Clinics Have Capacity to Help Families Catch Up on Vaccinations During COVID

A new survey of medical practices finds providers appear to have the capacity to help children who have fallen behind on their vaccinations due to the coronavirus disease 2019 (COVID-19) pandemic.

In the US Centers for Disease Control and Prevention’s (CDC) July 10 Morbidity and Mortality Weekly Report, Tara M. Vogt, PhD, MPH, a member of the CDC’s COVID-19 Emergency Response Team, reported on one of the downstream impacts of the global pandemic: missed pediatric checkups and vaccinations.

Vogt and colleagues cited research suggesting that orders for pediatric vaccines had declined during the pandemic, as some providers temporarily shut their doors and some parents canceled or delayed annual checkups out of concerns that visiting a healthcare facility might expose their families to the SARS-CoV-2 virus.

The team wanted to find out whether local medical clinics had the capacity to help families catch up on missed vaccinations. To find out, they conducted a survey of practices that participate in the Vaccines for Children (VFC) program. The federal program allows children who are uninsured or on Medicaid to receive vaccines free of charge.

An estimated 86% of pediatricians in the US provide care in a VFC-enrolled practice, Vogt and colleagues wrote.

A total of 1933 practices responded to the survey, which was conducted from May 12-20. The vast majority of responding practices (89.8%) reported being open at the time. Of the remaining 10.2%, 197 said they were closed temporarily, and 9 practices reported being permanently closed. Rates of closures varied somewhat by region, ranging from a 15% closure rate in the northeast to a 6.2% closure rate in the south.

Of those that were open, 61.7% said they had reduced their hours of availability for in-person visits. Eight in 10 (81.1%) of open practices said they were offering immunizations to all their pediatric patients, and another 14.7% said they were offering vaccinations to “some” pediatric patients.

However, when asked if they expected to still be able to accept new patients for vaccinations through August, just 59.1% said “yes.” Of the remaining 40.9%, 21.3% said it was unlikely or they were closed, and 19.6% said they were unsure. Again, there were regional variations, with urban practices and those in the northeast less likely to be available for new patient vaccinations, and rural practices more likely.

“The results of the current national survey indicate that a majority of VFC-enrolled practices were open and offering routine immunization services to all pediatric patients in May or anticipate doing so in the near future,” investigators wrote, adding that vaccine orders appeared to return to near-normal levels in the latter half of May.

However, the authors said the regional variability provides cause for concern, particularly in regions like the Northeast. The problem, they said, is that if more families find themselves uninsured due to pandemic-related unemployment, they may not be able to get vaccines at their regular medical clinic if the clinic is not enrolled in VFC. Thus, they would need to find a new, VFC-enrolled medical home, which could be a challenge.

“[A] shortage of local VFC-enrolled practices willing and able to accommodate such patients could result in declines in (vaccine) coverage,” they noted.

Vogt and colleagues concluded that state and local public health departments, along with the CDC itself, must increase efforts to ensure the parents of newly VFC-eligible children are aware of the availability of free vaccinations. These agencies must also work to ensure parents understand the importance of vaccines, and the fact that vaccination services can be provided safely despite the pandemic.

At a provider level, Vogt and colleagues said clinics should use their electronic health records to identify patients who have fallen behind on vaccinations, and seek to schedule appointments to help those children catch up.