Can vaccination-at-home help kids get immunised during the pandemic? Here are some pros and cons

It is important for children and babies to keep their vaccinations up to date, because vaccines protect them from serious diseases. It also implies that when your child returns to interacting with other children, they have protection from other diseases, too.

By Dr Vidheya Venkatesh

Meera is postponing vaccinations for her six-week-old son because she fears her family could contract the virus or another infection if they visit a hospital setting. She says typically her children are vaccinated on time, but is being ultra-cautious about interactions outside of their home during the pandemic. What should parents do when they have so much fear and anxiety about childhood vaccinations?

The year 2020 has been challenging, and as the pandemic continues, one of the biggest challenges for parents has been to administer routine childhood vaccination and for healthcare professionals to provide those services. It was a noticeable and a visible trend that routine childhood immunization coverage had decreased significantly not just in India but globally. As per the recent statistics available from WHO, UNICEF, GAVI, and the Sabin Vaccine Institute, country lockdown measures had substantially hindered the delivery of immunisation services in at least 68 countries, putting approximately 80 million children under the age of 1 at increased risk of contracting vaccine-preventable diseases. As the virus continues to spread, immunisation efforts must continue to prevent outbreaks of other diseases, and one of the potential solutions that all parents could use is the availability of home vaccination services.

I was surprised to note our very own unpublished data suggests since the lockdown (starting April to October), we have attended more than 6,000 parents for queries related to vaccination and more than 1,500 of them have been given home vaccination services. 

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What do home vaccination services offer?

The outbreak had brought fear and uncertainty and one of the biggest concerns for most parents was how to safely get routine vaccinations for children. While we continue to face disruption in our daily lives, the short answer for every parent is, do try to get your child vaccinated where services are available. It is important that children and babies keep their vaccinations up to date because vaccines protect them from serious diseases. It also implies that when your children can return to interacting with other children, they’ll have protection from these diseases, too. Home vaccination services offer the safety, comfort and convenience to get these vaccinations on time through qualified and well-trained health care professionals. Experienced professionals not just ensure the administration of a vaccine, but also explain about the post-vaccination effects such as fever or chills as seen in a few cases. The concept of providing home visits was part of a doctor’s routine until recently, which has seen an increase in recent times.

Benefits of home vaccination are manifold

  • The routine vaccinations are given to the child as per schedule.
  • The wait time for the patient is significantly reduced.
  • Blessing for working parents as it helps to maintain a work-life balance.
  • The familiarity of the surroundings would reduce the natural anxiety in parents and the child.
  • It provides opportunity for a general check-up of the child by a health care professional. 
  • Reduces the exposure of the parents and the child to infections.
  • Reduces crowding of patients in the hospital set up.

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Potential risks of home vaccinations

  • Potential risks of missing certain health conditions as physical examination may not be always possible with the paediatrician. Video consultations in order to determine whether the child is fit for vaccination at home would seem to be a logical solution. In such cases, the advice would be to administer the vaccine in the hospital setting.
  • Potential for adverse events. This risk can be averted by availing the services of trained nursing personnel in BLS to administer the vaccine. In children who have had adverse reactions to vaccines, the advice would be to give further vaccines in the hospital setting.

The ongoing pandemic is a reminder of the importance of vaccination which could lead to epidemics of diseases which are entirely preventable. The declines in routine paediatric vaccines and doses administered may indicate children and their communities face increased risks for outbreaks of vaccine-preventable diseases such as the measles outbreaks in the US and the UK over the last couple of decades. Continued coordinated efforts between health care providers and public health officials at the local, state, and federal levels, will be necessary to achieve rapid catch-up vaccination. I strongly believe prevention is always better than cure, and basic immunizations for children and adults, and comprehensive vaccinations can be administered by home services at the comfort of your home.

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It is imperative that the ongoing pandemic is taken as an opportunity to not just sustain but widen the reach and scope of the digital leap in delivery of healthcare services, and at the same time ensuring healthcare is accessible and affordable. Increased tie ups and collaborations with the private sector is required to ensure every child in India receives immunisation. Indeed, childhood vaccination has proven to be one of the most effective public health strategies to control and prevent diseases in children. We hope that every child gets her right to vaccination services even during the pandemic. 

(The writer is a Senior Consultant, Neonatologist and Paediatrician at Cloudnine Group of Hospitals, Bengaluru)

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