November 4, 2021
The COVID-19 pandemic has significantly disrupted routine immunizations for children, adolescents and adults, according to the U.S. Department of Health and Human Services . You may hear from our members about catching up on delayed vaccinations. We’ve created resources for them about staying current on routine vaccines . Examples of routine vaccinations include:
- Influenza (flu) vaccine annually for ages 6 months and older
- Human papillomavirus (HPV) vaccine for ages 9 to 14 years, or for ages 15 to 26 years if not received earlier, to protect against some cancers
- Measles, mumps and rubella (MMR) vaccine for ages 12 to 15 months; 4 to 6 years; and adults with no immunity or medical conditions
- Pneumonia vaccine for older adults and adults with health issues that weaken their immune system
- Shingles vaccine for adults ages 50 and older
See our preventive care guidelines on immunization schedules.
COVID-19 vaccine: The Centers for Disease Control and Prevention (CDC) recommends the COVID-19 vaccine for everyone ages 5 and older and booster shots in certain populations . The CDC says that other vaccines may be given with the COVID-19 vaccine. The U.S. Food and Drug Administration granted full approval of the Pfizer COVID-19 vaccine for ages 16 and older, and emergency use authorization (EUA) for ages 5 to 15 years old. The Moderna and Johnson & Johnson vaccines have EUA for ages 18 years and older. Learn more about COVID-19 vaccines and coverage .
Closing Care Gaps
As part of monitoring and helping improve quality of care, we track two measures related to immunizations. Both are Healthcare Effectiveness Data and Information Set (HEDIS®) measures from the National Committee for Quality Assurance (NCQA).
- Child Immunization Status , which tracks the percentage of children who received by their 2nd birthday a total of four diphtheria, tetanus and acellular pertussis (DTaP); three polio (IPV); one MMR; three haemophilus influenza type B (HiB); three hepatitis B (Hep B); one varicella (VZV); four pneumococcal (PCV); one hepatitis A (Hep A); two or three rotavirus (RV); and two flu vaccines.
- Immunizations for Adolescents , which tracks the percentage of 13-year-olds who had one dose of meningococcal vaccine; one tetanus, diphtheria and pertussis (Tdap); and the complete HPV vaccine series by their 13th birthday.
Tips to Consider
- Identify members who have missed vaccinations and contact them or their caregivers to schedule appointments.
- Check at each visit for any missing immunizations and deliver vaccines that are due.
- Address common misconceptions about vaccines.
The above material is for informational purposes only and is not a substitute for the independent medical judgment of a physician or other health care provider. Physicians and other health care providers are encouraged to use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment. The fact that a service or treatment is described in this material is not a guarantee that the service or treatment is a covered benefit and members should refer to their certificate of coverage for more details, including benefits, limitations and exclusions. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider.
HEDIS is a registered trademark of NCQA. Use of this resource is subject to NCQA’s copyright, found here.