Is it safe to see the pediatrician for vaccines and medical visits?

We’re tackling a few urgent questions from parents in this time of coronavirus and COVID-19. Are you wondering if babies and children should continue to have vaccines on schedule? Thinking about how to manage regular medical appointments, and which situations require in-person visits to a pediatric practice? Read on.

Should parents take babies for initial vaccines right now? What about toddlers and older children who are due for vaccines?

The answer to this question is going to depend on many factors, including what your doctor’s office is offering. As with all health care decisions, it comes down to weighing risks and benefits.

In general, we think that getting those early immunizations in for babies and toddlers — especially babies 6 months and younger — has important benefits. It helps to protect them from infections such as pneumococcus and pertussis that can be deadly, at a time when their immune system is vulnerable. At the same time, they could be vulnerable to complications of COVID-19 should their trip to the doctor expose them to the virus.

For children older than 2 years, waiting is probably fine — in most cases. For some children with special health conditions, or those who are behind on immunizations, waiting may not be a good idea.

The best thing to do is call your doctor’s office. Find out what precautions they are taking to keep children safe, and discuss your particular situation, including not only your child’s health situation, but also the prevalence of the virus in your community and whether you have or might have been exposed. Together, you can make the best decision for your child.

When you need to bring your child to the doctor, even during a COVID-19 pandemic

As we all hear from all sides every day, the best thing we can do to keep ourselves and our communities safe during the COVID-19 pandemic is to stay home. But what if your child has a doctor’s appointment?

Certainly, anything that isn’t urgent should be postponed until a safer time. This would include checkups for healthy children over 2 (many practices are postponing checkups even for younger children if they are generally healthy, so check with your doctor’s office). It also includes follow-up appointments for anything that can wait, like a follow-up of ADHD in a child that is doing well socially and academically. Your doctor’s office can give you guidance about what can wait — and when to reschedule.

Many practices are offering phone or telemedicine visits, and it’s remarkable how many things can be addressed that way. I have been doing telemedicine visits, and have been struck by how much care I can give by talking with families and patients, and seeing them over video.

What requires an in-person visit?

Some things, though, do require actual contact with the patient, including:

• Acute illness or injury that could be serious, such as a child with trouble breathing, significant pain, unusual sleepiness, a high fever that won’t come down, or a cut that may need stitches or a bone that may be broken. Call your doctor for guidance on whether to bring your child to the office or a local emergency room.
• Children who are receiving ongoing treatments for a serious medical condition such as cancer, kidney disease, or a rheumatologic disease. These might include chemotherapy, infusions of other medications, dialysis, or transfusions. Your doctor will advise you as to any changes in treatments or how they are to be given during the pandemic, but you should not skip any appointments unless your doctor tells you to do so.
• Checkups for very young children who need vaccines and to have their growth checked (check with your doctor as to their current policies and practices)
• Checkups and visits for children with certain health conditions. This might include children with breathing problems whose lungs need to be listened to, children who need vaccinations to protect their immune system, children whose blood pressure is too high, children who aren’t gaining weight, children who need stitches out or a cast off, or children with abnormal blood tests that need rechecking. If your child is being followed for a medical problem, call your doctor for advice. Together you can figure out when and how your child should be seen.

The bottom line

Talk to your doctor or their representative. So much is going to depend on not just your child’s condition, but also on how prevalent the virus is in your community, whether you have had any exposures (or possible exposures), what safeguards your doctor has put into place, and how you would get to the doctor. Every situation is a bit different, and all of us in health care are doing our best to take the best care of patients that we can during this extraordinary time.

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