TABLE 5

Measures Used to Increase Uptake of Recommended Vaccines in Children in KPSC During the COVID-19 Pandemic

Minimize risk of exposure
 Screen for symptoms of COVID-19 and contact with persons with possible COVID-19 before arrival and on arrival at the facility and isolate symptomatic patients as soon as possible
 Limit and monitor points of entry to the facility and install physical barriers (plastic sneeze guards)
 Evaluate visitors and exclude as appropriate
 Require cloth face covering in persons 2 y of age and older
 Ensure adherence to respiratory hygiene, cough etiquette, and hand hygiene
Ensure staff adhere to prevention and control procedures
 Employ standard precautions, including hand hygiene before and after all patient encounters and exposure to potentially infectious material and environment cleaning between patients
 Require medical mask at all times, with mask type determined by potential for exposure
 Use eye protection (goggles, face shield)
Make spatial separation possible
 Separate sick from well patients by time (eg, well visits in morning, sick visits in afternoon) or spatially (eg, different areas, different locations)
 Reduce crowding in waiting rooms. For example, patients remain outside (in vehicles if possible) until called into the facility for their appointment. This is also done in supporting departments, including pharmacy, laboratory, and radiology.
 Offer telemedicine visits for visits that do not require an in-person physical examination
 Use hybrid telemedicine (history, virtual examination, discussion with parents) with in-person encounters for portions requiring face-to-face contact (vital signs, growth parameters, vaccinations, laboratory tests)
 Establish drive-through or parking lot vaccine clinics (facilities permitting) for older children (started with 11 y and older, now some areas seeing younger children)
Outreach
 Nursing outreach: contact members whose children are due for immunization using EHR-embedded algorithm that alerts when certain vaccines are due
 Focus initially on youngest members for whom timing is most critical (<24 mo)
 Remind parents that VPDs remain a threat to their children and to their community
 Reassurance of safety: describe safety measures taken
 All persons on campus and within facilities must wear masks
 All persons, including members and staff, are asked CDC-recommended screening questions, have their temperature taken, and are triaged to the appropriate area (well versus acute condition unlikely to be COVID-19-associated versus possibly COVID-19-associated condition [fever and/or COVID-19-associated symptoms])
Give all vaccines that are due to minimize No. visits needed