Pediatricians should identify children who have missed well-child visits and/or recommended vaccinations and contact them to schedule appointments inclusive of newborns, infants, children and adolescents.Additionally, pediatricians should continue to follow federal and state guidelines on newborn screening and ensure timely follow-up for out-of-range results per AAP interim guidance on newborn screening. If the infant is positive for SARS-CoV-2, close outpatient follow-up beyond the initial in-person visit via telephone, telemedicine, and/or additional in-office visits through 14 days after birth is recommended. Appropriate PPE should be used in the ambulatory care setting, per AAP interim guidance. If no alternate caregiver is available, the mother should accompany the infant to the visit if she is not too ill to do so. If the mother is positive for SARS-CoV-2 and still in her recommended isolation period and the infant is negative, an alternate caregiver (if available) who is SARS-CoV-2 negative and masked should accompany the infant to their visit to minimize risk of transmission. See AAP interim guidance FAQs: Management of Infants Born to Mothers with Suspected or Confirmed COVID-19 and Post-Hospital Discharge Guidance for Breastfeeding Parents or Newborn Infants With Suspected or Confirmed SARS-CoV-2 Infection. Outpatient newborn care should not be compromised because of COVID-19, and newborn visits should take place in person.For practices that have successfully implemented telehealth to provide appropriate elements of the well examination virtually, these telehealth visits should continue to be supported, followed by a timely in-person visit. Consistent with previous guidance, all well-child care should occur in person whenever possible and within the child’s medical home, where continuity of care may be established and maintained.Pediatric practices can also serve as COVID-19 vaccination sites. Primary care pediatricians are prepared to ensure all newborns, infants, children and adolescents are up to date on their comprehensive well-child care, inclusive of appropriate screenings, complete physical examination, laboratory examinations, fluoride varnish and vaccines. Concern exists that delays in vaccinations may result in secondary outbreaks with vaccine-preventable illnesses.
Despite these efforts and a rebound increase in outpatient visits to near pre-pandemic levels, a significant cohort of children remain behind on regular well-child care and routine immunizations. Pediatricians rapidly adapted to provide appropriate elements of well examinations through telehealth when clinically warranted and also implemented measures to provide in-person care as safely as possible. Since the onset of the pandemic, a significant drop in well-child visits has resulted in delays in vaccinations, delays in appropriate screenings and referrals and delays in anticipatory guidance to ensure optimal health. Specifically, well-child care should be provided consistent with the Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents (4th Edition) and the corresponding Bright Futures/AAP Recommendations for Preventive Pediatric Health Care (Periodicity Schedule). The American Academy of Pediatrics (AAP) strongly supports the continued provision of health care for children during the COVID-19 pandemic.
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