was determined to give those children the vaccinations that are so crucial to keeping them healthy and preventing the spread of infectious diseases such as measles, whooping cough and chickenpox.

“Families were scared, and we wanted to be as flexible as possible, so we gave them their vaccines in the parking lot, with the child in the car seat,” said Goodwin, a pediatrician with Martin’s Point Health Care, a network of primary care practices in southern Maine.

Goodwin said by reaching out to families and educating them about the risks of COVID-19 versus the greater risk of missing childhood vaccinations, her staff was able to quell fears and most families showed up for vaccinations and well visits. Patients with respiratory illnesses, or those suspected of having COVID-19, go to a separate office in Brunswick for care to keep them separated from healthy individuals.

“What we didn’t want to happen was to create a measles outbreak in November from missed vaccines,” Goodwin said.

To date, Maine has reported 1,023 confirmed COVID-19 cases, with 51 deaths. Children seem to be less affected by the virus, but scientists say they can still be asymptomatic carriers and spreaders of the virus, one reason schools have closed and Maine and many other states have implemented strict physical distancing rules.

A national survey of pediatricians by PCC, a pediatric health records firm, shows that vaccinations plummeted from mid-February through April as coronavirus infections spread, with a 50 percent decline in measles vaccinations and 42 percent decline in those for pertussis (whooping cough).

But the survey didn’t differentiate between vaccinations given during the crucial months of birth to 2 years old and boosters given to children age 4 to 11. A missing vaccination can leave an infant vulnerable if exposed to an infectious disease, but boosters, although important, can be delayed by a month or six weeks without much disruption, pediatricians said.

By age 2, children should have received an array of vaccinations.

“If you miss vaccines given at two months, you are playing a long game of catch-up,” said Dr. Genevieve Whiting, a MaineHealth pediatrician in Westbrook. The U.S. Centers for Disease Control and Prevention recommends pediatricians prioritize children up to age 2 for vaccinations during the COVID-19 pandemic.

At MaineHealth primary care practices, pediatricians are routinely re-scheduling booster shots for children ages 4 and older and prioritizing children ages 2 and younger. A 4-year-old already has some protection through earlier vaccinations, and as long as they are caught up within the same year, delaying boosters is an “acceptable option,” Whiting said.

Dr. Mary Jennings, chief of pediatrics for InterMed, which offers primary care in southern Maine, said the health care group has not seen any significant decline in parents bringing infants in for vaccinations. Patients suspected of having COVID-19 are sent to other offices, while vaccinations are done at Intermed’s Marginal Way offices in Portland.

The strategy has worked, she said.

“People are very appreciative that they know when walking into our Marginal Way offices that they are less likely to come into contact with people who could be ill,” Jennings said.

Still, Whiting said, the booster shots for older children are “absolutely important” and pediatricians across Maine will be working over the summer to make sure re-scheduled appointments are kept.

Goodwin said her Brunswick office is going to host “catch-up” clinics later this summer for children who missed their spring vaccinations.

Some of those children will be entering kindergarten or middle school and will need school-required vaccines to do so. A new law approved in 2019 that survived a “people’s veto” initiative in March goes into effect in fall of 2021. The law – passed by lawmakers because too many families were opting out of school-required vaccinations – eliminates non-medical exemptions for vaccinations needed to attend school.

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