Keeping up with Children's Checkups, Visits and Vaccines

Routine visits to your child's pediatrician might have been postponed during the COVID-19 surge. But now with children back at school, it is more important than ever to schedule your child's routine pediatrician appointments. Well-child visits are an essential tool for children's health, and Alexy Arauz Boudreau, MD, a primary care physician at Mass General for Children, says there could be additional risks by putting these visits and vaccines off.

Why Routine Visits Are Important

As families manage the strain of the pandemic, checkups are more important than ever for tracking your child’s development, keeping vaccines up to date and screening for mental health and other issues.

In particular, children with chronic conditions such as asthma, obesity and ADHD need to regularly visit their pediatrician to ensure they are receiving proper care. New learning environments and new challenges could require different treatment methods, and in some cases adjustments for medications.

“Don't wait,” says Dr. Arauz Boudreau. “Especially with so many uncertainties, chronic care is important.”

Routine care is so essential that MGfC continued these appointments even during the surge through virtual visits and in-person visits. Virtual visits help to keep the number of people at the hospital low to enforce physical distancing. But there are other advantages to being able to do a routine visit from home.

“For instance, there's nothing like seeing a two-year-old play in their own environment to really get a sense of what their development is like,” says Dr. Arauz Boudreau. “Sometimes when they come into our pediatric office, it is a very foreign situation to them, so they become shy and coy and less engaging, whereas when they're in their own home, they're very talkative and outgoing and you see their natural curiosity because they feel very safe in a familiar setting.”

Plus, she says, adolescents are often much more relaxed in a virtual world, which makes it easier for pediatricians to connect with them and offer support for any issues they are facing. Physicians can see the teen’s home environment and get clues about their interests based on posters on their walls or sports equipment in the background.

“Many times, being able to have a conversation with an adolescent virtually, in the comfort of their own home, they'll open up in ways that they might not in the office,” says Dr. Arauz Boudreau.

While virtual visits can be a great option, there are often important aspects of the appointment that must be done in person, such as giving vaccines, checking vital signs, and measuring growth parameters.

Immunization Schedules

“Nationwide, there has been a decline in vaccination rates, and that puts us at risk for other infectious diseases,” says Dr. Arauz Boudreau. She explains that there are several risks associated with delaying routine childhood vaccines.

Many vaccines require multiple doses so that the immune system can get a high enough boost to be able to fight an infection if they are exposed to an infectious organism. Especially during the first two years of life, children receive many vaccines that are administered based on a schedule that scientists and medical experts have established for optimal protection.

“It can be difficult to manage the schedule if it gets delayed,” says Dr. Arauz Boudreau. “Plus, you're tinkering with the optimization of the vaccine schedule.”

Vaccines don't just protect the individual child. They protect the community against infectious disease. If your child skips a booster shot, for example, they could be at risk for getting sick and infecting others with an illness that could have been prevented. When there is a decrease in vaccinations, it decreases herd immunity, which increases community spread. While these are all terms the public has become familiar with regarding the novel coronavirus, the same principles also apply to other diseases such as measles, pertussis and influenza.

Developmental Screenings

Well-child visits also involve much more than shots. Additional aspects include:

• Physical measurements to track growth
• Mental health and developmental screenings
• Lab tests to check for lead, anemia and lipid profiles

“With many preventative issues, the quicker you address them, the less likely there will be lasting effects,” says Dr. Arauz Boudreau.

For instance, by screening for issues such as lead poisoning and early signs of depression and anxiety, physicians can intervene and get children and caregivers the resources they need to prevent more severe outcomes.

“Time and time again, we have been able to show that the sooner we can intervene to help a child get back on track in their development, the more likely they'll be able to make the gains that they lost,” Dr. Arauz Boudreau explains.

How Safe Is Your Pediatrician's Office?

Now that much more is understood about the virus and how it is transmitted, health care professionals have created and refined protocols to keep themselves, their patients, and other visitors safe.

“Safety is our top priority,” says Dr. Arauz Boudreau. “At Mass General for Children, we have taken very serious steps to make sure that our environment is as safe for our patients and our employees as possible.”

These steps include:

• New procedures that reduced the number of people passing through hallways and waiting areas
• Hand hygiene, with frequent hand washing and additional hand sanitizer stations throughout facilities
• Mandatory face masks
• Multiple COVID-19 symptom screenings for anyone entering the office

“As a pediatrician, I feel much safer in our clinic settings than I do in most other public settings because I know how much care and effort has gone into the new protocol,” says Dr. Arauz Boudreau. “I'm much more comfortable walking into our hospital than I am into one of our grocery stores.”