Reduced capacity, coverage mark significant challenges ahead of flu season

Washington, DC, June 30, 2020 — Today, the National Association of County and City Health Officials (NACCHO), representing the country’s nearly 3,000 local health departments, released new data documenting the impact of the COVID-19 response on local health department immunization programs. These programs’ routine operations, funding, and workforce have largely been realigned for COVID-19 efforts. The COVID-19 response has taken time, attention, and personnel away from all other unrelated health priorities, as already-underfunded and understaffed local health departments respond to this unprecedented pandemic. However, in doing so, existing essential services, such as immunization, are strained or paused, with health impacts that can ripple through communities.

Local health department immunization programs are being affected by not only the logistical challenges of vaccinating children and adults in times of social distancing and stay-at-home orders, but they are also working to monitor cases and outbreaks of vaccine-preventable diseases occurring under the radar, which could increase as communities reopen. These same individuals are also charged with leading local public health planning efforts to address the overlap of COVID-19 spread and flu season in the fall, as well as in our nation’s ambitious planning for the eventual mass distribution of the COVID-19 vaccine.

In response to NACCHO’s Impact of COVID-19 on Local Health Department Immunization Programs assessment, nearly 90% of respondents indicated that local immunization programs and services have been impacted by the COVID-19 response. Significant impacts include:

• Reduced or suspended immunization clinic services and counseling with a prioritization of certain patient groups including those that are immunocompromised, pregnant, age birth to 24 months, or for individuals requiring specific services such as rabies vaccines or series completions/catch-up vaccinations.
• Shuttered outreach, education, training, and partnership efforts due to staff being pulled away to focus on the COVID-19 pandemic response or social distancing guidelines.
• Reduced program activities including routine school assessments or audits, vaccine-preventable disease surveillance and outbreak control, and Vaccines for Children program-related activities.
• A notable decline in local vaccination coverage rates similar to findings at the national level, risking the chance for outbreaks.

Despite the challenges, these programs are adopting innovative and redesigned service delivery methods when possible to adapt and fulfill their critical public health function to provide this essential, life-saving service. These include:

• Adjusting clinic hours and appointment schedules to accommodate reduced staff capacity.
• Adopting online/telehealth services to offer immunization education and counseling, which is essential to promoting vaccine confidence.
• Conducting home visits or drive-thru vaccination clinics to maintain social distancing guidelines and accommodate stay-at-home orders.
• Addressing patients’ safety concerns by conducting health pre-screenings before a clinic visit and outreach via telephone and social media to inform patients of clinic protocols in place to mitigate the risk of COVID-19 during a clinic visit.

Reports From the Field is a series highlighting the impact of COVID-19 on the work of local health departments on other public health priorities. Previous reports include cover the Impact of COVID-19 on HIV, STI, and Viral Hepatitis Programs; Food Safety Programs; and Vector Control Programs.

For more details on NACCHO’s response to COVID-19, see our information page: https://www.naccho.org/programs/our-covid-19-response

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About NACCHO

The National Association of County and City Health Officials (NACCHO) represents the nation’s nearly 3,000 local health departments. These city, county, metropolitan, district, and tribal departments work every day to protect and promote health and well-being for all people in their communities. For more information about NACCHO, please visit www.naccho.org