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It's time for well-child checks — and vaccinations

July 10, 2020 | UCI Health
UCI Health pediatrician Dr. Candice Taylor listens to Nathan Le's heartbeat as his mother, Pauline Le, holds him.
Pauline Le, left, steadies her son, Nathan, while UCI Health pediatrician Dr. Candice Taylor conducts his six-month well-baby check. Such routine visits are vitally important to a child's continued well-being, Taylor says.

Parents understandably postponed visits to the pediatrician during the lockdown phase of the novel coronavirus pandemic. It initially made sense for all but the most urgent healthcare needs.

Now, however, it’s time to get those well-child visits on the calendar, says UCI Health pediatrician Dr. Candice Taylor.

Parents can rest assured that UCI Health has adopted rigorous measures to prevent the spread of the virus that causes COVID-19 and to protect the health and safety of its youngest patients and their families.

Learn more about UCI Health safety measures › (video)

It’s especially important for parents to schedule vaccinations for their children now — not waiting for a vaccine against coronavirus, as great as it would be to have one.

The immunizations given at well-child visits are ones that keep kids and the larger community safe from potentially dangerous diseases such as measles, mumps, chicken pox and diphtheria.


Ensuring herd immunity

UCI Health pediatrician Dr. Candice Taylor
“The last thing we want is an outbreak of another illness, one we already know how to prevent,” says UCI Health pediatrician Dr. Candice Taylor.

California’s immunization rates are already down this year by 40%, which could threaten protective "herd immunity" for those highly infectious diseases.

Herd immunity is conferred when most people in a community are vaccinated. For example, to achieve herd immunity for measles, 93% to 95% of a population must be immunized.

Even before the pandemic, the nation had been experiencing several years of measles outbreaks in communities where vaccination rates had fallen. In 2019, 1,282 measles cases were reported, the most since 1992.

As schools discuss reopening their campuses for classes in the fall, Taylor says it’s important for children to be up to date on their vaccinations to avoid getting sick and sickening others. In fact, in California, it’s the law.

“We can’t afford to lose herd immunity,” she says. “The last thing we want is an outbreak of another illness, one we already know how to prevent.”

Safety measures

Avoidance of medical settings during the pandemic has led to troubling delays in care in some cases, Taylor says. Some children with appendicitis weren’t taken to emergency rooms until perforation had occurred.

UCI Health safety measures will be evident to parents arriving at pediatric offices in Anaheim, Irvine, Orange and Santa Ana, which are open and seeing patients.

  • Everyone — visitors and employees, alike — is screened for COVID-19 symptoms, including a temperature check.
  • Masks are required of all patients, their families and employees. For those who don’t have a mask, one will be provided.

Taylor says they even have child-sized disposable masks with cartoon designs on them for their young patients. However, babies and toddlers under age 2 should not wear face coverings.

Parents also will notice:

  • Check-in lines to keep patients and their parents a safe distance from others
  • Signs reminding everyone to keep at least six feet apart
  • Rooms sanitized between each visit
  • The entire clinic area cleaned thoroughly during the lunch hour

Parents who feel safer waiting outside can be called in when an exam room is ready, Taylor says. 

Other changes include:

  • Scheduling well-child visits earlier in the day
  • Taking patients and their parents to exam rooms as quickly as possible to to limit overlap with others in the waiting room
  • Caring for patients with fever or other COVID-19 symptoms in a separate clinical area to prevent any viral spread

With these precautions in place, she says, parents can feel secure in having a sick child checked by a doctor promptly.

Emotional well-being

But it’s not just acute medical problems that concern Taylor. Many children have been through a rough time emotionally for the past few months, even if they haven’t shown signs to their parents, she says.

“Children aren’t living in isolation,” she explains. “They’re part of the greater family and social ecosystem.”

That is why during well-child visits she and other UCI Health pediatricians will also be alert for signs of any physical and mental health issues that might have arisen during the pandemic.

Sometimes, Taylor says, gentle questioning from a pediatrician who establishes rapport with a child may help uncover emotional concerns that need to be addressed.

She recalls a young boy she saw recently for a well-child checkup. “He was crying because he hadn’t been able to spend time with his friends at school,” she says, noting that some school-age children have conversations and share feelings with their teachers and friends that may not be possible at home.

Making kids a priority

Telemedicine visits are helpful for many healthcare checks but some — like well-child checks — require focused, in-person examinations to ensure a child’s well-being.

Routine pediatric exams are essential to keep track of children’s physical development, Taylor says. Their growth should be monitored and the development of gross and fine motor skills observed. Hearing and vision assessments also should be done regularly. Children with special health concerns, such as asthma, eating disorders or other chronic conditions, also need to be seen regularly.

Wearing masks and gloves does make it a little more challenging for pediatricians to build rapport with kids. Taylor misses smiling and laughing visibly with patients, but she compensates by laughing through her mask and smiling with her eyes. She also tries to use body language and assume positions that allow her to engage with patients.

This may mean sitting in child-sized chairs when talking to families, squatting to speak directly at face level with a toddler, singing songs or making funny noises when examining babies. It also includes pausing to step away from the computer to talk with a teenager and assure them of their value.

With all this in mind, Taylor says, UCI Health pediatricians will continue to provide the safest possible environment for young patients because the health and well-being of children, families and communities matters now more than ever.

 

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