June 3, 2020

Children’s Hospital experts say well-child visits remain as crucial as ever

Pediatricians at Monroe Carell Jr. Children’s Hospital at Vanderbilt are stressing the continued importance of well-child visit for infants, children and adolescents, particularly during the COVID-19 pandemic.


by Christina Echegaray

Pediatricians at Monroe Carell Jr. Children’s Hospital at Vanderbilt are stressing the continued importance of well-child visit for infants, children and adolescents, particularly during the COVID-19 pandemic.

Well-child visits — regularly-scheduled checkups — are important from birth through adolescence to ensure that children are thriving at home and at school. During these visits, doctors check a child’s growth and development, test vision and hearing, assess health issues and manage ongoing health care needs. Children also receive any vaccines that are due.

Shari Barkin, MD, MSHS, chief of the Division of General Pediatrics, along with her colleagues from the Vanderbilt Pediatric Primary Care Clinic, answers several questions about why well-child visits are as important as ever and talks about what the clinic is doing to prevent the spread of COVID-19 infection.


Should parents still bring their children in for well visits?

Yes. Well-child visits are essential to ensure your child is healthy, gaining weight, developing according to his/her age, and to receive the appropriate vaccines to prevent disease. These visits should occur in person, as much as possible, within your medical home, to maintain or establish continuity of care. To maintain appropriate physical distancing, we are prioritizing in-person well-child visits for all children 2 and younger, 4- to 6-year-olds, and 11- to 12-year-olds. These are the visits that are often associated with important timely vaccines and other time-sensitive assessments.


Why are yearly child well visits so important?

Well-child visits are very important to make sure your child is healthy, gaining weight and developing according to age. It is an opportunity to talk about concerns with your provider, discuss anticipatory guidance and parenting skills. They also are helpful in identifying, preventing problems and making appropriate referrals when necessary. In person well-child visits use appropriate screenings, complete physical exam, laboratory exams, fluoride varnish and vaccines to prevent diseases which cannot be provided in a telehealth visit. Often this is when undiagnosed issues can be identified and addressed.


What is Children’s Hospital doing to make these visits possible?

We’ve been identifying children who have missed their well-child visit and/or the recommended vaccinations and worked with parents to schedule them for an in-person appointment. These are prioritized because we want to make sure other conditions, including how children are developing, are not missed during this time when families are reducing their risk of COVID-19.


When parents need to come in, how have we prepared our clinics to ensure safety?

To help prevent families and employees from being infected, we are screening and giving out masks to every child and caregiver that comes to our facility. Every child can have one caregiver (who is not symptomatic) accompany them. We separate well and sick patients in different areas of our primary care clinic. We have modified our waiting room to ensure there is adequate physical distance between families. All rooms are cleaned after every visit. Your medical team is following strict guidelines, wearing masks and washing hands often. Your family’s safety is our priority.


Are there exceptions to bringing children in for well visits?

If your child had been diagnosed with COVID-19 and is doing well, parents and children should follow isolation guidelines to avoid contact with other children and families (and especially people who are older than 65 or have chronic illnesses).

We have also identified some children who are considered high risk for not doing well if they were exposed to COVID-19 (for example children with complex medical conditions). If we can support their health without bringing them into clinic, for example, through telemedicine, we will do that. However, if a child needs to be seen in clinic, we are happy to do that, using all our approaches to prevent infection.


Can my child be seen through a telehealth visit?

Whenever possible, we are scheduling telehealth visits. We have a wonderful system that connects to your child’s Electronic Medical Record (called My Health at Vanderbilt, MHAV) and other tools to provide secure and private telehealth visits. Telemedicine is a very good way to access some types of health care, where the chief complaint is observable (like a rash) or if the condition requires detailed discussions (checking to see if a child is tolerating new medications or therapies). If you are not sure if your child’s concern could be taken care of through telemedicine, just give our clinic a call: 615-936-2555.


Well visits are when children receive their vaccines. What are the ramifications of missing vaccines?

Missing childhood vaccines places children at risk of contracting life-threatening, vaccine-preventable diseases, which, in turn, also places the community at risk of outbreaks. The vaccine schedule is a thoroughly tested and annually evaluated guide to provide children with the protection from these diseases in a safe and effective manner. Thus, we strongly recommend families follow the schedule for the health of their child and family.


Why is it important that parents ensure that their children receive the recommended vaccines when prescribed?

The childhood vaccine schedule was developed to ensure maximum immunity against the included vaccine-preventable diseases, thus alterations in when children receive the vaccines are not thoroughly tested to see if the same level of immunity would be achieved. In addition to protecting the individual, a certain number of children need to be vaccinated to prevent outbreaks; this is called herd immunity. This is the reason everyone has had to practice physical distancing for COVID-19, because there is no herd immunity, so just a few sick people can make many more people sick. While we are waiting for a COVID-19 vaccine, it is exceptionally important that children get the vaccines we already have so we don’t have an epidemic (like measles) on top of the COVID-19 pandemic.

Further, the schedule has been evaluated (and continues to be evaluated every year) for safety. We know that administering vaccines according to the schedule is extremely effective in protecting our children against the diseases and overwhelmingly safe, which is why it’s important that parents try to stick to the schedule as closely as possible.