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Never a More Important Time: Getting Children Vaccinated on Schedule

A conversation with Susan Fleischman, M.D., chief medical officer, Blue Shield of California Promise Health Plan

The new school year begins this month for children throughout California but going back to school won’t be the same as many children continue remote learning due to COVID-19.

Historically, the annual back-to-school rush has meant that parents spend weeks prior to opening day buying school supplies and other items for their children. For some parents of first-time school children, it also typically meant rushing to comply with legal requirements for up-to-date childhood vaccinations so their children could be admitted to school. (Children excepted from this legal requirement are those with age or medically validated health problems for whom vaccines would be harmful or fatal).

Susan Fleischman, M.D.

Now, in this altered academic world, healthcare professionals are concerned that many children who continue to attend school remotely won’t get caught up with vaccinations they need to protect their lives and those of their family and community from preventable diseases.

We asked Dr. Susan Fleischman, chief medical officer at Blue Shield of California Promise Health Plan, the importance of getting children immunized on time, especially in midst of a pandemic.

Why is it important for parents to get their children immunized?

Immunizations are the cornerstone of preventive care in children throughout the world. Making sure that immunizations start early, from birth, and continue consistently throughout a child’s life ensures that they are protected against infectious diseases that used to be commonplace, such as polio or whooping cough. When children are immunized, they are protected, and that also supports the entire community and achieves herd immunity which protects all of us.

I think that our society has forgotten how prevalent infectious diseases used to be, and we take for granted the good health that the vast majority of children and adults in our country enjoy regarding infectious diseases because of vaccinations from childhood. The COVID-19 pandemic has been a painful reminder of how vulnerable we can be to infections for which we are not immune.

What are examples of diseases that used to be prevalent in the U.S. and have now disappeared or been significantly diminished?

Polio is a good example. In the first half of the 20th century, polio struck down children of all ages. It paralyzed them, requiring them to live in iron lungs for months, and usually crippling them for life if they survived. When Dr. Jonas Salk invented the polio vaccine in 1953 and children everywhere got that vaccine, polio soon disappeared

Measles is another example. However, people – both in America and abroad – have neglected to get children inoculated against this formerly common disease, and measles epidemics have broken out.


How do parents know what types of vaccinations their children need and when?
Pediatricians and family physicians are on the front line to help parents manage the schedule required for vaccinations for their children, beginning when they are babies. Children’s pediatricians often provide parents with a long-term immunization schedule when children are born. Also, the Centers for Disease Control & Prevention lists the type of childhood immunizations and the schedule required. There are “catch up” schedules as well and it’s never too late for parents to get their children up to date on immunizations.

Are there any ages when children are especially vulnerable to disease and must get vaccinated?

For children, getting vaccinated at any age is critical. It’s also just as important that they don’t fall behind in their vaccine schedule and get them at the right age. This year, it’s critically important that children get the seasonal flu vaccine, in addition to others that are required for their age.

However, the reality is that sometimes parents forget or neglect a regular vaccine schedule due to stressors in their lives such as job loss, housing problem or food insecurity. It’s only when children need to go to pre-school or to kindergarten that they are required to catch up on all missing vaccinations. In the healthcare world, we call this the “back-to-school” healthcare rush.

Now that many children in California will be learning remotely and may not be going to a physical school, do you expect to see a change in this vaccine “catch up” mindset?

Yes. This is a major concern for many clinicians like me. We also believe some children may not get vaccinations because families fear going into a medical office during the COVID-19 pandemic. At Blue Shield of California Promise Health Plan, we have launched an intensive outreach program to contact our Medi-Cal families to remind them of the importance of getting their children vaccinated because this is important for their health and wellbeing. 

Are there children who cannot be vaccinated due to significant health problems?

Yes, there are some children who have medically validated health issues, such as an auto immune disease, blood issues, allergies or other serious problems and cannot receive vaccines due the potential harm it could cause them. Getting vaccinated could be potentially harmful or fatal for them. Yet, they can go to school because the rest of the school children and community members have been inoculated. “Herd immunity” is working. When other children are not immunized, they put these vulnerable children at risk.


What can parents do to reduce their anxiety and concern about taking their child into the doctor for vaccinations?

Parents can call their children’s primary care provider’s office and ask about their safety protocols.

During this pandemic, pediatricians have been rigorously active and ahead of the curve to ensure they can take care of children who are healthy and children who are not.  Many pediatric practices have designated specific hours only for well-baby or well-child check-ups, and other hours only for visits from children who have troubling symptoms or are ill. The American Academy of Pediatrics has issued guidance to pediatricians to continue to provide immunizations to children during COVID-19.