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Routine vaccination of children in the United States appeared to have declined dramatically in March and April, in the weeks after Covid-19 was declared a pandemic and the United States government declared a national emergency, a new study published Friday shows.

The authors, from the Centers for Disease Control and Prevention and other institutions, used vaccine ordering data from pediatricians who administer vaccines through the Vaccines for Children Program, which provides government-purchased vaccines to about half of the children in the United States. The study, published by the CDC in its Morbidity and Mortality Weekly Report, compared orders for the period from Jan. 7 through April 21 this year to the same period last year.

The findings suggest childhood vaccination efforts nearly ground to a halt between March 13 — when the national emergency was declared — and April 19.

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There was a 2.5 million-dose decline in orders of regular childhood vaccines — not counting influenza vaccines — and a 250,000-dose decline in vaccines containing measles protection in that period, the authors reported.

Doctors and public health experts have worried that a vast number of regular health care needs — including preventive care interventions like vaccinations — have gone unmet in the past few months as people shy away from interacting with a health system that has, at least in some places, been overwhelmed by caring for Covid-19 patients.

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Pediatricians in particular have been concerned that children may be missing critical vaccinations, which the new data confirm has happened.

“Routine immunizations in young children are critical to maintain during the pandemic,” said Kathryn Edwards, a pediatrician and scientific director of the Vanderbilt Vaccine Research Program in Nashville, Tenn. “The usual childhood diseases are still around and we need to protect our children from them.”

Paul Offit, a pediatrician and vaccines expert at the Children’s Hospital of Philadelphia, said his institution had urged all pediatricians to continue to hold well-child appointments for children under the age of 2 to ensure they got their vaccinations on schedule.

“I think that didn’t happen,” Offit said. “I think there were a number of practices that didn’t do that because they were too scared. And so this is the result. You have this dramatic decline.”

Neither Edwards nor Offit was involved in this study.

The research suggests that the drop-off in vaccinations was less acute — though still sharp — in children under the age of 2 than in those aged 2 to 18 years old. It also points to a gradual uptick in administration of measles-containing vaccines in children under the age of 2 from about the end of March. But weekly numbers administered to children aged 2 to 18 remained a fraction of the previous weekly total through the end of the study period.

“The identified declines in routine pediatric vaccine ordering and doses administered might indicate that U.S. children and their communities face increased risks for outbreaks of vaccine-preventable diseases,” the authors warned.

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