Even as the United States prepares to roll out a covid-19 vaccine to school-aged children, its efforts to vaccinate teens – who have been eligible for the vaccine since May – continue to meet a lackluster response.
So far, about half of children ages 12 to 17 are fully immunized in the United States, compared to nearly 70% of Americans 18 and older. Paediatricians expect it to be even more difficult to persuade skeptical parents of young children to get their children vaccinated. Many are concerned about the potential unknowns of a relatively new vaccine compared to the low risk of serious disease covid poses for children.
A recent KFF poll found that 27% of parents of 5-11 year olds said they plan to get them vaccinated ‘right away’, while 30% said they ‘definitely will not’ get vaccinated for their children. children from 5 to 11 years old. More than three-quarters of parents of children in this age group said they were “very” or “somewhat” concerned that not enough is known about the long-term effects of the vaccine in the children.
“I don’t quite agree with everyone getting vaccinated,” said Tara Currier, 42, a mother of four in Marysville, Calif., Who has decided not to vaccinate her three. older children, aged 12, 14 and 16. plans to delay immunization for her 10-year-old daughter.
While she is fully vaccinated herself, Currier said she will not vaccinate her children until she is sure the vaccine is “actually protection and not something that will affect their bodies later on.” I don’t know what to answer yet, because the vaccine has not been seen in people for a very long time. “
Public health officials and leading experts have increasingly emphasized that while children are at a lower risk of getting serious illness from covid, they are not at zero risk. Nearly 6.3 million children have tested positive for covid, and more than 580 have died, according to American Academy of Pediatrics. A small percentage developed long-term symptoms.
They also point out that vaccinating children is essential to slow the spread of the virus throughout the population. At national scale, over 45 million of people have been infected with SARS-CoV-2, which causes covid, and more than 745,000 have died.
The Food and Drug Administration has cleared the Pfizer-BioNTech covid vaccine for emergency use in children aged 12 to 15 in May, after approving the same shot for teens 16 and over five months earlier. On Friday, the agency cleared a lower dose of the vaccine for emergency use for children aged 5 to 11, and injections are expected to be available this week after approval from the Centers for Disease Control and Prevention.
In approving the Pfizer vaccine for children and adolescents, the FDA said that ongoing clinical studies show that children and adolescents face greater risks of covid and its potentially devastating side effects than of an effect. Rare secondary vaccine involving inflammation of the heart reported in some young adults.
Yet California offers insight into the challenges that health officials and pediatricians face in persuading parents across the country to adopt the new vaccines. The state ranks in the top quartile of the country for overall immunization rates, with 72% of people 12 and older vaccinated, according to the CDC. But this number masks vast disparities between the older and younger age groups.
Statewide, only 59% of children ages 12 to 17 were fully immunized by October 24. In comparison, 71% of people aged 18 to 49 were vaccinated by this date; 80% of residents aged 50 to 64; and 75% of residents aged 65 and over.
In addition, adolescent vaccination rates vary wildly from region to region, another microcosm of the United States. less than a quarter of this age group are vaccinated.
Marin County is one of the state’s success stories. Relatively wealthy, staunchly Democrat and overwhelmingly white, the county had vaccinated 93% of children ages 12 to 17 as of Oct. 19, according to the California Department of Public Health. This is more than double the rate of children aged 12 to 17 vaccinated in rural Madera County in the Central Valley; and it eclipses the 16% of children ages 12 to 17 vaccinated in Modoc County, in the mountainous northeast of the state.
When young teens became eligible in the spring, Marin County public health officials set up two mass vaccination sites with “a lot of fanfare and confetti and a sort of ribbon-cutting feeling,” said Dr Matt Willis, County Public Health Officer. Families were impatient and within 10 days the county had vaccinated half of its teenage population.
For parents who were more hesitant, “pediatricians were essential,” Willis said. Dr Nelson Branco, a pediatrician in Larkspur, said his practice waited a few weeks before opening its own vaccination clinic. They checked the vaccine registry for their 4,000 patients aged 12 to 17, identified 800 who had not been vaccinated, then emailed them inviting them to one of their weekly clinics and to call for all questions.
“We found that there were a lot of parents of teenagers who were very anxious for their children to resume more normal activities,” said Branco. “We see the same things with parents of young children. The question is “When?” »Not« Should I? “”
In a rural county like Madera, which has not voted for a Democratic president since Jimmy Carter, low vaccination rates reflect factors beyond a conservative political lean, said Dr Nicole Webb, pediatrician at Valley Children’s Healthcare in Madera. On the contrary, many residents face logistical challenges that do not exist for Californians in suburbs and cities, where a pharmacy or doctor’s office is a short drive or transit ride away.
“I think the tempting thing is to try to make blanket generalizations based on blind political or ideological, but I think it’s actually a lot more complicated than that in a place like this,” Webb said. .
Even in counties reporting high vaccination rates among adolescents, there are pockets where pediatricians have difficulty convincing suspicious parents. Santa Clara County has vaccinated 75% of children ages 12 to 17, according to the CRPD. But in his office in central San Jose, Dr Amna Khan said most of his patients were on the fence.
The Santa Clara Valley Medical Center receives primarily Medi-Cal patients, and many of Khan’s patients are recent immigrants. “In my patient population, they have many reasons to be suspicious of government and medicine in general,” Khan said. “This is not a political statement. It is mistrust of the things they have heard from their family, from their church or from their neighbors.
Often times, these conversations are a “tough dance” that Khan must navigate with cultural sensitivity and the help of translators. Sometimes she faces the minefield of parent-teen conflict, with arguments erupting in the examination room between children who want the vaccine and parents who refuse.
No matter where parents are raising their children, the pediatricians said, the common factor behind their decision to vaccinate – or not – is concern for their child’s safety.
Parents who line up to immunize their children worry about the threat of covid. Parents who are reluctant to get the vaccine worry about the possible side effects of the vaccine. Somewhere in the middle, parents don’t know what to think due to conflicting information they’ve gotten from social media or friends.
Even among parents who have undoubtedly vaccinated their children against other diseases, the choice over covid is not obvious.
“Parents are now saying, ‘You know what? I don’t think it’s good for my child. I don’t think I’m going to make that decision, or at the very least I’m going to wait at least six months, maybe a year or maybe more before I even consider this for my child, ”said Jessica calarco, a sociology professor at Indiana University who has followed a group of moms to Indiana throughout the pandemic.
“They’ll say, ‘You know what, my kid wears masks. We wash our hands. We are responsible for the play dates. And so, the vaccine is just not necessary because we are doing enough, and my child is healthy enough that he is probably doing well.
Doctors and public health officials say they regularly find themselves explaining to parents that covid does harm children.
“There have been over 35 pediatric deaths in California alone, and that’s more deaths than what we see with the flu,” state epidemiologist Dr Erica Pan told reporters last week. from California. “This is just not an acceptable number of child deaths when such effective and safe prevention is available. “
The Covid has triggered multisystem inflammatory syndrome in children, a potentially fatal disease in which the immune system attacks the body and interferes with organ function, in more than 660 California children since March 2020, Pan said. Six died.
California is expected to have more than 1.2 million doses of the weaker version of the vaccine for children ages 5 to 11 the first week the vaccine is approved for emergency use, Pan said. Pediatricians will be central to the state’s efforts to immunize children, as well as clinics at school sites and door-to-door campaigns led by community leaders.
In Yuba City, pediatrician Dr Mark Sawyer tells patients, “If you want to stop hearing about covid on the radio and stop hearing about blockages and everything, then that’s it, this is the way. . Just get vaccinated.
Phillip Reese, assistant professor of journalism at California State University-Sacramento, contributed to this report.