While serious cases of Covid in young children are relatively rare, public health experts and officials worry that the lethargic pace will put the country’s youngest children at undue risk as a new potential wave of Covid-19 infection approaches in the fall or winter.
“We know that children can be severely impacted from illness, hospitalization and unfortunately hundreds of children have died from Covid,” Sarah Meyer, the chief medical officer of the CDC’s Immunization Services Division, told POLITICO. “Our message really is that no child should die from Covid. This is now a vaccine-preventable disease.”
As with older groups, the announcement that children between the ages of 6 months and 5 years were eligible for the vaccine was followed by a burst of demand from those eager to get it right away. But this time, that first bump was much smaller and started to stabilize early on.
“It peaked in their eligibility relatively early, and it’s likely to creep in that direction,” Jen Kates, senior vice president and director of Global Health & HIV Policy at Kaiser Family Foundation, told POLITICO. “So this group is going to be a much longer-term challenge to get them vaccinated.”
In some ways, this slower launch was designed that way. Unlike previous vaccination campaigns, the federal government’s strategy focused more closely on getting the most doses into the hands of pediatricians and primary care physicians. Officials hope that encouraging parents to have conversations with medical providers they already trust will build trust over time and convince more parents to get their children vaccinated.
Most states prohibit pharmacists from vaccinating children under the age of 3, and state and federal mass vaccination sites that supported previous waves have largely closed. Most children in this group are also too young to attend school, another potential source of outreach.
“We expected these kinds of trends; our vaccination program for this age group is different from the one we have conducted before,” said Meyer. “We know that parents want their youngest children vaccinated by their health care providers, in their medical home, so these are the health care providers they know and trust and are familiar with in these settings.”
According to surveysParents generally agree that their child’s pediatrician or health care provider is their most trusted source of information about the Covid-19 vaccine.
“We know a lot of our parents are looking on the Internet and social media and their friends, but if they really want that reliable information, they go to their primary care physician or pediatrician,” said Ada Stewart, a primary care physician in South Carolina who is also the board president of the American Academy of Family Physicians, POLITICO told.
In some ways, experts said, this more deliberate approach is part of the transition to treating Covid-19 as a common endemic disease against which children are routinely vaccinated.
“It’s not just Covid that our kids are chasing because they didn’t come to the offices. So now is our chance to catch up,” Stewart said.
But the effort also comes at a particularly difficult time for physician practices, which are grappling with widespread staff shortages and disrupted finances in the wake of the pandemic.
Many pediatricians who stocked the vaccine for older children have decided not to order doses for the youngest group, due to the vaccine’s difficult storage requirements, minimum order sizes and expected low demand from parents. That makes it even more difficult for the minority of parents who want to have their toddlers vaccinated as soon as possible.
“I can’t tell you how many parents I’ve had that come up to me and say, ‘Oh thank goodness you have the vaccine because we can’t find it anywhere else,’” said Sandra Bonat, a New York pediatrician who serves as a consultant. for VIP StarNetwork, a state-contracted cellular carrier to get the vaccine to underserved communities.
Still, about 85 percent of children under age 5 live within a 5-mile radius of a vaccination site, according to the CDC. The agency also contacted providers through the Vaccines for Children network, a long-standing program aimed at administering vaccines to uninsured or underinsured children.
While pediatricians and general practitioners are uniquely equipped to deal with problems, parents remain very reluctant to vaccinate their youngest children, with most saying they want to “wait and see” how the first rollout goes.
“As the ages pass, parents are increasingly concerned about the impact this will have on my child’s long-term development. There has been a lot of misinformation on social media about the long-term effects,” Bonat said. Compared to other routine vaccines, parents still see the Covid vaccines as something “new and different”.
The decision to allow the youngest group vaccine last — a standard practice in vaccine development — could also be a contributing factor.
“The sense of urgency about Covid-19 in our country is much less than it was,” Kates said.
Anecdotally, pediatricians said parents’ personal experiences with mild Covid cases have reduced their propensity for children to get the shot, despite studies showing the vaccines still provide additional protection for those who’ve had it.
“We have parents who say junior has got Covid and is fine, so why should I vaccinate him,” Stewart said.
While vaccine hesitancy takes many forms, the politicization of the pandemic likely plays a role as well. Of the parents of children under the age of 5, 38 percent of Democrats and Democratic-oriented respondents say they plan to have their children vaccinated immediately or have already done so, compared with 6 percent of Republican and Republican respondents, according to a survey. Survey of the Kaiser Family Foundation performed in mid-July.
“We’ve been living with Covid-19 as a political football first, and I think it’s heightened people’s fear and anxiety about it all,” Kates said.
While rates are low everywhere, state-level data on the proportion of the youngest age group vaccinated shows a strong bias — and one that is more extreme than for older age groups.
While some jurisdictions — such as the District of Columbia and Vermont — are leading the way, other states have placed less emphasis on the latter age group or, in the case of Florida, decided not to recommend the vaccine at all, in violation of federal guidelines.
For pediatricians and general practitioners, the problem requires a special degree of sensitivity and understanding.
“As doctors, we shouldn’t talk about politics and really listen to the patients and meet them where they are,” Stewart said.
And while most doctors are on board with federal recommendations, divisions remain. Practitioners in rural parts of the country are less likely to recommend pediatric Covid-19 vaccines, according to a March CDC report.
Nevertheless, federal officials are optimistic that as the weeks go by, more toddlers and babies will have the opportunity.
“This is a time of year when a lot of kids go to the doctor, so we expect the number to rise,” Meyer said. “We’re going into the fall and winter season where we’ve seen increases in cases in the past, and sometimes that will prompt parents or others to go out and get vaccinated if they had delayed until then.”