Prioritizing Vaccinations for Young Children During COVID-19
March 27, 2020
As I/T/U facilities respond to the unique challenges of the SARS CoV-19 virus pandemic, it is important to prioritize regular childhood immunizations, especially for infants and younger children, in an effort to reduce the burden of disease from vaccine preventable illness.
Childhood Vaccines: Essential Healthcare Services
American Indian and Alaska Native children suffer from high morbidity and mortality from vaccine preventable infections, with a death rate up to 5 times higher than that reported for white infants in the United States.1 Those without adequate immunization are vulnerable to preventable infectious diseases and complications. Currently, more children may be at risk of not receiving their immunizations due to fear of exposure to the SARS CoV-19 virus.
The Centers for Disease Control and Prevention (CDC) is encouraging children to receive recommended immunizations throughout the COVID-19 pandemic.2 The CDC recommends that clinicians prioritize newborn care and vaccination of infants and young children (through 24 months of age). Guidance from the American Academy of Pediatrics (AAP) advocates for immunizing the youngest children as a top priority in the context of well child care during the COVID-19 pandemic.3
Recommendations to Reduce COVID-19 Exposure During Vaccination Encounters
The AAP and CDC both recommend modifications to visits, clinic schedule, and physical space to ensure the safety of clinicians, staff, and patients. Some ideas to consider:
- Conduct well visits for newborns, infants, and younger children who require immunizations; reschedule those in middle childhood and adolescence to a later date when appropriate.
- Schedule well visits in the morning and sick visits in the afternoon.
- Separate patients with sick visits in different areas of the clinic or another location (even another building) from patients presenting for well visits.
- Utilize alternate “clean” sites for providing immunizations.
All ACIP recommended vaccines for routine use are included on the IHS National Core Formulary.
As described in the Indian Health Manual, report all significant or unusual Adverse Vaccine Events (AVE) to the VAERS program.
Instructions for reporting are located on the IHS Pharmacovigilance website. Please ensure that you document "IHS" in field #26 of the form.
References
- Immunization in American Indian & Alaska Native Children & Adolescents , AAP Redbook, 31st Edition (2018–2021), pp. 93–95.
- CDC Coronavirus Disease 2019 (COVID-19) Home Page .
- Guidance on Providing Pediatric Ambulatory Services via Telehealth During COVID-19 . American Academy of Pediatrics, Critical Updates on COVID, Updated April 15, 2020.
