Back-to-School Vaccine Catch-Up: Strategies From a Family Physician

As back-to-school season begins, pediatric vaccination coverage is a top priority for primary care clinicians. In this interview with Patient Care®, family physician Sarah Sams, MD, shares practical strategies for identifying patients who are behind on vaccines, addressing catch-up schedules, and prioritizing immunizations based on current public health concerns.

Sarah Sams, MD, is a board-certified family physician who is a member of the board of directors of the American Academy of Family Physicians (AAFP). Dr Sams also an associate director and full-time faculty member at Grant Family Medicine Residency in Columbus, Ohio.

The following transcript has been lightly edited for style and clarity.

Patient Care: Back-to-school season is here. How can clinicians ensure pediatric patients are up to date with their vaccines?

Sarah Sams, MD: Most of us now have electronic medical records, and those usually have health maintenance tabs where you can run reports to see who is due for particular vaccines. You can then reach out individually to those patients, either by phone or MyChart, and say, “Hey, looks like your child might be behind on vaccines.”

The other thing is to pay attention to vaccine needs when kids come in for non–well visits—when they’re here for an ear infection, strep throat, or something else in between well-child checks. If they can’t get the vaccine at that time, or don’t want it because of the illness, at least remind them they’re behind and immediately schedule a follow-up appointment so they can get caught up as quickly as possible.

Patient Care: What is your approach to catch-up vaccination for children who may be behind?

Dr Sams: I actually saw a child this week who needed catch-up vaccines. They had been going to a different physician early in their childhood and hadn’t received them. We’re now following the schedule, because certain intervals must occur between doses of a particular vaccine.

Often, we’ll schedule nurse visits for vaccines in between well-child checks. If the family is hesitant to do them all at once, we start with the vaccines for illnesses the child is most likely to come in contact with. For example, right now there’s been a measles epidemic in many places. If they’re old enough—post–1 year—and can get the measles vaccine, we might start with that. We focus on the diseases most concerning for that age group or location.

We don’t see much polio right now, so if a family wants to space out vaccines, we might delay that one since the risk of exposure is low. But if the family is willing to do multiple vaccines in a visit, we’ll do as many as possible, then schedule a shorter interval between well-child checks for nurse visits to complete the series.

For more of our conversation with Dr Sams, check out How Physicians Can Strengthen Vaccine Confidence During National Immunization Awareness Month