The National Association of Pediatric Nurse Practitioners (NAPNAP) supports the timely and complete immunization of all infants, children, adolescents, and adults to maximize the health and well-being of all people. Since the COVID-19 pandemic began, routine immunizations have declined in the United States and worldwide. Countries have suspended national immunization programs as a result of current COVID-19 pandemic. Disruption of immunization services increases the risk for vaccine-preventable diseases to reach epidemic levels. It is imperative that children and adults are immunized as recommended by the Centers for Disease Control (CDC) and Prevention and the World Health Organization to protect people in the United States and around the world from vaccine-preventable diseases. As seen in 2019 with the measles outbreak, if a community is not at the targeted 90-95% immunity, it opens the door for vaccine-preventable disease to spread. During the COVID-19 pandemic, different strategies are required to maintain access to immunizations in order to protect people from vaccine related illnesses and disease.

NAPNAP recommends community clinics, private offices, hospital and school-based clinics remain open during the pandemic to allow patient access to immunizations. Using innovative solutions, offices can adapt to provide safe opportunities for the well population to receive in-person care and immunizations. Strategies may include:

1. Scheduling separate well visits and sick visits hours during the day to avoid exposure, with thorough cleaning of the clinic between each population to decrease risk of COVID-19 transmission
2. Staggering appointment times so people are not clustered together in common areas
3. Allowing people to wait in their cars until exam rooms are available to avoid exposure in waiting rooms
4. Providing virtual well checks and a separate clinic to administer routine immunizations
5. Calling or sending secured messages to families of children who are due for their routine well visit to allay fears and offer flexibility to schedule appointments
6. Using every patient contact as an opportunity to offer immunizations and minimize missed immunization opportunities
7. Simultaneously administering all immunizations due during the visit per CDC Pink Book recommendations
8. NAPNAP recommends children ideally receive immunizations at their medical home for continuity of care, but also supports reviewing and providing immunization at every patient contact regardless of setting.