This week, HHS announced that it will allow pharmacists to vaccinate children ages 3-18, superseding state laws to the contrary. On the surface, expanding access to childhood vaccinations may seem like a good move but not so fast. While the evidence is clear that childhood immunization rates have declined since the COVID pandemic hit, allowing big box stores and chain pharmacies to vaccinate children undermines the concept of children having a medical home and would result in a lack of continuity of care for children and adolescents.
In a statement from the president of The American Academy of Pediatrics (AAP), Dr. Sally Goza explained why this recent move by HHS is incredibly misguided. Dr Goza explains that “creating a new vaccine system is not only unnecessary, but it will not provide children with the same level of optimal medical care they receive from the pediatrician who knows the child’s medical history. Most children and adolescents receive vaccines as part of routine well-child check-ups, when other important health care is provided, including developmental and mental health screenings, counseling about nutrition and injury-prevention, and chronic disease management. Conversations about immunizations are part of those visits, and can be tailored to respond to parents’ unique questions.”
Instead of changing the rules, we need to ensure that families understand that it is critical to their child’s health to maintain their child’s relationship with her pediatrician. As Dr. Goza noted, “pediatricians’ offices are open and safe. We have all necessary childhood and adolescent vaccines in stock with trained medical professionals who can administer them. We know that the best, safest place for children to get vaccinated is in their medical home.”
Superseding state authority to determine the scope of provider practices is contradictory to how CMS has dealt with other state flexibilities – for example, the ability to waive Medicaid specific statutory requirements. A key example of this is CMS approval for ten states to impose work requirements as a condition of Medicaid eligibility even after the courts have determined that doing so is contrary to the purpose of the Medicaid program.
The emergency order creates more chaos and confusion at a time when parents need calm reassurance. Children and families would be better served by focusing on how to keep children safely and securely connected with their pediatricians during the pandemic rather than making hasty decisions that may have unforeseen consequences on children’s health and well-being.