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Adapted from CDC; Non-flu vaccines include all pediatric vaccines recommended by the Advisory Committee on Immunization Practices; Chart: Naema Ahmed/Axios

A decline in pediatric care during the pandemic has put a lot of children behind the curve on routine vaccinations.

The big picture: As states decide to reopen schools and day care centers, children behind on their shots could pose a threat to themselves and others — on top of the risk of spreading the coronavirus.

"The last thing we want during a COVID pandemic is another epidemic of measles and pertussis and diphtheria here in the U.S.," Gary Kirkilas, pediatrician and professor at the University of Arizona College of Medicine in Phoenix, tells Axios.

By the numbers: Non-influenza vaccine doses decreased by an estimated 21.5% from January through April, according to the Centers for Disease Control and Prevention.

  • Publicly purchased non-flu vaccines, including hepatitis, meningitis, polio, and rotavirus, were also sharply down in April, compared to this time last year.

In New York City, vaccinations plummeted 63% overall, and 91% for kids older than 2, compared to the same time last year.

  • In California, shots for children are down 40%.
  • In Detroit, less than half of children younger than 2 are now up to date on their vaccinations, per a CDC case study.

What's next: Some local children's hospitals are partnering with public health departments and school districts to help parents get back on track with vaccinations or missed doses.

Before the pandemic, states were already struggling getting mandatory immunizations like measles, mumps and rubella and voluntary vaccines like the flu shot into people and children for a variety of reasons.

  • State public health departments were battling the highest measles tally in 27 years. 31 states had nearly 1,300 measles cases in 2019.
  • Doctors are concerned the same population who's hesitant to get immunized will be just as opposed to a coronavirus vaccine once available if the process appears rushed.
"Parents are still very scared. They don’t want to expose their kids unnecessarily and to be honest, school in the fall is not on people’s radar right now. ... Especially in lower-income populations, they’re not thinking about immunizing their kids. They’re thinking about when they can go back to work and keep a roof over their head."
— Lisa Gwynn, associate professor clinical pediatrics and public health sciences at the University of Miami

The bottom line per Kirkilas: "Clearly the greater risk for parents is not immunizing. It’s not the risk of COVID, it’s not immunizing your child against diseases that have been proven to affect children more."

Go deeper: How the U.S. might distribute a coronavirus vaccine

Go deeper

Oct 1, 2020 - Health

Moderna says its coronavirus vaccine won't be ready until 2021

A laboratory technician preparing a blood sample for a vaccine clinical trial sponsored by Moderna. Photo: Paul Hennessy/NurPhoto via Getty Images

Moderna CEO Stéphane Bancel said Wednesday that his company's coronavirus vaccine won't be available for widespread distribution until at least spring 2021, according to Financial Times.

Why it matters: Bancel told FT that the drugmaker will not seek emergency authorization for FDA approval for its vaccine for front-line medical workers and at-risk individuals until Nov. 25 at the earliest.

CDC: 3,689 COVID-19 or coronavirus-like cases found on cruise ships in U.S.

Cruise Ships docked in April at the port at Marina Long Beach due to a no-sail order in Long Beach, in California. Photo: Apu Gomes/AFP via Getty Images

There have been at least 3,689 COVID-19 or coronavirus-like illness cases on cruise ships in U.S. waters, "in addition to at least 41 reported deaths," the Centers for Disease Control and Prevention said late Wednesday.

Driving the news: The CDC released the data from the period of March 1 through Sept. 29 in an emailed statement confirming the extension of a no-sail order for cruise ships through Oct. 31, as first reported by Axios' Jonathan Swan on Tuesday in his article revealing CDC director Robert Redfield was overruled in a push to extend the order into 2021.