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In the movie Spiderman, Peter Parker’s guardian, Uncle Ben, tells him, “With great power there must also come great responsibility.” Over the past decade, pediatricians, family physicians, nurse practitioners, physician assistants, office nurses, and the entire primary care staff have been handed increased power and responsibility. The power to protect our children from vaccine-preventable diseases and the responsibility to ensure that every child receives all necessary vaccines in a safe and effective manner.
More children receive a greater number of vaccines today then ever before in our history and the majority of these are given in primary care settings. Children receive an increased number of vaccines with up to 23 injections given for 11 different diseases. The US immunization rates are at the highest level ever for 2-year-olds with almost 74% of children up-to-date for the 4:3:1:3:3 schedule.1 Primary care practice teams provide 73% to 85% of the immunizations for children (personal communication, Pennsylvania Department of Health Immunization Program, Harrisburg, PA).2–4 For many children and families the Vaccines for Children (VFC) Program has been the key to receiving immunization services in a medical home. The VFC Program has meant an end to the fragmented system of care that required families to have a preventive care visit with their pediatrician and then schedule another visit with the local public health center to receive vaccines. Children still receive immunizations from public health clinics, but many clinics are now primary care settings and not just immunization-only shot clinics. So over the last decade and a half, since the measles epidemic, the health system has made significant progress in protecting children and adolescents through immunization services provided by medical home.
The primary care practice is not alone in the immunization process and this adds to the complexity. Primary care practices …
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