Prioritizing Childhood Immunizations During Covid-19
As a result of Oregon’s shelter-in-place order, coupled with fear surrounding Covid-19’s spread, Oregon experienced a sharp reduction in childhood vaccinations, with Multnomah County reporting an 18 percent drop compared with this time last year.*
While it’s understandable parents would want to keep their children home during a viral pandemic, Cynthia McPhee, MD, pediatrician at Kaiser Permanente Northwest, says delaying immunizations for life-threatening diseases can be a mistake.
“Right now, with people staying home, there isn’t a huge risk of spreading measles,” she says. “But as soon as we start going back out into our communities, if we don’t have that herd immunity, that’s when the disease can start spreading.”
In response, Kaiser Permanente Northwest began reshaping pediatric centers across the region to provide safe, accessible vaccination clinics.
While Covid-19 stay-at-home orders were in effect, two clinics prioritized vaccination appointments for babies up to 6 months old. Deemed “well-child sites,” both Tanasbourne Medical Office in Hillsboro and Gateway Medical Office in Portland were set up to treat patients in a space with minimal risk of exposure to potential infection.
“[They were places] we could bring healthy babies to do their well-baby checks and get their vaccines,” says Dr. McPhee. “At the same time, it gave parents peace of mind that they were bringing their newborns to a place where sick people were not going to be.”
In early April, the clinics expanded care to include children up to age 2—the age range classified as being the most vulnerable to deadly, vaccine-preventable diseases like measles and pertussis. Parents responded positively to the well-child site initiative as immunization rates have risen significantly in the area since opening.
In May, additional pediatric clinics began expanding service to include vaccinations and well-child checks for children up to age 6. To help ensure a safe environment inspired by the well-child sites, some creative solutions were implemented to complement standard Covid-19 prevention protocol like physical distancing and mask wearing.
“Each clinic is set up differently, so a few have been able to create divides between healthy and sick,” says Sarah McGee, practice director of Pediatrics at Kaiser Permanente Northwest. “For example, Cascade Park clinic has a lot of entrances, so if you have a kid with a respiratory infection, you’ll go through a door to see a doctor that’s housed within that module, whereas a healthy kid will go in a completely different door and into a module with only healthy kids.”
Other precautions have included scheduling divides, which save morning appointments for immunizations and well-baby checkups and limit sick visits to afternoons, making it safer and easier to bring a healthy child in for routine vaccinations.
Taking a Proactive Stance
Another innovation Kaiser Permanente Northwest has prioritized during this challenging time is its virtual panel support tool, which alerts providers to patients’ care gaps such as missed booster shots.
“This tool lets us reach out to patients who are due for vaccines and get them scheduled,” says Dr. McPhee, who notes how important that will become as Oregon school districts begin to discuss reopening in September.
“We need to make sure that if we’re sending children back to school, we are protecting them from vaccine-preventable illnesses,” she says. “That includes kids going into middle and high school who need their pertussis booster, their meningococcal vaccine, and their cancer-preventing HPV vaccine—we don’t want to send kids back into their communities without protection.”
As of June 24, 2020, all 13 pediatric clinics are open for immunizations and child well-checks. For more information on Kaiser Permanente’s commitment to pregnant women and children, visit kp.org/maternity/nw.