As Omicron Surges, Effort to Vaccinate Young Children Stalls

Two months after Pfizer’s COVID vaccine was approved for children ages 5 to 11, only 27% had received at least one injection, according to Jan. 12 data from the Centers for Disease Control and Prevention. Only 18%, or 5 million children, have had both doses.

National efforts to vaccinate children have stalled even as omicron has turned into the education heart of millions of children and their families amid staff shortages, closures and raging battles over how to operate safely. Vaccination rates vary widely across the country, according to a KHN analysis of federal data. Nearly half of 5- to 11-year-olds in Vermont are fully vaccinated, while in nine mostly southern states, less than 10% get both shots.

Pediatricians say the slow pace and geographical disparities are worrying, especially against the background of record numbers of cases and hospitalizations of children. School-based vaccine mandates for students, which some pediatricians say are needed to dramatically increase rates, remain virtually non-existent.

“You have these large numbers of vulnerable children going to school,” said Dr. Sameer Shah, director of the Children’s Hospital Medical Center in Cincinnati. Compounding the problem, states with lower vaccination rates are “less likely to require masking, distancing, or other nonpartisan public health precautions,” he said.

In Louisiana, where 5% of children ages 5 to 11 are fully vaccinated, Democratic Governor John Bel Edwards added the shot to his list of required school vaccinations in the fall, despite the objections of state lawmakers, who are mostly Republicans. District of Columbia and California, where about 1 in 5 elementary school children are fully vaccinated, have added similar requirements. But these places are exceptions — 15 states have banned covid vaccine mandates in K-12 schools, according to the National Academy of State Health Policy.

Shah said the states are one of several “scientifically valid public health strategies”. “I think what would be ideal; I don’t think we as a society have the will to do that.”

Demand for vaccines soared in November, with an initial wave of enthusiasm after the vaccine was approved for younger children. But parents have vaccinated younger children at a slower rate than 12 to 15-year-olds, who became eligible in May. It took nearly six weeks for one in five younger children to get their first shot, while teens reached that milestone within two weeks.

Experts cite several factors that slow the effort: Because children are less likely than adults to be hospitalized or die from the virus, some parents are less inclined to vaccinate their children. Disinformation campaigns have raised concerns about the immediate and long-term health risks of the vaccine. Finding appointments at pharmacies or with pediatricians was like a bear.

“One of the problems we’ve had is the perception that children are not at risk of getting seriously ill from this virus,” said Dr. Yvonne Maldonado, chair of the Infectious Diseases Committee of the American Academy of Pediatrics. “This is clearly not true.”

Parents are left to put up with the weight of what poses an even greater threat to their children: the Covid virus or a vaccine to prevent the virus. Research overwhelmingly shows that the virus itself poses a greater risk.

Children can develop long-term debilitating symptoms or a fatal inflammatory condition after contracting the virus. And new research from the Centers for Disease Control and Prevention (CDC) finds that children are at increased risk of developing diabetes in the months following infection with the Covid virus. Other respiratory infections, such as influenza, do not carry a similar risk.

Kathryn Lehmann said she had concerns about myocarditis — a rare but serious side effect that causes inflammation of the heart muscle and is more likely to occur in boys than girls — and considered not vaccinating her two sons because of that risk. But after reading the side effects, I realized that the condition is more likely from the virus than the vaccine. “I felt safe giving it to my kids,” said Lyman, a physical therapist in Missouri, with 20% of younger children getting at least one dose.

Recent data from the Centers for Disease Control and Prevention’s scientific advisors found that myocarditis was extremely rare among children ages 5 to 11, with 12 cases reported as of December 19 identified among 8.7 million doses administered.

The dramatic differences in where children are vaccinated reflect what happened with other age groups: Children were less likely to get shots in the Deep South, where indecision, political opinions and misinformation lowered adult vaccination rates as well. Alabama has the lowest vaccination rate for children ages 5 to 11, with 5% fully vaccinated. States with high rates of adult vaccines such as Vermont, Massachusetts, Connecticut, and Maine vaccinated the largest share of their children.

Even within states, rates vary widely by county based on political leanings, density, and access to the shot. More than a quarter of children in populous Illinois counties around Chicago and Urbana are fully vaccinated, with rates as high as 38% in DuPage County. But rates are still less than 10% in many of the state’s rural and state counties. In Maryland, where one in four children is fully vaccinated, rates range from more than 40% in Howard and Montgomery, two affluent suburban counties, to less than 10% along parts of the rural East Coast.

Nationwide, a November KFF poll found that 29% of parents ages 5 to 11 would definitely not vaccinate their children and an additional 7% would only if necessary. Although the rates were similar for black, white, and Hispanic fathers, political differences and the division of families’ locations. Only 22% of urban parents would not vaccinate their children, while 49% of parents in rural areas oppose it. Half of Republican parents said they would definitely not vaccinate their children, compared to just 7% of Democrats.

The White House said officials continue to work with trusted groups to build confidence in the vaccine and ensure access to vaccines. “As we’ve seen with adult vaccines, we expect confidence to grow and more and more children to be vaccinated over time,” company spokesman Kevin Munoz said in a statement.

chasing shots

Just before her youngest son’s fifth birthday, Lyman was eager to book Covid vaccination appointments for her two sons. But the pediatrician did not introduce them. Attempts to book slots at CVS and Walgreens before her son was 5 were unsuccessful, even if the appointment happened after his birthday in late November.

“It wasn’t easy,” she said. Wanting to avoid separate trips for her two children, ages 10 and 5, she made appointments at a hospital half an hour away.

“Both of my kids got all their vaccinations from the pediatrician, so I was kind of shocked. It could have certainly been easier,” Lyman said. that.”

The Biden administration has directed parents to retail pharmacies and 122 children’s hospitals with vaccine clinics. Nationwide, more than 35,000 sites, including pediatricians, federally qualified health centers and children’s hospitals, have been set up to vaccinate young children, according to the department. However, giving the covid vaccine to children presents hurdles that have not been prominent in other vaccinations.

Claire Hanan, executive director of the Association of Immunization Managers, said enrolling pediatricians in the covid-19 vaccine program is a challenge because of the application process, reporting requirements for administered doses, and staffing.

“A lot of them are understaffed right now and they don’t necessarily have a huge capacity to serve,” she said. In addition, “it is not easy to involve schools in school clinics in certain areas just because of the political environment.” Health centers, government officials and other groups have set up more than 9,000 school vaccination sites for children ages 5 to 11 nationwide.

The CDC’s long-term program, Vaccines for Children, provides free injections for influenza, measles, smallpox, and polio, among others. Nearly 44,000 physicians are enrolled in the program, which is designed to immunize children who are Medicaid-eligible, who are uninsured or underinsured, or who are from Aboriginal or Indigenous communities. More than half of the program providers offer covid shots, although prices vary by state.

Pharmacies are heavily used in Illinois, where 25% of children ages 5 to 11 are fully vaccinated.

Ngozi Ezeki, a pediatrician and director of the Illinois Department of Public Health, said 53% of the injections for younger children as of January 5 were done at drugstores. Twenty percent occurred in private clinics, 7 percent in local health departments, 6 percent in federally qualified health centers and 5 percent in hospitals.

“You need all the pieces of the pie” to vaccinate more children, Izeki said.

Children respond to the “common good”

The Levite Jewish Community Center in Birmingham, Alabama, tried to boost vaccinations with a party, offering games and sweets, even a photo booth and DJ, along with picks provided by a well-known local drugstore. Brooke Bowles, the center’s director of marketing and money development, estimated that about half a dozen of the 42 people who got a dose in the middle of a December day were children.

Bowles was surprised that children were more likely to roll up their sleeves when their parents emphasized the greater benefit of getting vaccinated. “These kids were amazing,” she said. In parts of the Deep South like this, pro-vaccine groups are facing a tough climb—as of January 12, only 7% of Jefferson County children had received both injections.

The public good is what pediatricians have emphasized to parents who stand on the fence.

“Children are carriers of infectious diseases,” said Dr. Elaine Costello, chief of ambulatory pediatrics at Boston Medical Center. “They are very generous with their microbes,” spreading the infection to vulnerable relatives and community members who may end up in the hospital.

Seventy-eight percent of hospitalized adult patients received at least one dose. For kids 5 and older, the figure is 39%, with younger kids having lower rates than teens, Costello said. Amid the onslaught of misinformation in particular, “having these long conversations with very reluctant and reluctant families was exhausting.”

However, she can point to the successes: A mother who lost her grandfather to Covid was nonetheless reluctant to vaccinate her son with obesity and asthma that Costello was seeing for physical therapy. The mother eventually vaccinated all four of her children after Costello told her that her son’s weight put him at greater risk of severe disease.

“It felt like a victory to me,” Costello said. “I think her thinking was, ‘Okay, he’s a kid — he’s going to be fine. ‘ And I said, ‘Well, it might be fine, but it might not be.’

methodology

Immunization numbers are from the Centers for Disease Control and Prevention as of January 12.

National vaccination rates are calculated by the Centers for Disease Control and Prevention (CDC) and include vaccines provided by federal programs such as the Indian Health Service and the Department of Defense, as well as US territories. To compare the vaccination rollout for children and teens, we calculated Day 0 as the day the CDC approved the vaccine for each age group: May 12, 2021, for children ages 12-15, and November 2, 2021, for 5–11 years.

The CDC provides state and county vaccination numbers. These numbers do not include the small percentage of children who have been vaccinated by federal programs. To calculate the rates for children ages 5 to 11, we divided the total number of children ages 5 to 11 in each state or county.

To calculate the number of 5- to 11-year-olds in each state, we used the US Census Bureau’s 2019 Population Estimates Program dataset, the most recent version available. For the county-level data, we used the National Center for Health Statistics’ race-linked population estimates, which contain one-year county-level estimates. We chose the 2019 estimates from the 2020 classic, so the data will reflect the same year as the statewide estimates.

Age-specific vaccination data is not available in Idaho, Hawaii counties, and many California counties. For county-level vaccination data, we excluded states in which the county was unknown for at least 10% of children vaccinated in that state.

Visit Github Repository To read more about the data and download it.

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