As concerned families stayed home this spring in an effort to protect their family and communities, important well child care visits were missed. In a recent report, the Centers for Disease Control and Prevention stated that routine ordering of pediatric vaccines was significantly decreased due to the COVID-19 pandemic. The report showed that from mid-March to mid-April, doctors in the Vaccines for Children program ordered approximately 2.5 million less doses of all routine vaccines and 250,000 fewer doses of measles containing vaccines compared to the same period in 2019.1 It is vital that pediatricians take steps to increase access to care as they do their best to ensure patient safety. This will involve reworking some office procedures that have been in place for generations. In his article, Dr. Schuman provides some specific suggestions as forward-thinking providers attempt to adapt to the current climate in health care.
Strategies to increase patient safety include having patients wait in the parking lot rather than a waiting room, and offering separate well and sick visit appointments at different times of the day. Pediatricians need to communicate the importance of continuing to access health care, including well visits and vaccinations, to their patients. Part of this process should be clearly communicating the safety measures put in place to protect families as they receive health care.
In addition to in-person visits for vaccinations, telehealth visits should be maximized, and billed appropriately. Many pediatricians have not used telehealth in their practice prior to 2020. In this article, various telehealth platforms are discussed, including costs and details pertinent to pediatric practices. An additional layer to evaluating patients virtually is the decision on when to prescribe an antibiotic. Not surprisingly, antibiotics are often not necessary; however, Dr. Schuman discusses some potential guidelines on when it might be appropriate to prescribe antibiotics during a telehealth visit.
In addition, to maximizing safety and health care visits, either in-person or virtually, the author points out the importance of stocking up on personal protective equipment in anticipation of the continued presence of COVID-19 throughout the fall and winter.
This era requires flexibility, openness to new information although rigorously evaluating the available data at the same time, and the ability to communicate effectively with patients and their families via new modalities. As we scramble to keep up, this issue of Contemporary Pediatrics is rich with helpful information.
1. Santoli J, Lindley M, DeSilva M et al. Effects of the COVID-19 pandemic on routine pediatric vaccine ordering and administration — United States, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(19):591-593. doi:10.15585/mmwr.mm6919e2
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