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Please share this information widely.
Important: Interim Guidance for Immunization Delivery
The COVID-19 pandemic has caused health care providers to change how they operate and provide essential services to patients. Ensuring that immunization services are maintained or reinitiated is essential for protecting individuals and communities from vaccine-preventable diseases and outbreaks and for reducing the burden of respiratory illness during the upcoming influenza season.
CDC has issued Interim Guidance for Immunization Services During the COVID-19 Pandemic to help immunization providers in a variety of clinical settings plan for safe vaccine administration during the COVID-19 pandemic. This guidance will be updated as the COVID-19 pandemic evolves.
Highlights include:
- Considerations for routine administration of all recommended vaccinations for children, adolescents, and adults, including pregnant women.
- General practices for the safe delivery of vaccination services, including considerations for alternative vaccination sites.
- Strategies for catch-up vaccinations.
Thank you for your support of public health during this challenging time.
Vaccinating During COVID-19
Decrease in Immunization Administration Data:
Since the start of wide-spread COVID-19 in communities, childhood immunizations in Wisconsin have significantly decreased. This trend is being seen throughout the U.S. and worldwide. Given this trend, we want to share data with you and provide suggestions to reduce risks in both the short and long terms.
The overall number of immunizations administered has decreased from mid-March to June 2020, compared to the average for the same time period over the past five years (see table below, “Number of Immunizations Administered per Week in Wisconsin...” ).
 This impact is being seen across all age groups as measured by the number of doses administered (Figure 2, below). Of note, certain age groups seem to be more affected than others—vaccination of school-aged children seems to be more impacted than the youngest cohort.
If these trends continue, they will have significant, long-lasting impacts on herd immunity against vaccine preventable disease, create opportunities for the spread of disease, and lead to potential outbreaks.
 The last table, below (“Number of Immunizations Administered to Individuals Aged 19 Years and Older…”) includes the number of non-influenza vaccines administered to the adult population of Wisconsin in 2020 vs. the past 5 years' average. Data represents the total number of adult immunizations with vaccine groups—Tetanus, Td, Tdap/Pertussis, Pneumo, Pneumo-Poly.
Recommendations to Continue Vaccinating
It is important to continue vaccinating children and adolescents during the COVID-19 pandemic. Health care providers in communities affected by COVID-19 are using strategies to separate well visits from sick visits. Examples include:
- Scheduling well visits in the morning and sick visits in the afternoon.
- Separating patients spatially, such as by placing patients with sick visits in different areas of the clinic or another location from patients with well visits.
- Collaborating with other providers in the community to identify separate locations for holding well visits for children.
- Lowering the number of patients on site at any one time. Think about closing the waiting room or registration area and have patients check in by phone from the parking lot.
- Considering different entrances in your clinic that sick and well patients may enter.
- Marking entrances clearly for patients who are high risk for COVID-19.
- Telling patients who are ill to use telemedicine or a phone call. Some chronic conditions may be safely managed by a phone consult or telemedicine visit.
- Examining patients by car visit. Tell patients to drive to the clinic and wait in their car while staff go outside to check on them.
- Giving vaccine to people in their car. Make sure to use proper hygiene and waste disposal practices outdoors just as you would indoors.
- Screening all patients and caregivers for high-risk symptoms.
- Referring high-risk adults to pharmacies who can give vaccines at less busy times to keep them safer.
Important: If a practice can provide only limited well-child visits, health care providers are encouraged to prioritize newborn care and vaccination of infants and young children (through 24 months of age). In this case, we advise communicating to your parents and caregivers where older children and adolescents can safely receive vaccine services in your community, and/or communicate your plans for when patients can plan to return to your office for full services.
Because of personal, practice, or community circumstances related to COVID-19, some providers may not be able to provide well-child visits, including provision of immunizations, for all patients in their practice. Recognizing that COVID-19 will likely be circulating in the community for many months to come, providers should consider longer-term plans for providing immunizations safely and communicate the safety provisions to patients.
Helpful Resources for Providers:
Sending Reminders to Your Clients
To support your efforts in bringing back into your clinics the cohort of children in need of catch-up immunizations, we want to provide resources for recalling patients (clients) in the Wisconsin Immunization Registry (WIR).
WIR offers reminder and recall (R/R) letters, postcards, and address labels you can use to help reach your clients. Reminder letters can be used for patients with upcoming appointments, while recall letters can be used when a patient falls behind with appointments.
For questions and guidance about the WIR Reminder/Recall tools, email the WIR Help Desk (DHSWIRHelp@wi.gov) or call 608-266-9691.
Note: In response to population inflation within the registry, changes to WIR client status are being developed that are intended to improve R/R lists. You may see (especially local health departments) jurisdiction cohorts become more manageable once these changes are put into place. More information will be coming soon.
Influenza
Vaccine Data by County Updated
We recently updated the Influenza Vaccination Rates by county for the 2019–2020 season.
Planning for a Safe 2020–2021 Influenza Vaccination Season
Vaccinating a majority of your patients against influenza early in the fall will be vital to reducing morbidity and mortality that would impact already fragile communities and high-risk groups, as well as further strain medical facilities and the need for PPE. Using recommendations such as the reminder letters listed above, we encourage you and your practice to begin considering the following:
- How will you communicate to all of your patients about the importance of an annual influenza vaccine?
- How do you plan to let patients know when they can come in for a flu vaccine appointment?
- How will you safely provide influenza vaccines as well as other recommended vaccines?
- How will you increase influenza vaccination and aim to do so earlier compared to previous seasons?
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