Closing the Pediatric Immunization Gap

In March 2020, COVID-19 was officially declared a global pandemic. While experts have increased their understanding of the virus since that time, it will likely be years before we can fully assess the magnitude of COVID-19’s impact on our healthcare system. Already, numerous “post-pandemic” healthcare trends have been identified: increases in virtual care adoption, high levels of caregiver burnout, spikes in mental health concerns, and more. Of these industry-wide disruptions, one particularly alarming trend is the decline in childhood and adolescent vaccination rates across the country.

The CDC’s Child and Adolescent Immunization Schedule recommends 16 vaccinations for infants younger than 15 months of age, and 16 additional vaccinations for children ages 18 months to 18 years. But according to a study conducted by WHO and UNICEF, 23 million children around the world did not receive one or more of these basic childhood vaccines in 2020. This is the highest recorded number of missed vaccines since 2009 and represents a 3.7 million increase from 2019. This decline in critical pediatric immunizations poses a serious threat for future outbreaks of diseases such as smallpox, polio, measles, and mumps. Clinicians and healthcare providers play an important role in shifting this trend by getting children back on track with their routine vaccinations.

Barriers to Routine Childhood Vaccinations

Parents or family members who harbor vaccine hesitancy remain a contributing factor to the substantial decline in childhood and adolescent immunizations. However, these “conscientious objectors” are by no means the only driving force behind this decline. Challenges related to social disadvantages such as inconvenient clinic hours, limited patient access, and unaffordable vaccination administration fees take a significant toll on overall vaccination rates. Furthermore, recent shifts during the pandemic to remote learning and telehealth have decreased already limited in-person interactions and opportunities for vaccine administration.

How Providers Can Help Close the Gap

The potential long-term consequences of declining childhood vaccination rates include outbreaks of vaccine-preventable diseases as well as a decline in communities achieving herd immunity. Industry experts and pediatric clinical leaders have identified several key recommendations to help healthcare providers boost pediatric immunization rates:

  • Engage families proactively—Take every opportunity to engage with parents/guardians by acknowledging the important role they play in their child’s care team, reaffirming their role in the decision-making process, and fostering a dialogue that helps build vaccine understanding and trust.

  • Reach out to families directly—Assess the vaccination status of all your pediatric patients and contact the parents/guardians of those who have fallen behind schedule via phone, mail, or text message. If possible, leverage an automated system or third-party vendor to assist with outreach to avoid disrupting your existing workflows.

  • Increase patient access—Consider opportunities to make vaccinations more convenient and accessible for families. Examples include reducing wait times, expanding office hours, offering information about opportunities to receive vaccines for free or at minimal cost, and partnering with alternative vaccine administration settings such as schools and daycare centers.

As trusted advisors, providers are essential to effective vaccine advocacy. By understanding and proactively addressing the driving forces behind decreased pediatric vaccination rates, practices can better support their clinicians’ efforts to keep children healthy.