Covid vaccines for children aged five to 11 are inching closer to authorization in the US, with possible availability as soon as early November, and experts are already looking to the next hurdle: actually getting the shots in those young arms.
Only one-third of parents plan to vaccinate their children as soon as the vaccines are ready, the non-partisan Kaiser Family Foundation has found. Another third of those surveyed want to wait and see how the rollout goes.
“What’s going to be actually more challenging, beyond having the infrastructure to be able to administer the Covid-19 vaccines, is ensuring that parents feel comfortable vaccinating their children,” Syra Madad, an infectious disease epidemiologist and senior director of the System-wide Special Pathogens Program at NYC Health + Hospitals, told the Guardian.
About half of children 12 and older have been vaccinated in the months since the vaccines were given the green light for those ages.
Vaccinating people of all ages is a crucial part of ending the pandemic, said Dr Saad Omer, an infectious disease epidemiologist and director of the Yale Institute for Global Health.
“We will not be able to get out of this pandemic without vaccinating children – both for their own sake and for the sake of having overall protection,” he added.
Covid-19 cases in parts of the US are beginning to plateau or decline – and that could give families a false sense of security that vaccinating kids isn’t necessary, Madad said. But that’s actually the best time to get the shots, because the vaccines can prevent new spikes.
“You can’t vaccinate your way out of a surge. You want to make sure that you have immunity built up to prevent that surge from happening,” Madad said.
“Right now, we have every indication that we may see another surge,” Madad added.
A little over half (56.5%) of the US population has been fully vaccinated – not nearly enough coverage to prevent future outbreaks from spreading. And because wealthy countries have taken the lion’s share of the vaccines, other countries have extremely low vaccination rates.
Any community, at home or abroad, with low rates could contribute to the emergence of other, possibly more serious variants.
“If that does happen, we want to prevent that surge from happening, and the best way that we know is obviously vaccinating ahead of time,” Madad said.
Yet communication from federal agencies has frequently been flawed and politicized.
“With the previous administration, it was nonexistent almost, and it was every man, woman, child for themselves, to be very honest,” Madad said. While the Biden administration had done a better job, she said, “we continue to struggle with that even today – we see that even with the booster shot communication. It’s been very confusing and frustrating.”
Conversations about the importance, safety and effectiveness of the vaccines also need to happen at all levels, not just the federal government, she said. “At the local level, at the community level, at the individual level – that’s what makes an impact. Not with somebody standing at a podium saying ‘this is safe and effective.’”
People are more likely to trust their own doctors, community leaders, friends and family when it comes to health advice, Madad said.
There have also been mixed messages from public health leaders about how much children are affected by Covid and whether they need the vaccines at all. That’s also diminishing confidence and adding confusion about vaccines, Omer said: “The fact that a lot of parents are getting mixed messages has confounded this issue.
“Public health agencies have been well behind in having effective communications campaigns – for all sorts of vaccinations,” Omer said. “This time, we need to get ahead of it.”
He recommended having a communications campaign for families ready to go at the same time the pediatric vaccines hit the shelves.
“We need to engage pediatricians – and arm them with not just facts, but approaches to communicating around Covid vaccines,” he said. “There’s a whole science of communication, but we haven’t done that.”
Talking about safety and efficacy from the clinical trials is important – and so is removing barriers to access and making vaccinations as easy as possible, Omer said.
When the first one-third of families rush out to get the shots, he said, the CDC should immediately conduct studies on side-effects in real-world settings, using databases like the Vaccine Safety DataLink, which compiles millions of records from providers.
The CDC has produced some data from these sources, “but not as much as needed”, Omer said.
Farther down the line, officials can build on existing childhood vaccine mandates – but it’s important not to do this too soon, he said. “Before you mandate it, make sure it’s super easy to get your child vaccinated.
“California is talking about fall 2022 – that’s a reasonable timeframe,” Omer said. Mandates and requirements shouldn’t be “too punitive”, offering alternatives like masking and regular testing options at first, as a “way to nudge parents”.
Omer characterized the US response to the pandemic as “doing the right thing, but a few months late”. Scaling up testing, monitoring breakthrough cases, mandating masks, digitizing immunization records – the US has consistently been behind the eight ball on mitigation and prevention, and Omer is worried about what will happen if leaders aren’t able to rise to this occasion.
“The first rule of controlling an outbreak of any size is to outpace it – to get ahead of it. As long as you’re following an outbreak, the outbreak is beating you.”