Make children’s vaccines accessible

Capitol Weekly welcomes Opinions on California public policy or politics. Please read our guidelines for opinion pieces before submitting an Op-Ed. Submissions that do not adhere to our guidelines will not be considered for publication. 

OPINION — In agricultural Kern County, over 70% of children are on Medicaid. Like families across the country, their parents trust pediatricians with their children’s care. 

But for a quick question or if they need a vaccine, they may turn to their community pharmacy. This matters in areas with physician shortages, such as Kern, where there are only 41 primary care physicians per 100,000 people, well below the recommended 60-80. 

At Komoto Pharmacy, a community pharmacy in Kern where nearly 60% of residents identify as Hispanic or Latino, patients often visit after work and on weekends.

“Families trust us because we look like them, live as their neighbors, and speak their language,” a staff member recently told us.

Flu season started early this year in the Western U.S., and in California 59 people have already died from the flu. While there have been no recorded pediatric deaths yet this season, it is critical that vaccines are available and affordable to everyone. Health officials and pediatricians recommend flu vaccines as one of the most important steps to keep children over six months of age healthy and thriving this winter.

Many parents and families are heeding this guidance, though getting children vaccinated can be challenging. Vaccines for Children (VFC) program makes vaccines available at no cost to those on Medicaid. Yet pharmacies account for less than 1% of VFC providers across the country, despite their critical role in their communities’ health.

Despite noisy online narratives, most parents and families want to get their children vaccinated.  Komoto Pharmacy has been running out of children’s flu vaccines faster than they are able to restock them from VFC. For a recent vaccination event in partnership with the local high school, the pharmacy borrowed additional flu shots to meet demand. 

Most Americans are confident that most vaccines protect children and their local community against serious illness. This view is widespread regardless of political ideology, age, race or ethnicity. The biggest challenges with getting children vaccinated are often logistical.

One question circulating online right now is: “How can I find a pharmacy that carries the flu vaccine?” 

For people with private insurance, the answer is most often their pharmacy, where most people ages three and older can get vaccines. But for children on Medicaid, the answer is less straightforward.

As of April 2024, some states like Connecticut, Florida and South Carolina, had no pharmacies participating in VFC. California had only 11 participating pharmacies, with Komoto Pharmacy being only one of two in their county.

Instead of stopping by the pharmacy, many of the 70% of Kern’s parents must take time off work, wait for a pediatrician or clinic appointment, and juggle school schedules. Pharmacies are often open later and on weekends, know their communities and are a nexus of trust. But few can deliver a simple, preventive service flu vaccine to children who need it.

Community pharmacies can ease demand on pediatrician offices, educate parents and help children catch up on recommended vaccines. 

To be sure, there are well-documented barriers and costs for pharmacies to participate in VFC and adhere to the requirements set by the Centers for Disease Control. Training, equipment, staffing and reporting requirements can pose challenges to already-stretched pharmacy staffing. 

Many pharmacies operate on a tight margin, sometimes losing over $100 on a single prescription. Thousands of pharmacies across the U.S. have recently closed, a problem which disproportionately impacts communities of color. 

Yet, pharmacies serve as critical access points especially in rural communities.

When parents seek care, they are acting to protect their children and communities from disease, yet sometimes they cannot get one of health care’s most cost-effective tools. It is time to shift the narrative and the burden. In a county with 70% of its children on Medicaid, in a state with over 50% of its children on Medicaid, California has an opportunity to make vaccines easier to get.

Viable solutions exist. Small seed grants can fund initial training and the purchase of equipment, like refrigerators, required for VFC. Partnerships with schools or organizations with staff like school nurses can make the cost of vaccine administration more sustainable. Partnerships with local health departments can shift and share supply when pharmacies are awaiting their next delivery, keeping vaccines available and ready.

Additionally, policy changes to ensure sufficient reimbursement for vaccine administration will help pharmacies remain open and continue serving their communities. 

Together, community partnerships and policies to support pharmacy enrollment in VFC can have a big impact on the youngest Americans, their families and the health of their communities.

Barbara Rubino is a practicing primary care physician and a Public Voices Fellow on Public Health with The OpEd Project and Blue Shield California Foundation. Danielle Colayco is a pharmacist, health economist and the executive director of the Komoto Family Foundation.