This is the impact COVID-19 has had on vaccinations and routine dental care for kids

The COVID-19 pandemic has interrupted access to dental care and routine immunizations for many children and a new report from Toronto’s top doctor says that the city needs to work with the province to create a plan to address the backlog.

The report, which will be considered by Toronto’s Board of Health today, takes a wider look at the various impacts that the pandemic has had on children, including their mental health.

It says that during the pandemic Toronto Public Health had to suspend some of its routine immunization programs in schools, resulting in an estimated 73,000 students in grades seven through 12 who are missing at least one dose of the Hepatitis B, Human Papillomavirus, and meningococcal vaccines.

De Villa also says that the pandemic resulted in the suspension of Toronto Public Health’s dental screening program in schools, with virtual clinics and community clinics being used to partially fill the gap. She said that in 2018-2019 the school-based clinics helped identify 29,000 students who had urgent or non-urgent tooth decay requiring dental care but over the two year span of the pandemic the number of students who were able to access Toronto Public Health dental clinics was just over 3,600, resulting a “significant service gap.”

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“A phased resumption of school screening is being planned, prioritizing schools that historically presented with the highest rates of caries (i.e., tooth decay).” de Villa said in the report. “In the interim, TPH will be offering, as a pilot, dental screening for children and youth in grades seven and eight in tandem with the Hepatitis B, Human Papillomavirus and Meningococcal vaccinations currently being provided in the city-run Immunization clinics.”

In addition to the suspension of many school-based vaccine clinics, de Villa said that the pandemic has also left Toronto Public Health with limited resources to conduct “an assessment of routine vaccinations among childcare centre attendees and students for three consecutive school years.”

She said that as a result there is an “increased risk” of viral outbreaks in schools and child-care settings.

Going forward, she said that Toronto Public Health will work with school boards to offer routines vaccines alongside COVID-19 vaccines in high schools.

But she is also asking the board to approve a motion which would result in a formal request to the province for help tackling the backlog.

“As Toronto transitions to a new phase in living with and managing COVID-19, TPH is shifting its focus to ensure that the indirect effects of the pandemic on this population are thoroughly investigated and addressed through interventions developed in collaboration with education sector partners,” her report notes.

The update from de Villa on Monday comes amid a sixth wave of the pandemic that has a resulted in a significant increase in COVID-19 transmission.

De Villa told board members that “we are still very much in the pandemic” while acknowledging that we are in “a different phase” in which governments are “increasingly trying to establish a place where we are both managing COVID response and at the same time increasing acess to other aspects of life and other activities.”

She said that as part of that shift Toronto Public Health is reviewing the way it publishes COVID-19 data and will soon reduce its reporting so that it only provides updates on cases and active outbreaks twice a week (Tuesdays and Fridays). Information on deaths and vaccine uptake will be distributed once a week (Tuesdays and Fridays, respectively)

“We are now at the point where what is more meaningful is really around the reporting of trends rather than focusing on day-to-day changes. These day-to-day fluctuations are much less meaningful than they were, for example, in early 2020,” she said.