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Year:: 2021
Contributor:: Roberts, Anna L. (Author); Saal, Karen (Advisor)
Subject:: pediatrics; Quality Improvement; family medicine; COVID-19; pediatric immunization; pediatric screening; well-child care; sample size effect
DOI: https://doi.org/10.26300/qq7s-x350

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Abstract:: Well-child care (WCC) visits are essential for vaccinations. The COVID-19 pandemic disrupted this infrastructure, jeopardizing access to childhood vaccinations. Rhode Island created the Pediatric Primary Care Relief Program (PPCRP) to monitor and mitigate COVID’s effects. Coastal Medical has three family medicine (FM) and four pediatric (PED) practices that reported data to the state immunization registry (KidsNet). This project sought to determine differences in observed performance between Coastal FM and PED practices. This was a retrospective review of KidsNet and Coastal reports. An additional chart review was performed for kindergarten-aged patients to identify immunization exceptions at two timepoints: September 2020 (PPCRP start) and January 2021 (PPCRP end). These patients were categorized based on reason for missed vaccination. Collectively, Coastal’s practices met PPCRP goals in kindergarten vaccine readiness, second measles, mumps, and rubella (MMR) dose, seventh grade readiness, and lead screening. However, PED practices (n = 1099 patients) exceeded PPCRP goals, while FM practices (n = 61 patients) did not. Of kindergarten-aged patients, 38 (33 PED, 5 FM) did not meet vaccination requirements in September 2020; 42% (n = 14 PED, 2 FM) were due to a delayed WCC visit. In January 2021, 69 (57 PED, 12 FM) patients did not meet requirements; alternate vaccine schedules accounted for 32% (n = 22 PED, 0 FM). FM patients had similar exception reasons to PED patients. In 2020, Coastal did not experience the reduction in vaccination rates observed nationally during the pandemic because WCC visits were preserved during COVID-19. While FM practices did not meet PPCRP goals, chart review revealed that the reasons for missed vaccinations were similar between practice type. The decreased vaccination rate at FM practices was attributable to the sample size difference and not internal factors such as differences among providers.

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Roberts, Anna L., "Pediatric immunization and lead screening at Coastal Medical during the Rhode Island Pediatric Primary Care Relief Program (PPCRP) initiative in response to COVID-19" (2021). Gateways to Medicine, Health Care, and Research. Brown Digital Repository. Brown University Library. https://doi.org/10.26300/qq7s-x350

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Abstract for "Pediatric immunization and lead screening at Coastal Medical during the Rhode Island Pediatric Primary Care Relief Program (PPCRP) initiative in response to COVID-19"
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Gateways to Medicine, Health Care, and Research

The Gateways Program at the Warren Alpert Medical School of Brown University provides academically promising, motivated students new pathways to careers in the health sciences. This collection houses scholarly works produced by Master of Science in Medical Sciences (ScM) students …
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Pediatric immunization and lead screening at Coastal Medical during the Rhode Island Pediatric Primary Care Relief Program (PPCRP) initiative in response to COVID-19