Guidance on Providing Pediatric Well-Care During COVID-19

The American Academy of Pediatrics (AAP) strongly supports the continued provision of health care for children during the COVID-19 pandemic.  Specifically, well-child care should be provided consistent with the Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents (4th Edition) and the corresponding Bright Futures/AAP Recommendations for Preventive Pediatric Health Care (Periodicity Schedule).  

Since the onset of the pandemic, a significant drop in well-child visits has resulted in delays in vaccinations, delays in appropriate screenings and referrals and delays in anticipatory guidance to assure optimal health. Pediatricians have rapidly adapted to provide appropriate elements of well exams through telehealth when clinically warranted. However, additional elements require in-person visits.  Concern exists that delays in vaccinations may result in secondary outbreaks with vaccine-preventable illnesses. 

Primary care pediatricians are prepared to ensure all newborns, infants, children and adolescents are up to date on their comprehensive well-child care, inclusive of appropriate screenings, complete physical exam, laboratory exams, fluoride varnish and vaccines.  

See below for additional guidance. 

• Consistent with previous guidance, all well-child care should occur in person whenever possible and within the child’s medical home where continuity of care may be established and maintained.  For practices who have successfully implemented telehealth to provide appropriate elements of the well exam virtually, these telehealth visits should continue to be supported, followed by a timely in-person visit. 
• Pediatricians should identify children who have missed well-child visits and/or recommended vaccinations and contact them to schedule in person appointments inclusive of newborns, infants, children, and adolescents. Pediatricians should work with families to bring children up to date as quickly as possible. State-based immunization information systems and electronic health records may be able to support any catch-up immunizations. 
• Pediatricians should also inform families about the strategies already implemented in primary care medical home offices to assure safety. These strategies may include these examples:  

• Scheduling well visits and sick visits at different times of the day. 
• Separating patients spatially, such as by placing patients with sick visits in different areas of the primary care clinic or another location from patients with well visits. 
• Collaborating with providers in the community to identify separate locations for providing well visits for children.  

Additional Information 

• Guidance on Newborn Screening During COVID-19 
• COVID-19 Planning Considerations: Return to In-person Education in Schools 
• Latest messages from AAP President  
• AAP News COVID-19 Collection