Hesitancy, inequity: is the US ‘making the same mistakes’ with kids’ vaccines?

More than 360,000 children under the age of 12 have already received their first shot, according to the CDC. Doses began rolling out last week to the 28 million children in this age group.

However, some American parents are still hesitant about the vaccines. In a survey in October, only 27% of parents said they would get their kids vaccinated right away – a drop from 34% who said the same in September. At the same time, 30% of parents said they would “definitely not” vaccinate their kids, up from 24% the month before.

Although vaccines for kids 12 and older have been available for several months, only half of this age group has been vaccinated.

Heard-Garris, a pediatrician and professor of pediatrics at Lurie Children’s hospital of Chicago and Northwestern University, understands these concerns well. She co-authored a study finding that communities hardest-hit by the pandemic also have the highest rates of hesitancy toward children’s Covid vaccines. Black parents were more likely to be hesitant than white parents, and families with public insurance and lower incomes were also more inclined to hesitate.

The report also found encouraging signs: parents who received information about the vaccines from a variety of sources were less likely to have hesitations, with nearly two-thirds of parents worried about the potential long-term effects of the vaccine.

Lower-income parents are particularly concerned about missing work for vaccination appointments, paying for the shots, and being unable to get the vaccine from a trusted source.

Vaccines for kids ages five to 11 in the US are being administered at local pharmacies, pediatricians and family doctors’ offices, children’s hospitals and school clinics.

Heard-Garris is further concerned about “kids that are not plugged into the healthcare system or a primary medical home”.

The week vaccines were rolled out for five to 11 yearolds, more than 100,000 children tested positive for Covid, with 6.5 million kids testing positive since the pandemic began, according to the American Academy of Pediatric. The CDC reports 474 deaths of children between the ages of five to 18 since the beginning of the pandemic.

For several months, children have accounted for one-quarter of new cases in the United States, a disproportionate burden that has persisted despite the availability of vaccines for those aged 12 and up.

Jorge Caballero, a board-certified anesthesiologist and co-founder of Coders Against Covid, has found that white neighborhoods have twice as many vaccination sites as other neighborhoods. And within those neighborhoods, he told the Guardian, the sites tend to cluster in more affluent areas in what he calls “another round of prioritization for predominantly white neighborhoods”.

Interest in the vaccine is roughly equal across racial and ethnic groups, but access seems to be more limited, he said.

Caballero is concerned about equal access to vaccine for children and is calling for transparent data on race and ethnicity among children’s vaccinations from the CDC.

These inequities mirror previous disparities around testing and adult vaccinations, he said. “We continue to repeat the same mistakes over and over and over again. We’re just not being proactive enough in terms of addressing the gaps.”

“All we’re striving for is just equity,” Caballero said.

Vaccine campaigns should take into consideration the ongoing effects of structural racism and systemic oppression, Heard-Garris said.

“If you work three jobs and the vaccine clinic is only from eight to five, and you can’t afford to miss your job – how do we make sure that scheduling is there? If they’re already at an after-school program, can we have a vaccine clinic there?”

Her son’s school, for instance, sent out an email offering appointments that were easy to book and attend, since he wouldn’t need to be pulled out of school.

“The pandemic has completely disrupted not only the way of life for adults, but also children – school was not the same, the ability to go to birthday parties and connect with each other has been really disrupted,” Heard-Garris said. “Vaccines are important because they save lives, but they’re also important because of the social-emotional connections we’ve lost.”