It has become increasingly clear that the pandemic has had dramatic spillover effects on receipt of health care services unrelated to the coronavirus. In this brief, we review the evidence on children’s unmet health care needs during the pandemic and identify promising strategies to address these gaps, as well as barriers to widespread implementation of these strategies. We find large declines in childhood vaccinations in 2020 compared with prior years and serious concerns about children’s access to specialized therapies and mental health services. Children of color, children with special health care needs, children in families with low incomes or members with limited English proficiency, and children in rural areas face higher risks of unmet health care needs. We also find that health care providers have implemented several strategies to encourage receipt of needed care during the pandemic, including telehealth options, mobile clinics, pharmacist-administered vaccines, and expanded school-based services. But limitations in funding, access to internet or internet-enabled devices, and interpretation and translation services can prevent widespread and successful adoption of these strategies.

Thus, more coordinated, publicly funded, and focused efforts to reduce children’s unmet needs are urgently needed. State Medicaid and Children’s Health Insurance Programs, and the private managed-care plans that cover many children in these programs, have both policy tools and financial resources that could help address the declines in preventive care receipt among their child enrollees. Targeted federal funding to underresourced providers and communities and more concerted efforts to incorporate children’s health needs into policies for both in-person and virtual education would also be beneficial. Without these efforts to address children’s needs and reduce long-standing inequities, racial and socioeconomic disparities in children’s health and health care access will likely widen as the pandemic continues.