Be Ready to Immunize Kids Down to Age 3

Pharmacists in ALL states are authorized to order and give vaccines to kids down to age 3...as the gov't expands access due to COVID-19.

One of the goals is to offset a drop in pediatric vaccination rates...and you're well equipped to help meet this need.

Some medical organizations are raising concerns about fragmented care...including patients skipping routine visits.

Continue to collaborate. Emphasize the importance of well-child visits...and inform the prescriber when you give vaccines to kids.

Follow your pharmacy policies and state laws as things evolve.

Identify kids and teens who need vaccines.

For instance, review your state's online immunization registry...ask for the immunization record...or contact the prescriber. Some states require use of the registry to check records and document administration.

Rely on the CDC routine and catch-up vaccine schedules for kids.

For example, ensure kids under age 9 getting a flu vaccine for the first time receive 2 doses separated by at least 4 weeks.

And watch for 11- to 12-year-old kids who are due for HPV, meningococcal, and Tdap. Give these all at the same time if needed.

Calm fears if kids are resistant. Use distractions, such as asking about pets or school...or letting kids play on a smartphone. Or have a caregiver hold the child on the lap...or give them a bear hug.

Recommend sitting for at least 15 minutes after vaccination. And keep in mind, fainting is common in adolescents after any vaccine.

Administer vaccines in the arm for kids 3 and older...similar to adults. For IM deltoid injections, use a 5/8-inch needle...or 1 inch for kids over 130 pounds. Stick with 5/8 inch for subcutaneous injections.

Give combo vaccines if possible. For instance, pick ProQuad (MMRV) for kids who need both MMR and varicella.

Streamline workflow by leaning on your techs and interns to manage vaccine inventory...process and bill Rxs...and prep supplies.

Prevent mix-ups by separating pediatric and adult vaccines in the fridge...and double-checking products (DTaP versus Tdap, etc).

If needed, update your emergency kit to include a weight-based injectable epinephrine dose for kids under 66 pounds (EpiPen Jr, etc).

Keep a callback list for follow-up vaccines (flu, HPV, MMR, etc).

Find more tips to reduce anxiety and minimize pain from immunizations in our checklist, Vaccine Administration Strategies. And brush up your knowledge with our variety of immunization CE courses.

Key References

  • www.hhs.gov/about/news/2020/08/19/hhs-expands-access-childhood-vaccines-during-covid-19-pandemic.html (9-21-20)
  • www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html (9-21-20)
  • www.aappublications.org/news/2020/08/19/immunization081920 (9-21-20)
Pharmacist's Letter. October 2020, No. 361005



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