As precautions against the coronavirus have forced adults to change behaviors and increasingly stay at home, many in Arkansas have also missed vaccinations that are necessary to protect against other diseases, according to the top epidemiologist for the state Department of Health.
Starting in April, vaccinations for adults age 19 and older fell by more than half when compared with the average number of vaccinations performed that month over the previous two years, according to Health Department data.
The next month, vaccinations were down 41.8% from the previous two years. In June, the number of vaccinations was down 26.3%.
The numbers provided by the Health Department accounted for more than a dozen of the most common vaccines for adults, including flu, measles, hepatitis A and B, tetanus, shingles and pneumococcal.
"In general, they're all down," said the state epidemiologist, Dr. Jennifer Dillaha, who explained that many local health clinics temporarily closed or switched to telemedicine, while pharmacies limited their services to delivery or curbside pickup only. Both are significant sources of adult immunizations in Arkansas, she said.
"So the opportunity for vaccinations has decreased during this period of time," Dillaha said. "It's starting to pick up now. So we'll see how that goes, whether we're able to make some headway."
The Health Department only requires that immunization doses be reported for patients 21 and younger. Dillaha said the data voluntarily reported for older patients "can give a relative idea for how we're doing," though it cannot be used to accurately track immunization rates.
The Health Department has also noted a drop in childhood vaccinations during the pandemic, the Arkansas Democrat-Gazette reported in May.
Scott Pace, the owner of Kavanaugh Pharmacy in Little Rock, said his business has not seen a decline in pneumococcal or tetanus vaccinations over the first six months of the year. Vaccinations for shingles were down significantly at his business, though he attributed that to an increase in customers getting the vaccine in 2019 and not needing it in 2020.
"It could just be the providers are so overwhelmed they're not reporting it voluntarily," Pace said, adding that a "combination" of factors could be behind the statewide decline.
Walgreens, which has 80 stores in Arkansas, recently resumed its immunization services with additional safety precautions that require staff members administering vaccines to wear plastic face shields and patients to wear masks, according to company spokeswoman Alexandra Brown.
"At the height of shelter-in-place orders, we saw a decrease in consumer use of health services overall," Brown said in an email. "This is in line with industry data showing that primary care visits dropped significantly during the COVID-19 pandemic in the U.S."
Brown said patients are encouraged to schedule appointments in advance and fill out paperwork online in order to reduce wait times, during which patients are seated at least 6 feet apart from others.
Dillaha said the drop in vaccinations has not been linked to any new outbreaks of disease in Arkansas. An outbreak of hepatitis A in the state, which had infected more than 430 people as of last fall, is ongoing, she added.
But with many Health Department staff members being assigned to work on covid-19, Dillaha said, other diseases remain a threat.
"There may be things out there that we are not yet seeing," Dillaha said. "That's one of our concerns."
Another concern for the Health Department, Dillaha said, is the potential for an increased number of covid-19 cases this fall during the normal flu season, which she said could overwhelm hospitals.
"The more people that we can keep out of the hospital with the flu, the more pressure we can take off of our hospital system," Dillaha said. "Of course, individual people do not want to get flu or covid at the same time. So that's going to be important to get the flu vaccine when the time comes."
At the Kavanaugh Pharmacy, Pace said he has been getting more calls than normal from customers inquiring about the flu vaccine.
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"I do think the covid pandemic has caused some heightened awareness of people wanting to protect themselves against the flu," Pace said.
Adults over the age of 65 also are encouraged to get a pneumococcal vaccine to protect against bacterial pneumonia, according to the U.S. Centers for Disease Control and Prevention.
Dillaha encouraged adults to speak to their local pharmacists to make sure they are up to date on their full vaccination schedule.