COVID-19: Should children skip back-to-school checkups and vaccinations this year?

July 31, 2020 | Blogs

Even if your child will be doing virtual learning in the fall, annual checkups and vaccinations he or she would normally get around back-to-school time should not be deferred.

"Why is the checkup so important this year? First, many children are having trouble coping with the new reality we live in. Your child's physician can screen for mental health issues and make appropriate referrals or treatment recommendations as needed," says Scott Krugman, M.D., M.S., FAAP, vice chair of the Department of Pediatrics at The Herman & Walter Samuelson Children's Hospital at Sinai. "Second, even if schools aren't in person, every child needs to be up to date on their immunizations."

A flu shot will be especially important this fall, as it will probably be difficult for physicians to distinguish between COVID-19 and influenza. "So, reducing the risk of getting influenza will help everyone," Krugman says.

Some of the things LifeBridge Health pediatricians are doing to protect patients (and which you can ask your healthcare provider about) are:

ensuring a clean environment by disinfecting each room after every visit
eliminating the use of waiting rooms
requiring patients, family and staff to wear masks at all times
requiring staff to wear proper personal protective equipment (PPE) during procedures
arranging telehealth appointments (secure video visits or extended phone chats)
drive-thru vaccinations

"Pediatricians continue to urge families to keep their children up to date on vaccines and checkups" says Dana Silver, M.D., FAAP, FABM, director of Greenspring Pediatric Associates and a pediatrician at the Samuelson Children's Hospital. "They are adjusting schedules to use telehealth services where appropriate. But many children still need to be seen in the office for vaccines. To that matter, pediatricians are limiting or eliminating use of waiting rooms, socially distancing and increasing cleaning measures."

Silver adds: "The last thing we need is an outbreak of vaccine-preventable diseases in the midst of the COVID-19 pandemic."

In addition to the flu shot, a measles vaccine is also encouraged, says Susan V. Lipton, M.D., MPH, chief of pediatric infectious diseases at Sinai Hospital of Baltimore. "Both influenza and measles drop immunity, particularly immune memory and cell-mediated response, for a good six weeks following infection, and we have no idea what will happen with co-infection or sequential infection with COVID-19," Lipton says.

"Also," Lipton adds, "measles can look very much like Multisystem inflammatory syndrome in children (MIS-C) and Kawasaki (disease) with fever, rash, conjunctivitis and will make it harder to sort out."

The Centers for Disease Control and Prevention [CDC] has said that while the cause of MIS-C, a condition where different body parts can become inflamed, is not known, many children with the condition either had the virus that causes COVID-19 or had been around someone with COVID-19. In addition to fever and rash, symptoms of MIS-C can include abdominal pain, vomiting, diarrhea, neck pain, bloodshot eyes, and fatigue.

Kawasaki disease is an acute febrile illness of unknown etiology that primarily affects children younger than 5 years of age, with clinical signs including: fever; rash; swelling of the hands and feet; irritation and redness of the whites of the eyes; swollen lymph glands in the neck; and irritation and inflammation of the mouth, lips and throat.

Contact your healthcare provider right away if your child is showing symptoms of either of these conditions.

As always, continue to:

wash your hands often (with soap and water for at least 20 seconds, or use a hand sanitizer containing at least 60% alcohol)
avoid touching your eyes, nose and mouth with unwashed hands
avoid close contact with people who are sick
put at least six feet of distance between yourself and people who don't live in your household
cover your mouth and nose with a mask or cloth face cover

Visit lifebridgehealth.org or call 410-601-WELL to learn more about our services at LifeBridge Health and scheduling an appointment.