As omicron surges, effort to vaccinate young children stalls in many places – Orange County Register

Two months after Pfizer’s COVID-19 vaccine was authorized for children ages 5 to 11, just 27%  have received at least one shot, according to Wednesday, Jan. 12, data from the U.S. Centers for Disease Control and Prevention.

Only 18%, or 5 million kids, have received both doses.

The national effort to vaccinate children has stalled even as the omicron variant upends schooling for millions of students and their families, causing staffing shortages, shutdowns and heated battles over how to safely operate. Vaccination rates vary substantially across the country, a KHN analysis of the federal data shows. Nearly half of Vermont’s 5- to 11-year-olds are fully vaccinated, for example, while fewer than 10% have gotten both shots in nine mostly Southern states.

In California, 32.5% of kids 5 to 11 had received at least one dose and 21.2% were fully vaccinated, though inoculation rates also fluctuate from county to county.

Pediatricians say the slow pace and geographic disparities are alarming, especially against the backdrop of record numbers of cases and pediatric hospitalizations. School-based vaccine mandates for students, which some pediatricians say are needed to boost rates substantially, remain virtually nonexistent.

“You have these large swaths of vulnerable children who are going to school,” said Dr. Samir Shah, a director at Cincinnati Children’s Hospital Medical Center. Compounding the problem is that states with low vaccination rates “are less likely to require masking or distancing or other nonpartisan public health precautions,” he said.

In Louisiana, where 5% of kids ages 5 to 11 had been fully vaccinated, Gov. John Bel Edwards, a Democrat, added the shot to the list of required school immunizations for the fall, over the objections of state legislators, who are mostly Republicans.

The District of Columbia and California, where about 1 in 5 elementary school kids are fully vaccinated, have added similar requirements. But those places are exceptions: 15 states have banned COVID-19 vaccine mandates in K-12 schools, according to the National Academy for State Health Policy.

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

Vaccine demand surged in November, with an initial wave of enthusiasm after the shot was approved for younger children. But parents have vaccinated younger kids at a slower pace than 12-to15-year-olds, who became eligible in May. It took nearly six weeks for 1 in 5 younger kids to get their first shot, while adolescents reached that milestone in two weeks.

Experts cite several factors slowing the effort: Because kids are less likely than adults to be hospitalized or die from the virus, some parents are less inclined to vaccinate their children. Misinformation campaigns have fueled concerns about immediate and long-term health risks of the vaccine. And finding appointments at pharmacies or with pediatricians has been a bear.

“One of the problems we’ve had is this perception that kids aren’t at risk for serious illness from this virus,” said Dr. Yvonne Maldonado, chair of the American Academy of Pediatrics Committee on Infectious Diseases. “That’s obviously not true.”

Parents are left to weigh which is more of a threat to their children: the virus or the vaccine to prevent it. Overwhelmingly, research shows, the virus itself presents a greater danger.

Kids can develop debilitating long-COVID symptoms or a potentially fatal post-COVID-19 inflammatory condition. And new research from the CDC found that children are at significantly higher risk of developing diabetes in the months after a coronavirus infection. Other respiratory infections, like the flu, don’t carry similar risks.

Katharine 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 up on the side effects, she realized the condition is more likely to occur from the virus than the vaccine.

“I felt safe giving it to my kids,” said Lehmann, a physical therapist in Missouri, where 20% of younger kids have gotten at least one dose.

Recent data from scientific advisers to the CDC found myocarditis was extremely rare among vaccinated 5-to 11-year-olds, identifying 12 reported cases as of Dec. 19 out of 8.7 million administered doses.

The huge variations in where children are getting vaccinated reflect what has occurred with other age groups:

Children have been much less likely to get shots in the Deep South, where hesitancy, political views and misinformation have blunted adult vaccination rates as well. Alabama has the lowest vaccination rate for 5- to 11-year-olds, with 5% fully inoculated. States with high adult vaccine rates — such as Vermont and Massachusetts — have inoculated the greatest shares of their children protected against the virus.

Even within states, rates vary dramatically by county based on political leanings, density and access to the shot. More than a quarter of kids in Illinois’ populous counties around Chicago are fully vaccinated. But rates are still below 10% in many of the state’s rural and Republican-leaning counties.

In Maryland, where 1 in 4 kids are fully vaccinated, rates range from more than 40% in some wealthy suburban counties, to fewer than 10% along parts of the more rural Eastern Shore.

In Southern California, the results have been mixed.

In LA County, 31% of children 5 to 11 have received at least one vaccine dose while 20.4% have received both. In Orange County, 31 % of that age group have received at least one dose and 21% have been fully vaccinated. In San Bernardino County, it’s 15.5% and 9.6%, respectively. And in Riverside County, the rates are 17.2% and 10.3%.

Nationally, 29% of parents with 5- to 11-year-olds definitely wouldn’t vaccinate their children, a November KFF poll found, and an additional 7% would do so only if required.

Though rates were similar for Black, White and Hispanic parents, political differences and location divided families. Only 22% of urban parents wouldn’t vaccinate their kids, while 49% of rural parents were opposed. Half of Republican parents said they definitely wouldn’t vaccinate their kids, compared with just 7% of Democrats.

The White House said officials continue tworking with trusted groups to build vaccine confidence and ensure access to shots.

In Los Angeles, the nation’s second-largest school district pushed back the deadline for when students 12 and older must be vaccinated to next school year after it became apparent that tens of thousands of unvaccinated students would have been banned from in-person learning if the mandate had gone into effect this month, as originally planned.

At the same time, LAUSD has made the vaccines available to younger children and is encouraging families to have all eligible students inoculated.

The county’s Department of Public Health, acknowleding “enormous disparities in our vaccination rates between well resourced areas vs poorly resourced zip codes” is trying a multi-layered strategy to try to increase the vaccine rate.

“We are doing hundreds of school-based clinics in our most vulnerable communities, which have been successful in giving boosters and some pediatric doses,” a department spokesperson said via email, “and are continuing to try to encourage our pediatric providers to do direct outreach with weekly office hours co-hosted by the American Academy of Pediatrics, the LAC Medical Association and DPH.”

When the vaccine was first approved for this age group, Orange County parents were not as eager to get their young children the jab as neighboring parents in Long Beach, said Laurie Sicaeros of MemorialCare Health System, which has hospitals there and in Fountain Valley and Laguna Hills.

“The minute it was approved, Miller Children’s Hospital (in Long Beach) opened up clinics,” said Sicaeros, senior vice president and chief operating officer for MemorialCare. “And they were doing clinics seven days a week, and they were filling up those clinics.”

In Orange County, by comparison, many parents waited until their child turned 12​.​

But then omicron hit.

“There’s probably been a 25 % increase in appointments in the past two weeks for this age group,” Sicaeros said.

Cathery Yeh, a Seal Beach resident, didn’t wait for​ the omicron​ surge​. She got her 10- and 14-year-old daughters the vaccines shortly after they were available.

“We are a family that has always vaccinated our kids,” Yeh said.

By contrast, San Juan Capistrano’s Sarah Beck said she’s not sure it’s safe her 8-year-old son and 10-year-old daughter — despite she and her husband having had the vaccine.

“I’m very concerned about the COVID vaccine.,” beck said. “I won’t give it to them.”

In the Inland Empire, the battle’s been even tougher.

“There is just clearly more hesitancy in the Inland Empire and the state’s other Inland counties,” San Bernardino County spokesman David Wert said in an email, “than there is along the coast.”

As part of health department measures to improve rates, pop-up vaccine clinics were held at 29 different schools in December, Wert said. The county also partnered with community organizations to make getting the shot a playful experience for kids, with attractions such as puppet shows.

Health care providers who specialized in pediatrics were recruited into its vaccine network, Wert said. The county launched a pediatric vaccination page and has brought on an Ambassador Team to support parents with information during their decision-making process.

William Grover, a bioengineering professor at UC Riverside, said he got his three children vaccinated on the first day he found out they were eligible.

“That’s how eager we were to get them vaccinated,” Grover, who created a website that tracks active coronavirus cases in his kids’ district, said. Now, his three sons – who attend schools in the Riverside Unified School District – are fully vaccinated and the 12-year-old is recently boosted.

“I think we understood that humanity’s best chance of getting this pandemic behind us is to give immunity to as many people as possible,” he said, “and the best way to do that is through vaccines.”

The Hunt for Shots

Just before her younger son’s fifth birthday, Lehmann, the physical therapist from Missouri, was eager to book vaccine appointments for her two boys.

But their pediatrician wasn’t offering them. Attempts to book time slots at CVS and Walgreens before her son turned 5 were unsuccessful, even if the appointment occurred after his late-November birthday.

Wanting to avoid separate trips for her 10-year-old and 5-year-old, she nabbed appointments at a hospital a half-hour away.

“Both of my kids have gotten all their vaccines at the pediatrician, so I was kind of shocked. That would have certainly been easier,” Lehmann said. “And the kids know those nurses and doctors, so I think it would have helped to not have a stranger doing it.”

The Biden administration has pointed 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 kids, according to the White House. Yet, administering the COVID-19 vaccine to children presents obstacles that haven’t been as prominent for other inoculations.

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

“Many of them are short-staffed right now and don’t necessarily have huge capacity to serve,” she said. “It’s not as easy to engage the schools in school-based clinics in certain areas just due to the political environment.”

The CDC’s long-standing program, Vaccines for Children, provides free shots for influenza, measles, chickenpox and polio, among others. Roughly 44,000 doctors are enrolled in the program, which is designed to immunize children who are eligible for Medicaid, are uninsured or underinsured, or are from Native or Indigenous communities.

More than half of the program’s providers offer COVID-19 shots, although the rates vary by state.

Pharmacies have been heavily used in Illinois, where 25% of 5- to 11-year-olds are fully vaccinated.

Dr. Ngozi Ezike, a pediatrician and the director of the Illinois Department of Public Health, said 53% of shots administered to younger children as of Jan. 5 were done at pharmacies. Another 25% occurred at private clinics, 7% at local health departments, 6% at federally qualified health centers and 5% at hospitals.

“You need all pieces of the pie” to get more kids vaccinated, Ezike said.

Kids Respond to ‘the Greater Good’

The Levite Jewish Community Center in Birmingham, Alabama, tried to boost vaccinations with a party, offering games and treats, even a photo booth and a DJ, along with shots given by a well-known local pharmacy.

Brooke Bowles, the center’s director of marketing and fund development, estimated that about half a dozen of the 42 people who got a dose that mid-December day were kids.

Bowles was struck that children were more likely to roll up their sleeves when their parents emphasized the greater good.

The greater good is what pediatricians have pitched to parents who are on the fence.

“Children are vectors for infectious disease,” said Dr. Eileen Costello, chief of ambulatory pediatrics at Boston Medical Center.

At Boston Medical, 78% of adult patients have received at least one dose. For children 5 and up, the figure is 39%, with younger children having lower rates than adolescents, Costello said.

“It has been exhausting to have these long conversations with families who are so hesitant and reluctant,” she said.

Still, she can point to successes: A mother who lost a grandparent to COVID-19, for example, was nonetheless reluctant to vaccinate her son with obesity and asthma whom Costello was seeing for a physical. The mother ultimately vaccinated all four of her children after Costello told her that her son’s weight put him at higher risk for severe illness.

“That felt like a triumph to me,” Costello said.