practice management

COVID-19 Vaccine: What Pediatricians Need to Know

Even though there isn’t yet a pediatric COVID-19 vaccine, there’s plenty of preparation for pediatric practices to do in early 2021. Learn about the latest changes in the COVID-19 pandemic for pediatricians, from initial vaccine distribution, pediatric vaccine trials, financial assistance, HR questions, and more. A year after facing financial and logistical obstacles in caring for patients, the pandemic has shown the strengths of pediatricians that will see them through the first waves of vaccinations.

How can my practice receive COVID-19 vaccine?

Vaccines from two manufacturers, Moderna & Pfizer, were approved for emergency use by the FDA in December 2020. Most states are following the CDC’s recommendation that COVID-19 vaccine is distributed to prioritized groups, the first of which includes front-line workers, a group that includes pediatric practice employees. 

Qualified healthcare workers, including pediatricians, can apply to administer the COVID-19 vaccine during the first wave of vaccine rollouts via an agreement with the CDC and by signing up with their state’s vaccination program, which is sometimes the state medical board, the state vaccination program, or another body. While a pediatrician can apply to administer vaccine as soon as they choose, the office may actually receive vaccine in one of two ways: 

First, your practice may receive only enough vaccines to administer to your colleagues and employees as part of the phase 1A rollout to front line workers. Alternatively, you could agree to administer vaccines to other qualified patients as vaccine distribution continues. Vaccine inventory and healthcare logistic needs will vary from community to community, so a practice could find themselves in either of these situations or both, depending on their community’s needs and healthcare infrastructure. Healthcare workers who also practice at a hospital, for example, might be called to administer vaccines there, while a rural practice might serve whole families and not only children.

You can learn more about the CDC’s COVID-19 Vaccination Program Provider Agreement and its requirements here, including vaccine storage, educational modules for providers, and information on reporting to VAERS. If you’re a physician and have signed up for the CDC Vaccination Program via your state’s IIS, your state’s advisory body will contact you. You can then receive vaccines when they become available -- for some states, pediatric practices will start receiving vaccines in later phases when larger and younger populations are eligible.

The Pfizer vaccine is approved for patients 16 and older, while the Moderna vaccine is approved for patients 18 and older. While the CDC’s Phase 1A recommendation to vaccinate front-line workers won’t cover children under 18, this distinction between age requirements will become important as your practice prepares for wider administration to patients.

Administration Resources

You can find the AAP’s FAQ on COVID-19 vaccine administration here which can help answer many of the questions families will have about the vaccine, its effects, and why and when their child should receive it. The more confident and informed pediatricians are about the COVID-19 vaccine and its rollout, the more comfortable families will feel about choosing this healthcare option. The FAQ also lists a state-by-state resources guide so that you can sign up to administer the vaccine when it’s available in your community.

Physicians administering the COVID-19 vaccine can also complete a learning module, watch a webinar, and get more vaccine administration and reporting information from the CDC here.

Coding and Billing

At present, providers must distribute the COVID-19 vaccine regardless of insured status or ability to pay administrative fees. According to the CDC, “Providers may seek appropriate reimbursement from a program or plan that covers COVID-19 Vaccine administration fees for the vaccine recipient,” which may indicate coverage from programs such as CHIP and Medicaid, but they may not “seek any reimbursement, including through balance billing, from the vaccine recipient.”

The AAP is currently working to come to an appropriate physician work value. According to the AAP’s COVID-19 Vaccine FAQ, last updated on January 13th: “The AAP along with other specialty societies are working through the Relative Value Update Committee (RUC) process to present the Centers for Medicare and Medicaid Services (CMS) with a physician work value that they will either accept and publish or determine their own value. We are advocating that the value be above 90460.”

For the latest information on coding, billing, and more, be sure to check out PCC’s COVID-19 Links and Resources page.

Pediatric Vaccines: How to Prepare

At the time of this post’s writing, there is not an FDA-approved pediatric vaccine for COVID-19. While we will provide updates and guidance on the approval, release, and distribution of a pediatric COVID-19 vaccine as soon as this information is available, here are some things your practice can do now to prepare for vaccine rollout.

  1. Volunteer to be an administration site for eligible adults
  2. Advocate along with the AAP for the inclusion of pregnant women and children in vaccine trials, so that a pediatric vaccine can be achieved quickly and safely to protect children, pregnant people, and families.
  3. Prepare your knowledge in COVID-19 FAQ, including potential questions from vaccine-hesitant families.
  4. Prepare for the recall of patients 16 or older to receive the vaccine

At the time of this post’s writing, the Pfizer vaccine is approved for patients 16 and older, while the Moderna vaccine is approved for patients 18 and older. While the CDC’s Phase 1A recommendation to vaccinate front-line workers won’t cover children under 18, this distinction between age requirements will become important as your practice prepares for wider administration to patients.

Vaccine Confidence: Your Voice Matters

Pediatricians’ voices are trusted and crucial in the decision of many families in their vaccination decisions. The nature of the COVID-19 pandemic and vaccine development has meant that many families are naturally concerned about the efficacy, safety, and long-term effects of the vaccine on themselves and their children. Pediatricians can prepare now for important conversations that can help reassure families that the vaccine is both safe and important for individual and community health.

After listening carefully to concerns and questions, pediatricians can provide information tailored to families’ needs: this could range from how vaccines work, to vaccine development, to personal stories. The physician’s experience in choosing to receive the vaccine, even if they themselves were hesitant at one time, leans on the trusted relationship pediatricians build over a child’s lifetime and can offer reassurance and guidance during a difficult choice. 

Physicians and managers in your practice can connect with hesitant families and colleagues by learning more about vaccine hesitancy, and by sharing their own vaccination stories. Some healthcare workers are advocating by sharing stories and videos on social media. Whether you help spread confidence in the vaccine via Twitter, your practice website, or in individual moments with families, strong advocacy for the vaccine helps your community gain confidence in its safety, and can help protect as many families as possible.

Financial Help Available in 2021

The Payment Protection Program was renewed on January 11th, 2021. If your practice has not yet taken advantage of this valuable federal assistance, you may wish to submit your application as soon as possible. This program assists small businesses like pediatric practices pay their rent, their payroll, and keep the lights on, and when used as stipulated, the loan may be eligible for forgiveness.

On January 13th, the Small Business Administration introduced the Second Draw PPP Loan, which allows businesses who previously received a PPP loan and meet the following requirements to receive another loan under the same terms as the original PPP loan. Applicants must:

  • Have previously received a First Draw PPP Loan and will or have used the full amount only for authorized uses
  • Have no more than 300 employees; and
  • Can demonstrate at least a 25% reduction in gross receipts between comparable quarters in 2019 and 2020.

While the COVID-19 Economic Injury Disaster Loan (EIDL) Advance is no longer available at the time of writing, you may still apply for an EIDL loan, which matures at 3.75% for businesses over 30 years.

Much of what we know about the COVID-19 vaccination process in the U.S. is constantly evolving. We’re here to help provide you with the information you need to prepare your practice and your patients for these shifting circumstances as they happen. If you’d like to learn more about the resources available for pediatric practices, check out our resource page for updated information from billing to broadcast messages.

PCC's Latest COVID-19 Resources

Allie Squires

Allie Squires is PCC's Marketing Content Writer and editor of The Independent Pediatrician. She holds a master's in Professional Writing from NYU.