Philadelphia’s oversight of childhood vaccinations languished during the pandemic, city audit finds

The Philadelphia health department failed to properly supervise medical clinics that provide routine childhood vaccines at the height of the COVID-19 crisis, the city’s controller found in an audit released Tuesday.

The Philadelphia Department of Public Health acknowledged their staff skipped some on-site visits required by the federal government to ensure vaccines are properly stored and safeguarded. The audit from the Office of the Controller focused on a federal grant that supported routine childhood vaccinations, such as those for polio, rotavirus, hepatitis B, and measles, mumps, and rubella, from July 2020 through July 2021.

“A lack of proper oversight of the program can result in vaccines being improperly safeguarded or wasted,” Charles Edacheril, the acting city controller, said in a statement. ”Additionally, if we don’t have complete or up-to-date records for administered vaccines, that could result in health issues for those who need to receive those vaccines.”

The health staffers responsible for these checks were busy at the time conducting COVID testing, responding to outbreaks in nursing homes, and helping to administer COVID vaccines, health department spokesperson James Garrow said in a statement issued Tuesday in response to the audit.

There’s no evidence that the lax oversight resulted in significant waste or harm, the statement said.

The audit reviewed records from the federal Vaccines for Children program, which provides doctors’ offices with free vaccines for children who are uninsured or underinsured.

Roughly 150 medical offices in the city participated in the program in 2021. The city health department must conduct on-site visits once every two years to comply with the requirements of the federal Department of Health and Human Services.

The issue came to light through an audit of all city programs funded by federal grants.

The health department is now conducting site visits, as it did before the pandemic, Garrow said. If another health crisis as significant as the pandemic emerges, the department plans to dedicate some workers to properly managing the Vaccines for Children program.

The audit acknowledged the magnitude of the crisis facing public health officials at the time. Many doctors’ offices were closed or offering limited appointments for routine medical care, which complicated the health department’s ability to conduct in-person visits. Meanwhile, the department’s staff were fully focused on rolling out COVID-19 vaccine shots.

“Staff gave up evenings, weekends, and vacations to ensure the success of the (COVID) vaccination campaign,” Garrow said.

The health department did collect records from vaccine providers during this time, Garrow said, including information that tracked whether vaccines were being stored at the proper low temperatures.

Routine vaccination rates plummeted in Philadelphia in the first months of the pandemic, a city health department report from 2021 found, but began rebounding later in 2020 and by 2021 had nearly returned to pre-pandemic levels.