Childhood vaccinations are another casualty of the coronavirus pandemic.

Fewer children are getting scheduled vaccinations for diseases such as measles in Washington and across the world since March, when it became clear SARS-CoV-2 was rampaging across the globe.

The number of children 18 and younger being vaccinated in Washington dropped by 31% in August compared to the August average from 2015 to 2019. The downward trend began with a slight decrease in February then fell sharply in March with a 33% drop compared to the March average from 2015 to 2019 and bottomed out with a 39% drop in April.

Health experts worry that the reduction in the number of children being vaccinated increases the risk of outbreaks of diseases that are preventable with vaccinations.

“Adding more outbreaks on top of COVID-19 not only would put more people’s health at risk, it also could overload the health care system,” said Danielle Koeing, the health promotion supervisor with the state Department of Health (DOH).

The danger of not vaccinating was evident last year when a measles outbreak tore through Clark County in Southwest Washington.

Seventy people were infected during the Clark County outbreak, where only 85% of kindergartners had received the measles, mumps and rubella (MMR) vaccine. Most of those cases were in children with 93% of infections occurring between the ages of 1 and 18. In King County, a dozen people contracted measles last spring, including unvaccinated students at Bothell’s North Creek High School and at Issaquah High School. Measles had been declared eradicated in the United States in 2000.

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Childhood vaccines are highly effective and safe, and parents need to keep their children on track with the immunizations, said Dr. Beth Ebel, a professor of pediatrics at the University of Washington School of Medicine.

“Missing those doses, unless you make them up, your child has not gotten the training for her immune system that you need to be able to fight infection,” Ebel said.

Vaccination rates for Washington’s children 2 and younger have declined, but not as much as compared to 18 and younger.

Vaccines administered to children 2 years and younger were down more than 9% in August compared to the August average between 2015 to 2019. The biggest miss for 2-year-olds and younger was March, when immunizations were down nearly 26% compared to the same month’s average between 2015 and 2019.

Early during the pandemic, hospitals stopped elective procedures and people avoided bringing their children in to see their pediatricians or nurse practitioners.

“A lot of folks haven’t been in to see those people because of what’s been going on,” Ebel said. “So I think that’s one of the challenges that everyone has been facing.”

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Pediatricians are working with DOH, the Washington Chapter of the American Academy of Pediatrics and the Washington State Medical Association to get the word out that children need to keep up with vaccinations, Ebel said.

While many health-care systems are offering virtual options, health-care professionals are making sure clinics are safe for people needing appointments like receiving a vaccination that can’t be done online.

“I am so confident with the work that we’re doing to keep people safe in our clinics,” Ebel said. “I can only say that this is one of the safest visits or trips that you could take.”

Washington state isn’t alone when it comes to children not keeping up with vaccinations.

A recent report by the Bill & Melinda Gates Foundation found that vaccination rates have dropped worldwide to about 70%, the lowest percentage since 2000 and are approaching the level of vaccinations in the 1990s when 67% of children were vaccinated. The highest it got that decade was 72%.

According to the report, about 5% of the world’s children were vaccinated in the 1970s. That number increased to about 84% by 2019.