Prevention, protection, and trust for children’s health

For about 20 years, Barb Harvey, RN, has been providing potent shots in the arm for members of the Lancaster community to protect them from preventable diseases—and the first shot, before any vaccine, is always trust and information.

Harvey is the lead clinical nurse for the Penn Medicine Lancaster General Health ChildProtect vaccination program, which provides free vaccinations for uninsured children across Lancaster County—usually at the remote, rural community hubs where people naturally gather.

Since the program's inception in 1991 in response to an outbreak of rubella (German measles), ChildProtect has vaccinated about 80,000 children against preventable disease.

Each clinic location is different—a representation of the diverse communities found within Lancaster County. Some clinics, like the one in New Holland, PA, mostly serve Amish and Mennonite groups (collectively known as the Plain community), and others serve recent immigrants from a predominantly a Spanish-speaking population.

During any given ChildProtect vaccine clinic, a team of five or six ChildProtect nurses arrives at a community firehouse and starts their day setting up signage, welcoming desks, patient seating, and vaccination stations. They are usually greeted by crying children who are not thrilled about receiving their vaccinations.

Clinics are held every other month from February to December and provide all vaccines recommended by the United States Centers for Disease Control and Prevention for free to children from birth to age 18) who are uninsured or enrolled in Medical Assistance, Pennsylvania’s Medicaid program. The Lancaster initiative is mostly funded by the Pennsylvania Department of Health's Vaccines for Children Program.

Clinics are usually held at local, centrally located fire department halls to be easily accessible for local residents in each community.

Patients can make an appointment, but walk-in visits are also allowed. This helps in reaching the Plain community, where making appointments does not fit with cultural norms.

Families entering the clinic always start with a nurse consultation, to review the child’s medical history and determine which vaccines the child is due for. If they do not have vaccine paperwork, the team sets them up with a “blue card,” or a personal immunization record, that they can bring with them wherever they get immunized. The team often spends time looking up vaccine history or starts from scratch if the child recently arrived in the country.

The nurses who sign up to work at ChildProtect clinics go through additional training that other nurses do not receive. They have to be willing to work with sometimes needle-shy children, work long days from set-up to tear down, and travel to various clinic sites.

After reviewing a child’s vaccine history, nurses have one-on-one conversations with the family and offer information on each vaccine, including in many cases when parents have questions about vaccinations, especially before their children start school.

“Active listening, non-judgement, and an understanding tone encourage vaccinations—we deliver facts without promoting fear,” Harvey said.

After paperwork is filled out and any necessary follow-up appointments are made, families move to the injecting nurse. And the cycle repeats.

Families have come to rely on the community vaccination clinics year after year. Not just to protect their children and broader community, but as a trustworthy source of health information.

Since the 2018-2019 school year, childhood vaccinations have decreased in the county. Medical experts theorize that vaccine misinformation—often circulated online around COVID-19 and other, decades-old vaccines has led to hesitancy. “In my experience at the clinics, vaccine mistrust is new since the last five years,” Harvey said. “Patients come in more knowledgeable of vaccines, but it’s not necessarily accurate knowledge.”

That mistrust has led to parents opting to sit their kids out of routine vaccines, opening the door for an outbreak of certain preventable diseases, including measles—a highly contagious viral infection that can be serious or deadly for small children.

Lancaster County had one confirmed case of measles (rubeola) in April 2025, after the person had contracted the disease while traveling to Texas—home to the country’s largest outbreak since the last national record number of cases in 2019. The trend is needless, since measles was declared eradicated in the United States in 2000 and a proven vaccination series keeps people safe across their entire lives.

But Lancaster County is at risk for a measles outbreak because the vaccination rates are lower than what is needed to have “herd immunity,” which comes through enough people in a community being protected via either vaccination or previous infection with a disease. That collective immunity forms a wall that makes it harder for the disease to spread.

Carol Weisser, RN, a Lancaster General Hospital nurse of 40 years who came out of retirement four years ago to work at ChildProtect clinics again, says she remembers when the clinics first started in the 90’s— during the rubella outbreak in Lancaster County: “I remember patients standing in line at one of first clinics at the Shady Maple grocery store waiting three to four hours for vaccinations.”

Rubella has similar symptoms to measles, though it is generally milder than measles in adults and children and is most dangerous for a growing fetus. Measles can cause serious illness in children and adults. Both viral infections are commonly prevented with the same combined vaccine.

The first dose of the MMR (measles, mumps, rubella) vaccine, typically given at 12 months of age, gives 93 percent immunity against measles. The second dose, which is typically scheduled at 4 years old, increases a child’s immunity against measles to 97 percent.

“This is why our work at the vaccination clinics is so important,” said Pringle. “When it comes to health care decisions, we welcome the opportunity to speak directly to patients to ensure they are receiving the information that will keep their families safe.”

Harvey says that wanting to help her community keeps her doing this work year after year. Her background working with vulnerable infants in the neonatal intensive care unit and with pediatric patients inspires this work, but she says the fact that some patients could be her own neighbors pushes her to serve.

“Our team of nurses deeply care about the children and families in our community, who are sometimes our friends and neighbors,” Harvey said. “We will do the work to protect them, even if that means taking the vaccines to them.”