Decrease in Immunization Administration Data:
Since the start of wide-spread COVID-19 community spread, childhood immunizations in Wisconsin have significantly decreased. This is a trend that is shared throughout the U.S. and worldwide. Given this trend, we want to share data with you and provide suggestions to reduce risks in both the short and long terms.
The overall number of immunizations administered has decreased beginning in mid-March and continuing through April 2020, in comparison to the average for the same time over past 5 years (Fig. 1, below).
This impact is seen across all age groups as measured by the number of doses administered, using data from the WIR for the month of March (Fig. 2, below). Of note, certain age groups seem to be more affected than others- vaccination of school aged children seems to be more impacted than the youngest cohort.
If these trends continue, it will have significant, long-lasting impacts on herd immunity against vaccine preventable disease, create opportunities for the spread of disease, and the potential for outbreaks.
Recommendations to Continue Vaccinating
It is important to continue vaccinating children and adolescents during the COVID-19 Pandemic. Healthcare providers in communities affected by COVID-19 are using strategies to separate well visits from sick visits. Examples include:
- Scheduling well visits in the morning and sick visits in the afternoon.
- Separating patients spatially, such as by placing patients with sick visits in different areas of the clinic or another location from patients with well visits..
- Collaborating with other providers in the community to identify separate locations for holding well visits for children.
- Lowering the number of patients on site at any one time. Think about closing a waiting room or registration area and have patients check in by phone from the parking lot.
- Considering different entrances in your clinic that sick and well patients may enter.
- Clearly marking entrances for patients who are high risk for COVID-19.
- Telling patients who are ill to use telemedicine or a phone call. Some chronic conditions may be safely managed by a phone consult or telemedicine visit.
- Examining patients by car visit. Tell patients to drive to the clinic and wait in their car while staff goes outside to check on them.
- Giving vaccine to people in their car. Make sure to use proper hygiene and waste disposal practices outdoors just as you would indoors.
- Screening all patients and caregivers for high-risk symptoms.
- Referring high-risk adults to pharmacies who can give vaccines at less busy times to keep them safer.
Important: If a practice can provide only limited well child visits, healthcare providers are encouraged to prioritize newborn care and vaccination of infants and young children (through 24 months of age). In this case, we advise communicating to your parents and caregivers where older children and adolescents can safely receive vaccine services in your community and/or communicate your plans for when patients can plan to return to your office for full services.
Because of personal, practice, or community circumstances related to COVID-19, some providers may not be able to provide well child visits, including provision of immunizations, for all patients in their practice. Recognizing that COVID-19 will likely be circulating in the community for many months to come, providers should consider longer term plans for providing immunizations safely and communicate the safety provisions to patients.
Helpful Resources for Providers:
- What Healthcare Personnel Should Know about Caring for Patients with Confirmed or Possible COVID-19 Infection
- Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings
- Guidance for administering vaccines when a child is sick
- CDC Coronavirus (COVID-19) webpage
Planning for Safe Annual Influenza Vaccination
Vaccinating a majority of your patients against influenza this fall will be vital to reducing morbidity and mortality that would impact already fragile communities and high risk groups, as well as further strain medical facilities and the need for PPE. Using recommendations listed above, we encourage you and your practice to begin considering the following:
- How will communicate to your patients about the importance of an annual influenza vaccine?
- How will you will safely provide influenza vaccines as well as other recommended vaccines?
- How will you increase vaccination and aim to do so earlier compared to previous seasons?