A pediatric vaccination program at Children’s Hospital Colorado has administered vaccines to more than 18,000 patients undergoing sedation or anesthesia since 2020, while a similar initiative in Philadelphia is expanding amid questions about parental consent, postoperative complications and safety monitoring.
By yourNEWS Media Newsroom
Children’s Hospital Colorado has reportedly administered vaccines to more than 18,000 pediatric patients while they were under deep sedation or general anesthesia since 2020, drawing attention to a growing hospital practice that allows children to receive immunizations during unrelated medical procedures.
The program was highlighted in a March 9, 2026, American Academy of Pediatrics publication by Drs. Caroline A. Pasquariello and Kim M. Strupp. The article described incorporating vaccinations into pediatric surgical and procedural care, particularly for children with neurocognitive conditions who may be unable to tolerate injections while awake.
The reported 18,000-patient figure has been cited in subsequent coverage, although the full AAP article is not publicly accessible for independent examination of the program’s consent procedures, safety outcomes or vaccination records.
The practice has attracted criticism from physicians and medical advocates who question whether parents receive sufficient information about potential risks when vaccination decisions are introduced shortly before a child’s surgery.
Supporters maintain that combining vaccination with an already scheduled procedure can reduce distress, avoid additional appointments and improve access to preventive care for children with significant medical or developmental challenges.
A similar program at Children’s Hospital of Philadelphia, called “Close Your Eyes, We’ll Immunize,” administered 2,054 influenza vaccine doses during the 2025-2026 flu season to children already undergoing sedation or anesthesia.
According to the hospital’s May 20 description of the initiative, families receive information about the opportunity before their child’s procedure and are asked again about their interest on the day of treatment. Vaccination is administered only when the family agrees.
The Philadelphia program began in 2023 and was developed to address barriers such as needle phobia, difficulty accessing routine medical appointments and declining influenza vaccination rates.
Hospital officials reported that approximately one-third of participating families said their children otherwise would not have received the influenza vaccine. Other families declined because their children had already been vaccinated, they had safety concerns or they preferred not to combine vaccination with surgery.
The hospital acknowledged that time constraints before procedures can limit opportunities for detailed discussions, identifying improvements in real-time vaccine counseling as an ongoing priority.
That limitation has become central to criticism of the programs.
Parents preparing for a child’s operation may already be evaluating anesthesia risks, surgical complications and recovery instructions. Critics argue that introducing another medical decision during that period could make it more difficult to fully consider potential benefits, adverse reactions and alternatives.
Pediatricians and medical advocates interviewed in an investigation published by The Defender questioned whether preoperative discussions consistently provide sufficient time for informed decision-making.
The distinction between vaccination during anesthesia and vaccination without consent is important. The Philadelphia hospital explicitly describes a parental-consent process. Available reporting does not establish that the Colorado program administered vaccines without parental authorization, although detailed consent documentation was not available for review.
Federal vaccination guidance generally requires health care providers to supply appropriate Vaccine Information Statements and give parents or legal guardians an opportunity to ask questions before routine childhood immunizations. Written consent requirements depend on applicable state laws and institutional policies.
Medical safety is another issue receiving attention.
A 2007 review published in Paediatric Anaesthesia examined how anesthesia and surgery may influence immune responses and vaccination outcomes in children.
The authors concluded that anesthesia-related immune changes appeared relatively minor and temporary, generally lasting approximately 48 hours. They found no evidence establishing a contraindication to immunization in otherwise healthy children undergoing elective surgery.
However, the researchers recommended considering intervals of two days after inactivated vaccines and 14 to 21 days after live attenuated vaccines before anesthesia to reduce the possibility of confusing vaccine-related symptoms with postoperative complications.
A 2017 review in Current Opinion in Anaesthesiology raised similar concerns, noting that fever and other common reactions following vaccination may resemble complications associated with surgical procedures.
Such overlapping symptoms can complicate postoperative assessments, particularly for children who cannot readily communicate discomfort because of developmental conditions, sedation or recovery from anesthesia.
The Australian Immunisation Handbook recognizes that vaccines may be administered during unrelated procedures under sedation when appropriate precautions are followed.
Its guidance identifies potential difficulties attributing adverse events, overlapping symptoms and inflammatory responses as considerations requiring individualized clinical judgment and postoperative monitoring.
At the same time, the Centers for Disease Control and Prevention’s clinical guidance states that current, recent or upcoming anesthesia and surgery are not, by themselves, contraindications to vaccination. Certain circumstances may nevertheless warrant additional precautions.
The available evidence therefore supports consideration of individual medical circumstances rather than establishing that vaccination during anesthesia is inherently dangerous or universally appropriate.
Financial considerations have also entered the debate.
Reporting on Philadelphia’s program indicated that vaccine administration generated more than $60,000 in revenue during the 2024-2025 influenza season. Hospital officials have acknowledged that reimbursement arrangements required administrative coordination, including safeguards intended to prevent unexpected charges to families.
Revenue from medical services does not independently establish improper financial incentives or misconduct. However, critics argue that hospitals should clearly disclose how vaccinations are billed and whether financial considerations influence recommendations.
Questions about safety monitoring have also accompanied discussions of expanding these programs.
A large observational study published in JAMA Network Open in 2024 examined vaccine safety outcomes among approximately 4.1 million children and identified signals requiring further investigation, including myocarditis among some adolescents and seizures in younger age groups.
Separate research involving approximately 5.1 million children in England examined myocarditis following COVID-19 vaccination, identifying a small increased risk following certain doses.
Those findings concern particular vaccines and populations. They do not demonstrate that administering routine vaccines under anesthesia produces higher rates of adverse events or that the risks of vaccination generally outweigh the benefits of preventing infectious disease.
Researchers emphasize that observed safety signals require evaluation alongside the risks of the diseases vaccines are designed to prevent.
Philadelphia’s program leaders have discussed expanding vaccination during anesthesia to include COVID-19, respiratory syncytial virus and other immunizations for eligible children who are not current with recommended preventive care.
Such expansion would introduce additional questions about vaccine-specific eligibility, informed consent, monitoring requirements and the appropriateness of administering different products during surgical procedures.
For children with neurocognitive conditions or severe needle-related anxiety, receiving vaccines while already sedated may eliminate the need for additional distressing medical encounters. For other patients, separating immunization appointments from surgery may be preferable.
The central issue remains whether families receive clear information and retain meaningful authority to accept or decline each intervention.
The Colorado and Philadelphia programs illustrate an approach to pediatric preventive care that is receiving greater attention as hospitals seek opportunities to improve vaccination access.
Although published medical guidance permits vaccination during anesthesia under appropriate circumstances, the growing use of these programs underscores the importance of documenting parental authorization, monitoring adverse reactions and clearly communicating potential risks.
Further disclosure of program-specific safety outcomes, consent practices and follow-up procedures would help establish how effectively participating hospitals balance preventive care with patient protections.
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