Vaccine Scheduling

At Yum Pediatrics we have made the decision that we are no longer able to provide injection visits for alternative vaccine schedules. We have accommodated some alternative vaccine schedules in the past, but as our practice is growing and changing it is no longer possible for us to do so.

Here are a few of the reasons for this decision:

I am the only physician here at Yum Pediatrics. Many of you have chosen this practice because you want your family to know one physician and for that physician to know your family well. However, accommodating alternative vaccine schedules takes an enormous amount of my time and resources, which makes me less available to my patients. I love to be able to see patients for same-day sick appointments when they need me. However if many families request to receive shots over 2-4 visits when they can be done in one visit, it leaves less time in my schedule to see necessary same day appointments.
Offering vaccines is incredibly costly. It is by far my biggest monthly expense. While most plans will cover the cost of the vaccines, it is never a guarantee and the reimbursement does not cover the specialized staff I need to administer vaccines safely, the price of the equipment, the upkeep to store and monitor vaccines, or the supplies to administer them. We also spend an enormous amount of unreimbursed time doing paperwork and site visits so that we can be certified to deliver vaccines to families who self pay or have state insurance. Offering alternative vaccine schedules multiplies these expenses, making the cost of providing vaccines unaffordable.
By far the most important reason for this decision is that I feel I am not providing the best care for my patients when I agree to alternative vaccines schedules. The vaccine schedule endorsed by the American Academy of Pediatrics and the CDC is the most well studied way of providing vaccines and is proven to be safe. I would not recommend this schedule to my patients if I did not have overwhelming evidence that it was in their best interest. It is the reason that my own children are vaccinated according to the AAP approved schedule. My experience and training have proven to me that the recommended schedule is safe and provides vaccines in a way that minimizes vaccine visits, which are often a fearful experience for children. We have put a lot of thought into making this practice a fun place for kids and feel that increasing shot visits makes kids more scared to visit us. Also, when we delay key vaccines we leave unnecessary gaps in immunity to vaccine-preventable illnesses. As a physician I have a duty to provide the best medical care that I can, and when I use vaccine schedules that are not studied I don’t feel like I’m doing my best job for my patients.

Because we realize that parents have a lot of questions we have gathered information about vaccines from The Children’s Hospital of Philadelphia, a center that is a leader in information about vaccine safety. If you are interested in reviewing that informational packet give our office a call and we would be happy to provide it to you. If you decide that you would still like to pursue an alternative schedule then we may be able to suggest other practices that have the ability to provide that service.

Thanks for your understanding.

Nimali Fernando, MD, MPH