Bringing Routine Childhood Vaccinations Directly to People
Early on in the pandemic, routine medical care unrelated to COVID-19 decreased significantly. Unfortunately, this trend included U.S. children missing an estimated nine million doses of vaccines in 2020.
According to a study by the Blue Cross and Blue Shield Association, vaccination rates for highly contagious but preventable diseases – including measles, whooping cough and polio – were down by 26 percent compared to 2019 levels.
Reducing risks to community health
Dr. Dawn Martin, medical director for Hennepin Healthcare’s Pediatric Vaccine Mobile, witnessed the drop in childhood vaccinations firsthand at Hennepin Healthcare’s Minneapolis clinic.
“Families were fearful and anxious about coming into a clinic setting,” says Dr. Martin.
“Immunizations are one of the greatest public health achievements of the last century and are responsible for saving countless lives,” says Dr. Mark Steffen, vice president and chief medical officer at Blue Cross and Blue Shield of Minnesota. “The ongoing risk of COVID-19 only increases the need for kids to get these shots. The last thing anyone wants to see right now is an outbreak of a preventable disease.”
Minnesota has already seen some outbreaks of preventable diseases in recent years, including a high-profile measles outbreak in 2017. During that outbreak, there were 65 confirmed cases in four counties, with an estimated 8,250 people exposed to the virus.
Steps parents can take
Dr. Steffen says the first and most important step is talking with your child’s doctor to find out if they are behind on their immunizations. Doctors and clinics have gone to great lengths to ensure people can safely get the care that they need and will be able to give parents an updated timeline for when children should receive certain vaccinations.
“I would also encourage parents to talk to their pediatrician about vaccinating eligible children to protect against COVID-19 as soon as possible,” says Dr. Steffen. “If we all do our part to protect ourselves, our community, and our most vulnerable populations I know we can be successful.”
An award-winning patient-centered approach in Minneapolis
Hennepin Healthcare’s Vaccine Mobile was a model solution to deliver childhood vaccines as preventive healthcare became especially limited for Black, Indigenous and People of Color (BIPOC) living in communities with high social vulnerability indexes (SVI) during the early days of the pandemic. When the Vaccine Mobile is out in the community to deliver care, it is staffed by a nurse practitioner or pediatrician, community paramedic and a resident.
“Pre-existing barriers to healthcare like financial strain, childcare challenges and limited transportation were really exacerbated by the pandemic,” says Dr. Martin. “We saw what was happening with vaccination rates and knew the best course of action was to deliver care to where the patients were.”
The program has been named a Trailblazer by Blue Cross and Blue Shield of Minnesota for its innovation in addressing racial and health equity.
Hennepin Healthcare serves patients from diverse racial and ethnic backgrounds: 38% Hispanic, 29% Black, 14% Black-African, 6% Asian and 13% White. Most are younger than 4 years of age, although there has been an increasing numbers of school aged children and teenagers, and they mostly reside in North Minneapolis, Downtown Minneapolis, Cedar Riverside, Richfield, Brooklyn Center and Brooklyn Park.
A young child received care from the Hennepin Healthcare Vaccine Mobile during a recent community event at PICA Head Start Early Childhood Development Center in Minneapolis.
Focusing on health equity
Closing the persistent gaps in childhood immunizations is a top priority for Blue Cross as the organization works to advance racial and health equity throughout Minnesota. Bringing this service to the community reduces barriers families face to accessing health care and community resources. Innovative models like the Pediatric Vaccine Mobile will have a role in addressing care gaps and connecting families to resources for years to come.
“As the Pediatric Vaccine Mobile program has expanded, we’ve been able to be more deliberate in connecting families with other community resources,” says Dr. Martin. “Funding from Blue Cross has allowed us to screen families for social determinants of health and refer them for appropriate support such as food resources, housing assistance, insurance coverage and to initiate or re-establish families with primary care.”
The program has worked well, visiting patients in their homes as well as at pop-up clinics at community-based locations. Hennepin Healthcare measures success of its Pediatric Vaccine Mobile program in terms of patient satisfaction, which was rated at almost 99% in a random phone survey conducted in the spring of 2021. The team has served over 800 families, delivered over two thousand essential childhood vaccinations, provided health assessments, food bags, children’s books and been able to refer families to additional community resources. Other vaccines, including the COVID-19 vaccine and influenza vaccine, were also offered to eligible children, teens and adults. Success is also measured by intangibles such as restoring trust between the healthcare system and BIPOC families.
The Hennepin Healthcare Vaccine Mobile is staffed by a nurse practitioner or pediatrician, community paramedic and a resident when out in the community delivering care.