O3025: Implementation and Evaluation of a Routine Immunization Program at a Pediatric Urgent Care Clinic During the COVID-19 Pandemic

Background: Childhood immunization has declined during the COVID-19 pandemic. Pediatric urgent care (PUC) centers may bolster immunization campaigns by offering vaccination during acute care visits. Few such programs have been described.

Methods: The Zuckerberg San Francisco General Hospital Children’s Health Center (CHC) provides primary, specialty, and acute care to an urban, under-served community. CHC’s PUC began offering routine immunizations to San Francisco Health Network (SFHN) patients in July 2020, and began monitoring performance in March 2021. The fraction of eligible patients receiving all recommended non-influenza/non-COVID immunizations and the number of vaccine doses administered in PUC and the SFHN was measured from March 1, 2020 – February 28, 2021.

Results: Of the 8503 patients that presented to PUC, 2616 (30.8%) were due for at least one vaccine. Of these, 1757 (67.2%) did not meet our site’s eligibility criteria. Of the 859 eligible patients, 340 (39.9%) received all recommended immunizations. No difference was observed by sex (37.4% for females v 41.1% for males, p=0.267), preferred language (39.5% for non-English v 39.7% for English, p=0.829), or race (39.7% for non-Black v 33.8% for Black, p=0.317). Patients aged 4-10 years (31.1% v 41.8%, p=0.006), patients seen by third-year residents (34.0% v 41.8%, p=0.026), and patients with a non-CHC medical home (40.9% v 32.3%, p=0.043) were less likely to receive all recommended immunizations. 53.3% of patients agreed to immunization when offered, and 96.3% of ordered vaccines were actually administered. 4.7% of all SFHN vaccine doses and 9.3% of adolescent SFHN vaccine doses were administered in PUC.

Conclusion: In real-world conditions during a pandemic, our PUC immunization program made a modest but meaningful contribution to a network-wide pediatric immunization campaign. Insufficient support for data collection, inadequate RN staffing, and frequent MD turnover presented challenges at our site. Further research is needed to determine the generalizability of our approach to other PUC sites.