CHIP Data Show Steep Drops in Vaccinations, Health Screenings

The COVID-19 Public Health Emergency is blamed for dramatic year-over-year reductions in healthcare services for children.

Health screenings and vaccinations fell dramatically for children enrolled in the Children's Health Insurance Program during the early months of the COVID-19 Public Health Emergency, the Centers for Medicare & Medicaid Services reported Wednesday.

When compared to data from March through May 2019, with the same three-month span in 2020, there were 1.7 million (22%) fewer vaccinations for beneficiaries up to age 2, 3.2 million (44%) fewer child screening services, 6.9 million (44%) fewer outpatient mental health services even after accounting for increased telehealth services, and 7.6 million (69%) fewer dental services, according to CHIP data released by CMS.

In a telehone call with media on Wednesday, CMS Administrator Seema Verma raised concerns that the drop in preventive and primary care services could have a long-term effect on the health outcomes for the 40 million children enrolled in CHIP, 75% of whom live in poverty.  

"Today's analysis gives us a much better understanding of how children have been affected by the pandemic and we're releasing it today to raise awareness about this critical public health issue," Verma said.

The problem is further exacerbated by the limited in-person instruction at many schools, which normally would provide a venue for these physical, dental, and mental health screenings and other services such as speech, physical, and occupational therapy.  

"The absence of these vital healthcare services may have lifelong consequences for these vulnerable children, and I call on states, pediatric providers, families, and schools to ensure children catch-up on overdue medical, behavioral health and dental appointments as well as childhood immunizations," Verma said.

Verma told reporters that the solution would not come solely from the federal government.

"From our perspective, we've provided a lot of flexibility to states around telehealth services. We've provided over 500 waivers to state Medicaid programs across the country," she said. "This is going to require state and local leadership on this is going to require local communities to put together a system of care for children. So we need to see collaboration between schools and health care providers, and also outreach to families." 

CMS said that, for children to catch up on missed vaccinations, vaccination rates must not only approach those of 2019, but to be much higher, in order to mitigate the 22% dip during the early part of the COVID-19 Public Health Emergency.

"This has not begun to happen, and increases the risk of transmission of vaccine-preventable illnesses, such as measles, mumps, and Haemophilus influenza," CMS said.

Newer preliminary data cited by CMS also show a strong uptick in the use of telemedicine for children, but "it is still not enough to offset this decline in care for vulnerable children."

"Further, although telehealth remains an important part of care delivery for children, some services, such as vaccinations, cannot be provided through this vehicle, which contributes to the current gap in their healthcare," CMS said.