Wednesday, February 8, 2023

As omicrons grow, immunization efforts for young children stalled

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

The national effort to vaccinate children has stalled, as the Omicron version slashes schooling for millions of children and their families, amid a heated battle over staff shortages, closures and how to operate safely. Vaccination rates vary greatly across the country, a KHN analysis of federal data shows. Nearly half of Vermont’s 5 to 11-year-olds have been fully vaccinated, while less than 10 percent have received both shots in nine mostly southern states.

Pediatricians say the slow pace and geographic disparities are worrying, especially against the backdrop of record numbers of cases and pediatric hospitals. School-based vaccine mandates for students, which some pediatricians say require rates to increase substantially, are virtually nonexistent.

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,“You have large groups of vulnerable kids going to school,” said Dr. Samir Shah, a director at Cincinnati Children’s Hospital Medical Center. The problem is that states with low vaccination rates are “less likely to require masking or distancing or other non-partisan public health precautions,” he said.

In Louisiana, where 5 percent of children ages 5 to 11 are fully vaccinated, Gov. John Bel Edwards, a Democrat, added the shot to the list of required school vaccinations for the fall, over objections from state legislators, Who are mostly Republicans. The Districts of Columbia and California, where about 1 in 5 elementary school children are fully vaccinated, have added similar requirements. But those places are the exception – 15 states have banned COVID vaccine mandates in K-12 schools, according to the National Academy for State Health Policy.

The mandate is one of several “scientifically validated public health strategies,” Shah said. “I think that would be the ideal; I don’t think we as a society have the will to do that.”

Demand for the vaccine soared in November, with an initial wave of excitement after the shot was approved for young children. But parents vaccinated young children at a slower rate than 12 to 15-year-olds who became eligible in May. It took about six weeks for 1 in 5 young children to get their first shot, while teens reached that milestone at two weeks.

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

“One of the problems we face is that children are not at risk of serious illness from this virus,” said Dr. Yvonne Maldonado, president of the American Academy of Pediatrics’ Committee on Infectious Diseases. “That’s clearly not true.”

Parents are left to weigh who is at greater risk to their children: the COVID virus or the vaccine to prevent the virus. Overwhelmingly, research shows, the virus itself presents a major threat.

Children can develop debilitating long-term Covid symptoms or a potentially fatal post-Covid inflammatory condition. And new research from the CDC found that children are at significantly higher risk of developing diabetes in the months following a COVID infection. Other respiratory infections, such as the flu, do not carry the same risk.

Katherine 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 that risk caused her two sons. Consider not getting vaccinated. But after reading about the side effects, she realized that the condition was more likely to be caused by a virus than a vaccine.

“I found it safe to give it to my kids,” said Lehman, a physical therapist in Missouri, where 20 percent of young children have received at least one dose.

Recent data from the CDC’s scientific advisors found that myocarditis was extremely rare in children ages 5 to 11, with 12 reported cases identified as of December 19 out of 8.7 million administered doses.

The huge variations in where children are getting vaccinated reflects what has happened to other age groups: children are far less likely to get the shot in the Deep South, where hesitation, political views and misinformation have driven adult vaccination rates as well. has been blunted. Alabama has one of the lowest vaccination rates for children ages 5 to 11, with 5 percent being fully immunized. States with high adult vaccine rates such as Vermont, Massachusetts, Connecticut and Maine have the largest shares of their children vaccinated.

Even within states, rates vary dramatically by county based on political leanings, density and access to the shot. In Illinois’ populous counties around Chicago and Urbana, more than a quarter of children are fully vaccinated, with rates as high as 38 percent in DuPage County. But rates are still below 10 percent in many of the state’s rural and Republican-leaning counties. In Maryland, where 1 in 4 children are fully vaccinated, rates range from over 40 percent in Howard and Montgomery counties, wealthy suburban counties, to less than 10 percent in parts of the more rural East Coast.

Nationally, a November KFF survey found that 29 percent of parents of 5- to 11-year-olds would definitely not vaccinate their children and an additional 7 percent would do so only when needed. Although rates were similar for families with black, white and Hispanic parents, political differences and location divided. Only 22 percent of urban parents would not vaccinate their children, while 49 percent of rural parents were opposed. Half of Republican parents said they definitely would not vaccinate their children, compared to just 7 percent of Democrats.

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

hunting for shots

Just before her younger son’s 5th birthday, Lehman was looking forward to booking a COVID vaccine appointment for her two boys. But his pediatrician was not presenting to him. Attempts to book a time slot at CVS and Walgreens before her son turned 5 were unsuccessful, even though the appointment took place after his November-November birthday.

“It wasn’t easy,” she said. To avoid separate visits for her 10-year-old and 5-year-old, she held off appointments at a hospital half an hour away.

“Both of my kids got all their vaccines at the pediatrician, so I was kind of surprised. It definitely would have been easier,” Lehman said. “And the kids know those nurses and doctors, so I guess that it would have helped a stranger not to do that.”

The Biden administration has pointed parents to 122 children’s hospitals with retail pharmacies and 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 administration. Yet giving children the COVID vaccine presents barriers that are not as prominent for other vaccinations.

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

“Many of them are just underemployed and don’t necessarily have a great capacity to serve,” she said. At the same time, “it is not so easy to incorporate schools into school-based clinics in some areas simply because of the political climate.” Health centers, government officials and other groups have set up more than 9,000 school vaccination sites for children ages 5 to 11 across the country.

The CDC’s long-running program provides vaccines for children, free shots for influenza, measles, chickenpox, and polio. Roughly 44,000 doctors are enrolled in the program, which is designed to vaccinate children eligible for Medicaid who are underinsured or underinsured, or from Native or Indigenous communities. More than half of the program’s providers offer COVID shots, although rates vary by state.

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

Dr. Ngozi Ezik, a pediatrician and director of the Illinois Department of Public Health, said that as of January 5, 53 percent of shots given to young children were done at pharmacies. 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 get more kids vaccinated, Ezike said.

Children Respond to ‘The Greater Good’

The Levite Jewish Community Center in Birmingham, Alabama tried to promote vaccination with a party, games and feasts along with shots given by a well-known local pharmacy, even a photo booth and a DJ. Offered. Brooke Bowles, the center’s director of marketing and fund development, estimated that about half a dozen of the 42 people who took the supplements in mid-December were children.

Bowles felt that when their parents emphasized the greater good in vaccination, children were more likely to have one up their sleeve.

“Those kids were just fantastic,” she said. In parts of the Deep South such as this, pro-vaccine groups face an uphill climb—as of January 12, only 7 percent of Jefferson County children had received both shots.

Pediatricians stress parents who are on the fence.

Chief of Ambulatory Pediatrics at Boston Medical Center, Dr. Eileen Costello said, “Children are carriers of infectious disease.” “They are extremely generous with their germs,” ​​spreading the infection to vulnerable relatives and community members, who may be more likely to end up in the hospital.

78 percent of hospital adult patients have received at least one dose. Costello said that for children age 5 and older, the figure is 39%, with younger children having a lower rate than teens. Especially amid the onslaught of misinformation, “it has been exhausting to have long conversations with families who are so hesitant and reluctant,” she said.

Still, she can point to breakthroughs: a mother who had lost a grandparent to Covid, yet reluctant to vaccinate her son for obesity and asthma, which Costello could see physically. Had been. After Costello told her that her son’s weight put him at higher risk for serious illness, the mother eventually vaccinated all four of her children.

“It felt like a victory for me,” Costello said. “I think his thinking was, ‘Okay, he’s a kid – he’ll be fine.’ And I said, ‘Well, he might be fine, but he might not.'”

Method for vaccination no.

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