New guidelines allow pharmacists to vaccinate children as young as 3, but doctors are unsure what it will achieve

Korin Miller
·6 min read

Childhood vaccination rates plummeted in the middle of March after the COVID-19 pandemic hit, in a trend that’s worrying for public health officials. Now the Department of Health and Human Services (HHS) has issued guidance to help expand access to childhood vaccines.

Under the guidelines, which were released on Aug. 19, pharmacists across the country are allowed to give shots to children, including the flu vaccine, starting at age 3. Previously, only 28 states allowed pharmacists to vaccinate children. The goal, the HHS says, is “to increase access to childhood vaccines and decrease the risk of vaccine-preventable disease outbreaks as children across the United States return to daycare, preschool and school.”

Doctor vaccinating girl in office
Under the new HHS guidelines, pharmacists across the country are allowed to give shots to children, including the flu vaccine, starting at age 3. (Photo: Getty Images)

Pharmacists and pharmacy interns must have completed certain training in order to be able to administer the vaccines, and need to inform pediatric patients and their families of the importance of having a well-child visit with their pediatrician or family care provider, the HHS says.

What does this mean for parents?

“On a practical level, these guidelines mean that parents now have additional options on where they can take their children for immunizations,” Dr. Uché Blackstock, founder and CEO of Advancing Health Equity and Yahoo Life medical contributor, tells Yahoo Life. “Over the spring, despite vaccinations being available, many parents were too scared to bring their children to the pediatrician’s office, although the message from pediatricians was to still bring your children in for their shots because it was safe. Now parents have the convenience to walk into any pharmacy instead of making an appointment with their physician.”

Additional access to childhood vaccines is crucial, Emily Brunson, a medical anthropologist and epidemiologist at Texas State University, tells Yahoo Life. She cites older research that found that, in many unvaccinated children, “it’s not a parental choice not to vaccinate, it’s an access issue.” Allowing pharmacists to administer childhood vaccines “will address access, which is a major and significant issue in the U.S. It’s a huge step for vaccine access,” Brunson says.

But pediatricians’ offices have been open and available to deliver vaccinations all along, Blackstock points out. “It may have made more sense to put the resources into messaging and outreach to parents and families in order to encourage them to go to their pediatrician’s office instead of spending resources training pharmacists around vaccine education and administering shots,” she says.

The American Academy of Pediatrics (AAP) publicly opposed the new guidelines, with AAP president Dr. Sally Goza saying in a statement that the move is “incredibly misguided.”

“In the middle of a pandemic, what families are looking for is reassurance and clinical guidance from the doctors they trust most to care for their children: pediatricians,” Goza said. “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.”

The AAP also expressed concerns that vaccinating children at pharmacies lowers the odds they’ll get their well-child checkups, and that few pharmacies participate in Vaccines for Children, a federal program that provides vaccines at no cost to children who are Medicaid-eligible, uninsured or underinsured, or who are Native American or Alaska Native.

The new guidelines also don’t offer new options for parents of children under the age of 3. “Children under 3 receive more frequent and critical vaccinations that must be administered by someone who knows their medical history well and can provide the clinical support needed by patients and their families,” Blackstock explains. “Pharmacists do not have the training necessary to care for very small children in this manner.”

Experts stress the importance of flu shots right now

While the new guidelines cover all childhood vaccines, they also include flu vaccinations, making it easier for parents to get their children over the age of 3 vaccinated against influenza.

The Centers for Disease Control and Prevention recommends that everyone over the age of 6 months should get a flu shot, “with rare exceptions.”

“I can’t think of any other time our history, since the influenza vaccination became available, when it was this important to get everyone vaccinated,” Dr. Juan Salazar, a pediatric infectious disease specialist and physician in chief at Connecticut Children’s, tells Yahoo Life.

It will be “very difficult” for everyone — including physicians — to be able to tell the difference between the flu and COVID-19 cases without a test, Salazar says. “As a result, kids or adults who get influenza will be considered potentially COVID-positive patients,” he says. “We don’t have the testing to test all of them, and it will create a sense of panic within communities that COVID-19 is surging again when it may be influenza.”

It’s also crucial to think about the potential strain on the health care system if there is an intense flu season, Blackstock says. “The importance of flu shots is critical in order to avoid any flu outbreaks, especially in the setting of circulating coronavirus, which could make children sicker if they were co-infected, but also place a strain on already limited health care resources,” Blackstock says.

Doctors say it’s unlikely that this increased availability will help people who have vaccine hesitancy

Vaccine hesitancy, which is a delay in accepting vaccines or refusing to get them, despite availability, is a real concern for physicians. “It can increase the risk of the spread of preventable diseases,” Salazar says.

But Salazar is doubtful that making vaccines more easily accessible will help encourage families who are already wary of vaccines to get vaccinated. “If you’re hesitant to get a vaccine from your trusted provider, you’re certainly not going to walk into a Walgreens, CVS or Rite Aid and get a vaccine,” he says. “That’s just not going to happen.”

Instead, Blackstock is hoping that this increased accessibility will help families who are nervous about going to a doctor’s office right now. “The fact is that people still have fear of being exposed to coronavirus going to physicians’ offices,” Blackstock says. “It remains to be seen whether they will feel less scared bringing their children to the pharmacist instead.”

For the latest coronavirus news and updates, follow along at https://news.yahoo.com/coronavirus. According to experts, people over 60 and those who are immunocompromised continue to be the most at risk. If you have questions, please reference the CDC’s and WHO’s resource guides.

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