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Researchers have documented a drop in child vaccination rates in Michigan since restrictions were imposed to slow the spread of the novel coronavirus, raising concern about outbreaks of other diseases such as measles, the U.S. Centers for Disease Control and Prevention said in a report on Monday.

The findings by the CDC researchers indicated that stay-at-home orders during the pandemic like those imposed in Michigan and other U.S. states may be reducing accessibility to routine immunization services and exposing children to risks from vaccine-preventable diseases.

Data from Michigan’s state immunization information system showed that just under half of 5-month-old infants were up to date for all recommended vaccines this month, compared to approximately two thirds of infants in May of the previous four years, the CDC researchers said in their report.

The researchers examined vaccine doses given to children at ages one, three, five, seven, 16, 19 and 24 months this year and the prior four years. In the 16-month age group, coverage with all recommended vaccines declined. The rate of measles vaccinations in particular fell to 71% this year from 76% last year.

In addition to a decline in up-to-date status in almost all age groups, the number of non-influenza vaccine doses given to children under age 24 months dropped more than 15% from January through April of this year compared to the same period the previous two years, the researchers found.

“The observed declines in vaccination coverage might leave young children and communities vulnerable to vaccine-preventable diseases such as measles,” the CDC scientists wrote in the report. “If measles vaccination coverage of 90%-95% … is not achieved, measles outbreaks can occur.”

The researchers found a drop in vaccination coverage in all the age groups they studied except for birth-dose hepatitis B coverage, typically administered in the hospital to newborns.

In a separate study looking at nationwide statistics, the CDC this month documented a drop in routine pediatric vaccine ordering and doses administered.

Since immunization requires in-person visits, the CDC researchers recommended ways to keep the services going. These included dedicating specific clinics or rooms for child vaccination, reducing the number of patients on site at a given time, having patients receive vaccinations from their vehicles in the parking lot and having providers work with families to identify children missing recommended vaccinations.