Access to Flu Vaccines in Pediatric Populations


Ravi Jhaveri, MD, discusses challenges in patient access to flu vaccines, and comments on the need to increase opportunities for vaccination for all pediatric patients.

Ravi Jhaveri, MD: So as we think about coverage across the population, I’m talking mostly about the United States, but I think there are many principles that apply across the entire world, which is that we still have a long way to go in terms of ensuring equal access. And so in the United States, we have had a lot of concerted effort, and we had an integrated system with primary care pediatricians and other pediatric providers to get the youngest kids vaccinated efficiently, we would have flu clinics and integrated vaccination in offices. And we would be very effective in especially young kids vaccinated, so kids between 6 months and 4 years and from kids 5 to 12. Because teenagers have fewer visits, they tend to be vaccinated at a much lower rate than the younger kids. But inherent in what I said was the idea that the families who have stable relationships and reliable access to providers had an advantage when it came to getting a vaccine. Those families who perhaps live farther away from care don’t have steady access; perhaps there are fewer pediatric providers in their regional area, whether it’s an urban or rural environment. And so there are obstacles to getting kids vaccinated. We know that individuals and families in those areas have lower vaccination rates. And so [we’re] trying to ensure that there are many options for receiving vaccine outside of the physician’s office, so whether this is commercial pharmacies, public clinics, local fairs, sort of pop-up [places], if you will, as many options as we can provide to level the playing field.

I think we also need to make sure that our communication is culturally sensitive to many, many groups. We know that, especially in this era of sort of splintering of media and media consumption that we really need to be thoughtful about the outlets that we use to communicate the importance of getting vaccinated, where and how patients get vaccinated, address their concerns in a way that respects their differences, reaches their level of health literacy and how they consume information, and not be patronizing or disrespectful with our answers. We shouldn’t assume anything, and anyone’s concern is valid and should be addressed, and offer a combination of informed science and compassion for those who have concerns. I would just say in our broader trends, unfortunately [in] the last several years we have seen declines in vaccination rates, [but] we were doing terrifically well perhaps at the highest rate in terms of flu vaccination rates in children…[in] 2017, 2018, 2019. And unfortunately, the pandemic and I think the current epidemic of misinformation, the combination of pandemic-induced hesitancy and loads of misinformation, and also some changes in access too, that primary care pediatricians have moved away from having flu clinics in their office. They’ll still give vaccines integrated with well visits, but very few are actually having flu clinics in the way they used to and dedicated flu vaccine visits. So I think the expectation is that the burden may be offloaded to pharmacies, and pharmacies are not always kid-friendly when it comes to vaccines. Some are, but for the youngest kids it’s often problematic. These are all challenges that I think we really have to address going forward and again in order to increase opportunities for all patients to get [the] flu vaccine because as I said before, flu vaccine is recommended for every patient. So the burden is on us as the health care system to make sure that people can get it in a multitude of ways.

Transcript is AI-generated and edited for clarity and readability.

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