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CDC maintains childhood immunization guidelines during COVID-19

A child receives a vaccine during a visit to the clinic. U.S. Air Force Senior Airman Tamika Bradley, 20th Medical Operations Squadron allergy and immunizations technician, prepares to administer a vaccine to a child at Shaw Air Force Base, S.C. National Infant Immunization Week is April 25 - May 2, 2020. (U.S. Air Force photo by Airman 1st Class Destinee Dougherty)

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Immunizations remain a vital component of pediatric health care, even during the COVID19 pandemic. Immune systems are still developing in children and infants. Vaccinations result in the production of antibodies to protect people from potentially deadly diseases, explained Ann M. Morse, a family nurse practitioner at the North-Atlantic Regional Vaccine Safety Hub, Naval Medical Center Portsmouth.

“Immunizations allow the immune system to recognize that germ, virus, or bacteria and fight off that disease, or limit the severity of complications if exposed to the real disease,” continued Morse.

Immunizations also protect public health through herd immunity by preventing a widespread outbreak of highly infectious diseases, like measles or whooping cough. Despite the current climate of social distancing, vaccine-preventable diseases continue to circulate. Individuals who have not been vaccinated and contract the disease could spread it to susceptible individuals because those infected can be contagious up to a week before developing any symptoms, explained Morse. She added that if children stop receiving necessary vaccinations, herd immunity decreases, increasing the likelihood of other potential viral outbreaks, like measles.

“If multiple individuals developed one or more different vaccine-preventable diseases, hospitals could again have decreased number of isolation rooms, critical care (ICU/CCU) beds, ventilators, protective coverings (masks, gowns, gloves, boots) and more,” Morse explained. She added there are a variety of infant or childhood respiratory illnesses that show similar symptoms of COVID-19, such as fever, cough, and body aches.

The Centers for Disease Control and Prevention continues to encourage childhood immunizations during the COVID-19 crisis, but recently updated its recommendations for health care providers to manage patient visits. The way health care providers schedule immunization appointments may vary according to social distancing standards, said Morse. It is also possible that depending on the influx of COVID-19 cases in a local community, some health care providers may not schedule in-person wellness visits, but will continue to offer immunizations, noted Air Force preventive medicine physician Lt. Col. (Dr.) Ruth Brenner, deputy chief of the Immunization Healthcare Division.

“Due to the pandemic, there is a strain on medical resources, so some clinics may not be able to support a full complement of immunization services or at the same location where immunizations may normally be received. I recommend contacting your primary care manager or clinic to ask what is available as well as community options,” Brenner said.

As a mother of young children, Brenner has had to navigate the medical system for important immunizations during the COVID-19 pandemic with the help of the Pediatric Clinic at her military treatment facility. For parents who choose not to immunize their children during the pandemic, there are "catch up" schedules provided by the CDC so that children don’t need to start over or repeat doses already received, explained Brenner. Many child care centers are allowing a grace period for childhood immunizations at this time, she noted.

“Each family should balance the risks and benefits before going to the clinic,” she said, adding that MTFs are adhering to CDC recommendations of social distancing and separating sick children from well children.

Amid the COVID-19 pandemic, the strain on health care systems is obvious, said Brenner, adding, “Pediatric immunizations remain an important aspect of the health of our children and our communities. Military treatment facilities are working hard to continue to offer pediatric immunizations during the current health crisis.”

Morse said military families should call their clinics to arrange times for their visit and ask about precautions they will need to follow upon entering the facility, such as wearing a face mask. “It will be important to ask about normal vaccine side effects and take home the vaccine information sheets,” she said.

Concerned parents can also call the IHD’s 24/7 Immunization Healthcare Support Center at 877-438-8222 and select option 1 to speak with an on-call nurse or provider.

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DoD COVID-19 Practice Management Guide Version 5

Technical Document
7/30/2020

This Practice Management Guide does not supersede DoD Policy. It is based upon the best information available at the time of publication. It is designed to provide information and assist decision making. It is not intended to define a standard of care and should not be construed as one. Neither should it be interpreted as prescribing an exclusive course of management. It was developed by experts in this field. Variations in practice will inevitably and appropriately occur when clinicians take into account the needs of individual patients, available resources, and limitations unique to an institution or type of practice. Every healthcare professional making use of this guideline is responsible for evaluating the appropriateness of applying it in the setting of any particular clinical situation. The Practice Management Guide is not intended to represent TRICARE policy. Further, inclusion of recommendations for specific testing and/or therapeutic interventions within this guide does not guarantee coverage of civilian sector care. Additional information on current TRICARE benefits may be found at www.tricare.mil or by contacting your regional TRICARE Managed Care Support Contractor.

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