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The Second COVID-19 Wave Might Not Be COVID-19

You have likely heard about the idea of a second COVID-19 wave, that after we stop SARS-CoV-2, it will come back again.

In early April, COVID-19 cases can be found in almost all countries around the world.

Unfortunately, even before SARS-CoV-2 has a chance to come back, we might see another wave of disease.

Diseases that aren’t so novel.

“The legacy of COVID-19 must not include the global resurgence of other killers like measles and polio.”

Dr Seth Berkley on COVID-19: massive impact on lower-income countries threatens more disease outbreaks

Diseases like measles, pertussis, yellow fever, and even polio.

The Second COVID-19 Wave Might Not Be COVID-19

Wait, what?

How could SARS-CoV-2 lead to outbreaks of polio?

Not surprisingly, according to the Global Polio Eradication Initiative (GPEI), “The COVID-19 emergency means that many aspects of the polio eradication programme will be—and in some areas are already– substantially affected.”

“All preventive polio campaigns should be postponed until the second half of 2020.”

Polio Eradication in the context of the COVID-19 pandemic

Instead of fighting polio, many resources will now go towards stopping COVID-19 until the end of June, both because it is too dangerous to continue and because trying to control SARS-CoV-2 is very important too.

“While halting important polio eradication activities is necessary, it will result in increased spread of disease and number of children paralyzed by wild and circulating vaccine-derived polioviruses. This will require a scale up of polio eradication efforts once the COVID-19 situation has stabilized.”

Polio Eradication in the context of the COVID-19 pandemic

Of course, polio isn’t the only problem.

“Due to the global circulation of the virus causing COVID-19 and the current pandemic, there is risk of disruption to routine immunization activities due to both COVID-19 related burden on the health system and decreased demand for vaccination because of physical distancing requirements or community reluctance. Disruption of immunization services, even for brief periods, will result in increased numbers of susceptible individuals and raise the likelihood of outbreak-prone vaccine preventable diseases (VPDs) such as measles.”

Guiding principles for immunization activities during the COVID-19 pandemic

Since it isn’t really possible to do mass vaccination campaigns and continue to maintain social distancing, there is a big risk for an increase of outbreak-prone vaccine-preventable diseases, including measles, cholera, polio, diphtheria, and yellow fever.

“The high potential for VPD outbreaks makes it imperative for countries to maintain continuity of immunization services wherever services can be conducted under safe conditions”

Guiding principles for immunization activities during the COVID-19 pandemic

Unfortunately, these vaccine-preventable diseases are still endemic in many areas, so we can’t count on travel bans to necessarily stop outbreaks either.

“UNICEF strongly recommends that all governments begin rigorous planning now to intensify immunization activities once the COVID -19 pandemic is under control. These vaccination activities must focus on children who will miss vaccine doses during this period of interruption and prioritize the poorest and most vulnerable children.”

Statement by UNICEF Executive Director Henrietta Fore on the disruption of immunization and basic health services due to the COVID-19 pandemic

And what happens once travel bans are lifted?

That’s right!

An increase in vaccine preventable diseases in any part of the world, whether it is measles, polio, or diphtheria, will mean that they can easily spread to any other place in the world that doesn’t already have high immunization rates.

VPDs As the Second COVID-19 Wave

All of this makes it especially important that we all work to maintain high childhood immunization rates!

“Because of personal, practice, or community circumstances related to COVID-19, some providers may not be able to provide well child visits, including provision of immunizations, for all patients in their practice. If a practice can provide only limited well child visits, healthcare providers are encouraged to prioritize newborn care and vaccination of infants and young children (through 24 months of age) when possible.”

Maintaining Childhood Immunizations During COVID-19 Pandemic

That’s why even though pediatric providers who are shifting to doing more and more telemedicine appointments are continuing to do well checks and vaccinate their younger infants and toddlers.

These well checks and vaccinations are essential to your children and the community. Maybe even more so if we can soon expect a big jump in outbreaks and epidemics of vaccine preventable diseases around the world.

That doesn’t mean that vaccines aren’t important for older kids or adults, but just that their doses can typically be delayed for a few months, as there is a wider range for when their vaccines can be given. For example, in most cases, waiting just a few months for an 11 year old to get their vaccines isn’t really a delay. Remember, they can be usually given when they a child is 11 to 12 years old, and not on the day they turn 11 years old.

But what about areas that didn’t have high immunization rates before the COVID-19 pandemic?

While we have all shifted to thinking about SARS-CoV-2, many of us remember that it wasn’t that long ago that we were working to control the largest measles outbreaks that we had seen in the United States in 27 years.

So what are we going to do to make sure that those outbreaks don’t return?

Will there be any efforts to make sure folks are vaccinated and protected before traveling out of the country, so that they don’t return with measles – or polio?

Are we going to strengthen our vaccine laws so that it isn’t easier to get a vaccine exemption than getting a child vaccinated and protected?

“So far, 14 major Gavi-supported vaccination campaigns against polio, measles, cholera, HPV, yellow fever and meningitis have been postponed, as have four national vaccine introductions. Collectively these would have immunised more than 13.5 million people.”

COVID-19: massive impact on lower-income countries threatens more disease outbreaks

Are we going to support vaccine advocates and those organizations that work to get people vaccinated and protected?

“This pandemic is highlighting the extent to which we are all connected — and it underscores the need to invest in health systems that can prepare and respond to routine needs and epidemics when they occur, including in the most underserved populations. It’s a good lesson — when we strengthen a health system to fight one disease, we strengthen that system to fight all disease. Whether the challenge is polio or COVID-19, every person deserves to live a healthy and productive life.”

Polio teams respond to COVID-19: A conversation with Dr. Erin Stuckey

Are we going to do something about all of the misinformation and propaganda against vaccines that scares parents away from vaccinating and protecting their kids?

Or are we just going to wait and hope we can handle the next public health crisis that hits us?

More On VPDs As the Second COVID-19 Wave

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