Editor's note:For the latest news about the COVID-19 pandemic, visit https://www.aappublications.org/news/2020/01/28/coronavirus.
A combination of factors caused by the COVID-19 pandemic threatens to disrupt the country's vaccine delivery system and put children's health at risk.
Drastically falling immunization rates among children have led to concerns of a secondary outbreak of an infectious disease (https://bit.ly/2BP0AgR). Meanwhile, pediatricians impacted by the crisis are facing significant financial challenges and struggling to keep their practices open.
If practices have to cut their hours or close, children and families won’t be able to access the timely care they need, including vaccinations.
To address these issues, the Academy is undertaking a comprehensive advocacy strategy focused on ensuring children can access life-saving vaccinations and pediatricians have the support they need to administer them.
"Pediatricians are the backbone of the childhood vaccine delivery system in the United States and are largely responsible for our nation’s success in vaccinating children," said AAP President Sara “Sally” H. Goza, M.D., FAAP, in a letter to the Department of Health and Human Services (HHS).
The multifaceted challenge at hand requires a multifaceted approach. The AAP has outlined extensive policy recommendations to federal leaders. Many of these priorities fall into three main areas.
Providing immediate financial relief to pediatricians
Following months of AAP advocacy, HHS announced in June that pediatricians, pediatric medical subspecialists and pediatric surgeons can access financial relief from the Provider Relief Fund, making approximately $15 billion available to Medicaid and Children's Health Insurance Program providers who have been left out of previous financial relief.
Practices across the country report seeing as low as 20% to 30% of their normal caseload due to social distancing, shelter-in-place orders and families delaying or forgoing care. To respond to the needs of their patients and families in light of COVID-19, pediatricians are transforming their practices and facing higher costs for personal protective equipment and workforce training. These competing issues have forced practices to lay off or furlough staff and even consider permanent closure.
As a result, it is difficult for children and families to access timely health care, which can mean missed vaccinations, well-child care and critical services that support their health and development.
For more information on the funding opportunity, visit https://bit.ly/2BXxImx.
Bolstering the vaccine delivery system
The Academy also is focused on advancing policies that maintain, support and bolster the vaccine delivery system.
Pediatricians often cover the upfront costs of purchasing, storing and delivering vaccinations, but payment for administering vaccinations often is inadequate. The ongoing health crisis and financial strain pediatricians are facing exacerbate this problem.
To address this burden and ensure children can receive vaccinations, the AAP is advocating for policies such as increasing Medicaid payments for vaccine administration, appropriately valuing vaccine administration codes and providing incentive payments for participants in the Vaccines for Children program.
Increasing vaccine rates and confidence
When a COVID-19 vaccine is available, it will be vital for children and adolescents to receive the vaccine to protect them and others from the virus. The AAP’s ongoing advocacy efforts will lay the groundwork to ensure that is possible.
Unfortunately, vaccine hesitancy persists in large part due to misinformation shared online, putting children at risk of being unvaccinated and susceptible to life-threatening but vaccine-preventable diseases.
As part of its continuing work to reiterate the safety and effectiveness of vaccinations — all the more important as the country combats COVID-19 — the Academy is urging Congress to pass the bipartisan VACCINES Act (H.R. 2862). The legislation would give the Centers for Disease Control and Prevention resources to monitor vaccine hesitancy and promote vaccine confidence through public messaging campaigns.
Turning policy recommendations into action
Beyond compiling its many recommendations, the Academy is engaging leaders at all levels of government.
Recently, the AAP sent letters to HHS and Congress outlining its priorities and actions to address them.
The Academy also is mobilizing chapters to urge their congressional delegations to support pediatric practices and protect children from vaccine-preventable diseases as well as take specific state-level actions.
In addition, the AAP created two resources for members: a one-page document on its vaccine strategy (https://bit.ly/AAPvaccineonepager) and a vaccine policy white paper Policies to Preserve the Vaccine Delivery System for Children (https://bit.ly/AAPvaccinepolicypaper).
For other resources, visit the COVID-19 webpage at www.aap.org and go to "Advocacy Resources."