Photo: Justin Lane/EPA
It’s been three months since the US approved Covid vaccines for children under five, but uptake in this group is extremely low. Meanwhile, Joe Biden said Monday the pandemic is coming to an end — a message that could lead to an ongoing slowdown.
More than 1,400 children have died from Covid in the US, according to the US Centers for Disease Control and Prevention (CDC), and at least 533 of those deaths were in children under the age of five. That makes Covid one of the top 10 causes of infant mortality in the country.
Still, only about 6% of children under the age of five have had their first injections, according to data from the CDC — by far the lowest percentage of any age group.
A recent study clearly shows that Covid vaccines save children’s lives. An extensive study followed children ages five to 11 and found that Pfizer’s mRNA vaccine was effective at preventing infection and incredibly protective against hospitalization and death.
To date, 1.19 million children under the age of five have received at least one Covid shot, a total vaccination rate of 6.2%. This age group was eligible for the injections on June 18, a year and a half after they were authorized for adults, but researchers found that vaccinations peaked within two weeks.
About four in ten children aged five to eleven are vaccinated, a percentage that remained fairly stable throughout the summer. In comparison, about three in four adults are vaccinated.
Even as some kids go back to school — a time when many families visit their doctor — rates have slowly risen. The reasons have to do with hesitations about the safety, effectiveness and necessity of vaccines, as well as limited access.
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In addition, many families say the federal advice on when and how to vaccinate children is confusing.
Hesitation about the safety and efficacy of the vaccines was a major cause of the delay. According to a July survey by the Kaiser Family Foundation (KFF), many families are concerned about the vaccines’ novelty, side effects, and overall safety.
“One of the things most mentioned was the feeling that the vaccine is too new, that not enough has been tested, especially for young children, and that more research is needed,” said Luna Lopes, senior research analyst at KFF.
There’s also the “common theme of not feeling like their child needs it, and just not worrying about Covid-19 as a threat to their child,” Lopes said.
That’s largely because many parents have absorbed the message that Covid doesn’t affect children, said Jessica Calarco, an associate professor of sociology at Indiana University, who began tracking families’ attitudes toward vaccines in 2018. Parents reported hearing from mainstream news outlets, national agencies such as the CDC and parenting advisories indicate that children are unlikely to become infected, pass on or become seriously ill from Covid-19.
“That laid the foundation for parents — especially white parents with kids who didn’t have pre-existing conditions, who didn’t have high-risk family members — to be sure to send their kids back to school and back to daycare,” he said. calarco.
“The problem, however, was that once parents got the idea that their children wouldn’t be seriously injured by Covid and that they probably wouldn’t pass it on to others, many of them stopped following the news,” she said. said.
Families told her they didn’t want to know if the risk level was changing or if new variants were emerging – “‘If something bad is going to happen, I just don’t want to know about it.'”
The same belief that children are essentially exempt from Covid has led them to think the vaccine is not necessary, she said. And many children have already had Covid at least once, so families think they will be protected from their infection and future illness will be mild.
More than half of parents believe the vaccine is a greater health risk than the virus. Even those who think the vaccines are safe for adults are concerned about their safety in children, according to a December 2021 KFF survey.
But more than a quarter of families who haven’t had young children vaccinated yet aren’t against it — they just want to see how the rollout goes, Lopes said.
Vaccination mandates can change families’ sense of urgency and need for vaccination. More than a third – 40% – of parents whose children have not been vaccinated now said they would get the injections if they were needed, Calarco said.
“If it were necessary for school, for childcare, for activities, that would tip the balance for parents.”
Especially as the pediatric vaccines move from emergency approval to full approval — as they have done for people over the age of 12 and 18, with the Pfizer and Moderna injections, respectively — more daycare centers, schools and activity providers could add them to their list of required vaccines for families, she said.
Very serious cases of Covid in children are not as common as in adults, but some children still get sick from Covid. Children under the age of two may be at particular risk for Covid, compared to older children.
Almost as many children are now hospitalized as last year during the Delta Wave. The health system is also under pressure from the simultaneous re-emergence of polio, parechovirus and a respiratory virus that can cause paralysis. In some places, the pediatric intensive care units already full.
And other facets of life, including school, can be disrupted even by mild illness, as the number of cases increases and few precautions, including vaccination, have been taken.
While some parents wait to have their children vaccinated, nearly half of the parents surveyed by KFF said they would “definitely not” have their child under five vaccinated, and that resistance is even greater among conservatives, with 64% of the Republicans say they will. not vaccinate their children.
That has led to geographic variability in vaccinations, with less than 2% of young children being vaccinated in Republican-led states. Florida, for example, does not recommend the vaccines at all for “healthy” children.
And families in rural areas are twice as likely to resist pediatric Covid vaccines, according to a March CDC report. Nearly 40% of parents in rural areas said their pediatricians did not recommend the vaccines, compared with 8% of parents in the cities.
The perceived lack of urgency also plays a role in some doctors’ offices
Across the country, four in 10 (15%) of parents who spoke to their doctors about vaccines for five- to 11-year-olds said they don’t believe their doctors recommend the injections, according to the December KFF poll.
That doesn’t necessarily mean the doctor advises against the injections, Lopes noted. And the majority – 70% – of families have not spoken to their pediatrician at all.
“A lot of times they don’t actively ask their pediatricians for information about it, and then pediatricians don’t actively provide information about it — so it seems like there’s a lot of silence,” Calarco said.
Doctors’ messages are important. Unlike vaccines for adults, there have been no mass vaccination sites for young children. Older children have had vaccination clinics at school, but they may not reach younger children. And most pharmacies don’t vaccinate children under the age of three. Instead, the rollout under the five largely depends on pediatricians and general practitioners, as they command a high level of trust.
But that plan means the vaccination rollout will be longer and more complicated in this age group, even among health care providers and families who are willing or eager to vaccinate. Children under the age of five usually see a doctor every three, six or twelve months, depending on their age. That means families can wait up to a year to talk to their pediatrician about vaccines.
There are also racial and socioeconomic disparities in access to vaccines. Nearly half of black parents of unvaccinated children under the age of five say they are concerned about having to take time off from work so their children can receive and recover from the vaccines, and about the same proportion of Hispanic parents say they are concerned about vaccinating their children. children in a place they trust, according to the KFF survey.
And not all pediatricians have highly refrigerated freezers to store the vaccines, further exacerbating access problems. They may be wary of ordering the minimum number of doses if it’s not clear that families want to get them. Staff shortages have also hit doctor’s offices, making vaccine clinics more difficult to run.
Amid reports from the White House that the urgency of the pandemic is waning and as vaccine funds dry up, it may become even more difficult for families to understand why and how to vaccinate their children.