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Back-to-school vaccinations in the age of coronavirus

Medical technician wearing a mask, filling an immunization needle Air Force Reserve Senior Airman Stephen Barley, an aerospace medical technician, prepares to help immunize U.S. Army Reserve engineers at the Pittsburgh International Airport Air Reserve Station, Pennsylvania. (U.S. Army Reserve photo by Staff Sgt. Dalton Smith)

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As the COVID-19 pandemic continues to disrupt everyday routines, including attending school in-person, parents may have questions about their children's back-to-school vaccination requirements. The following Q/A is adapted from a TRICARE Facebook chat with experts in the Defense Health Agency's Immunization Healthcare Division:

Will my children need their immunizations even if school buildings don't reopen?

Children need to be protected against vaccine-preventable diseases. Well-child visits and vaccinations are essential services to help ensure children are protected. Children who are not protected by vaccines may be more likely to get diseases such as measles and whooping cough.

Should they still get immunizations if they've been infected with COVID-19?

Routine vaccination should be deferred for those with suspected or confirmed COVID-19, regardless of symptoms, until they've met criteria to discontinue isolation. This will help protect health care personnel and other patients to the virus that causes COVID-19.

Will COVID-19 precautions also protect against vaccine-preventable diseases?

Social distancing does not guarantee protection against vaccine-preventable diseases. The risk may be lower, but the viruses are still circulating and can infect children.

Is it safe to take my child to a medical office for a well-child visit?

Call the provider's office and ask about ways they safely offer well-child visits during this time. Many medical offices are taking extra steps to make sure that visits can happen safely during the COVID-19 outbreak, including scheduling sick visits and well-child visits during different times of the day; asking patients to remain outside until it’s time for their appointment to reduce the number of people in waiting rooms; and offering sick visits and well-child visits in different locations.

What should I do if I can’t go to a military medical treatment facility?

If you’re enrolled in TRICARE PrimeA managed care option available in Prime Service Areas in the United States; you have an assigned primary care manager who provides most of your care.TRICARE Prime and your provider can’t provide the care you need, you will be referred to a TRICARE network provider. For all other plans, you can get covered vaccines from any TRICARE-authorized provider. TRICARE covers covered vaccines at no cost.  But when you get the vaccine from your provider, you may have to pay co-payments or cost-shares for the office visit or for other services received during the office visit.  You can get some covered vaccines at no cost at participating network pharmacies. To find a pharmacy that participates in the vaccine program, search online at the TRICARE website.

Is being up to date on immunizations more important for children of a certain age?

Children younger than age 2 have more frequent appointments and typically receive more vaccines, so they may have fallen further behind during the pandemic than children in other age groups. However, it's important to realize that vaccines require a certain amount of time between doses, called minimum intervals, so it may take multiple visits to get back on track. Work with the child’s health care provider to develop a plan that accounts for both missed doses and appropriate intervals between doses, so that your child is caught up as soon as possible.

If my children are healthy, why do they need vaccines?

If children aren’t vaccinated, they can spread disease to other children who are too young to be vaccinated or to people with weakened immune systems, such as transplant recipients and cancer patients. This could result in long-term complications and even death for these vulnerable people.

What is the harm of separating, spacing out or withholding vaccines?

Delaying vaccines can be risky. It increases the timeframe that children are susceptible to certain diseases, some of which are still fairly common.

Why are so many doses needed for each vaccine?

Getting every recommended dose of each vaccine provides the best protection possible. Depending on the vaccine, your child will need more than one dose to build high enough immunity to prevent disease or to boost immunity that fades over time. Your child may also receive more than one dose to make sure they are protected if they did not get immunity from a first dose, or to protect them against germs that change over time, like flu. Every dose is important because each protects against infectious diseases that can be especially serious for infants and very young children.

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