Covid Shots for Little Kids Are Finally Here. Now for the Hardest Part

Covid Shots for Little Kids Are Finally Here. Now for the Hardest Part

In some pediatric practices, injections are already going to the arms. Children’s Medical Group, a private practice in Atlanta, ordered doses as soon as allowed and received a first shipment Monday, the June 16 holiday. They started vaccinating at lunchtime. “We’ve had a lot of demand,” says Jennifer Shu, a practicing pediatrician and editor of the American Academy of Pediatrics. “We have even received calls from patients in other practices whose doctors do not have any Covid vaccine for this age group.”

As that suggests, and as parents are reporting on twitter—availability varies. This may be due to those early predictions of low acceptance; Practices and hospitals may not want to invest freezer space and staff time if they don’t expect much interest. But it may also be due to a bureaucratic hurdle that has dogged the Covid vaccination since its earliest days. Unlike almost all other vaccines, this one does not come from a commercial distributor; it is dispensed by the federal government and channeled through state health departments. So, to receive it, health care providers must complete paperwork from the CDC. That’s true even if they already participate in other government programs, like Vaccines for Children (known as VFC), which guarantees vaccines for families without private health insurance.

“Engagement from providers who typically participate in the VFC program has been pretty good,” says Marcus Plescia, a physician and medical director for the Association of State and Territorial Health Officials. “Getting him to private practice sites has been a slower process. They are not used to being part of government-run vaccination programs. Some of them don’t want to do that because of the paperwork and hassle.”

The childhood vaccination program can also be hampered by another long-standing problem: the size of vaccine vials. Each contains 10 servings and, once thawed and opened, must be used within 12 hours. “Pediatricians especially don’t like to waste vaccines. They see it as a precious commodity,” says Hannan. “Getting them to order enough vials to have the vaccine on hand every day, when they will potentially give one person a vaccine and discard nine doses because you don’t have nine other children, that’s a challenge.”

Another complication is that all the Covid protections so far, including vaccination, have been unevenly distributed. Half of those 19 million children under the age of 5 are children of color, according to a Kaiser analysis; 41 percent rely on Medicaid for insurance and 4.5 percent are uninsured. Since public sites, pharmacies, and schools are not available to help younger children, there will be additional pressure on community and federally qualified health centers to reach children near them. “We know from every part of the rollout that some of the most disadvantaged groups weren’t vaccinated at the same rate from the start,” says Jen Kates, director of global health and HIV policy at the Kaiser foundation. “These are children who are vulnerable for many different reasons, and the last thing anyone wants is for them to suffer disproportionately or have worse access to this intervention.”

At this point, experts expect slow acceptance, rather than No consumption. Parents whose children have upcoming well-child visits or summer appointments to prepare them for sports might choose to wait a few months rather than take a special trip. That has pros and cons: It leaves children vulnerable to covid longer, but it normalizes the vaccine as just one of a slew of shots they get in their early years.

For some parents, the problem will not be programming, but trust. They will need more patience from people within the medical system as they resolve their concerns, perhaps as they did themselves last year. “At their next pediatrician appointment, they can ask for a chat, which is different than calling the office” to schedule the shot, says Angela K. Shen, a visiting research scientist at Children’s Hospital of Philadelphia who studies attitudes toward vaccination. . “It can take several conversations, with your brother, your sister, your pharmacist and your pediatrician. These people in the middle are the ones that public health messaging strategies will want to go after, to answer their questions in a non-paternalistic way.”

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