Low demand for children’s Covid vaccines worries doctors

POLITICO contacted each state, the District of Columbia and Puerto Rico to find out how many recently approved Moderna and Pfizer-BioNTech vaccines they ordered, and 38 jurisdictions provided this data. Several states that have reported placing some of the lowest orders compared to their under-5 populations also have low Covid-19 vaccination rates for children ages 5 to 11, an early sign that vaccination for the youngest children may follow a similar principle. sample.

Since they became eligible last fall, 36.6% of children aged 5 to 11 have received one shot of Covid-19 and only 30% are fully vaccinated, compared to 69% of adults aged 5 to 11. 18 to 49 years old. slow uptake is partly because many parents do not believe the vaccine is necessary, effective, or that its benefits outweigh any risks.

For example, in Alabama, where 16 percent of children ages 5 to 11 received at least one dose of the Covid-19 vaccine, the state has ordered enough doses of vaccines for the youngest children to reach about 13 percent of the population under age 5. with a single dose.

Mississippi, which has a single vaccination rate of 5 to 11 years of age at just over 16 percent, has ordered enough shots to cover about 16 percent of the population under 5 years of age with a single dose, while Oklahoma, which has a single dose of 5 to 11 years of age The dose rate is over 20 percent, enough ordered to cover about 19 percent.

Florida, the only state that does not explicitly recommend Covid-19 vaccines for young children, has not pre-ordered any of the vaccines for children under 5 years of age. It has now allowed practitioners and health systems to order shots through the state portal, but does not make them available in state health programs.

The state did not respond to inquiries about his order, but the GOP governor did. Ron DeSantis said last month the vaccine has not gone through enough trials and clinical trials to determine its effectiveness in children.

This alarmed Lisa Gwynn, pediatrician and president of the Florida chapter of the American Academy of Pediatrics. “You don’t let your parents choose,” she said. “You are cutting off the supply.”

POLITICO calculated the percentage of the population under the age of 5 for which each state ordered vaccines using census data including newborns under 6 months of age who are not yet eligible for vaccination. The percentages therefore slightly underestimate the proportion of children covered by vaccination orders.

States, whose orders can cover requests from doctors, health systems, state and local health departments, say they have enough doses and can order more as needed.

The Mississippi Department of Health “ordered enough to meet the initial demand of the suppliers who ordered the vaccine and cover the costs of our county health departments, but we have the ability to order as many as we need in the future” – Liz Charlot, Director of Public Affairs agency, said in a statement to POLITICO. “Anyone who wants their infant or child to be vaccinated can do so.”

Several states noted that practitioners are ordering fewer vaccines due to storage restrictions, and one state reported that some vendors say they will wait for full FDA approval of vaccines before requesting a vaccine.

A spokesman for the CDC said the rollout of vaccines over the two holiday weekend could have impacted both demand and availability of prescriptions, and warned that it may be too early to match vaccine orders for ages 5 and younger with vaccine rates for older children.

To date, about 2,671,800 children under 5 years of age — out of nearly 19 million new eligible children — have received at least one dose of the vaccine since the FDA issued an Emergency Authorization for two manufacturers’ drugs on June 18. According to the CDC.

The government expected an early surge in vaccination of children under 5 due to pent-up demand from parents long keen to have their children vaccinated, but predicted that the surge would fade as a much larger group of parents wait for a decision.

The CDC is currently targeting doctors to help convince these parents and refine their case that vaccination makes sense.

“While we are trying to reassure, we also need to be sympathetic to families who say, ‘I need a minute. I want to think about it,” said Sarah Oliver, chair of the CDC Immunization Practices Advisory Committee Working Group. June 29 webinar. “Giving people space to answer very intelligent questions is how we get these numbers.”

Contacting providers for help

State vaccine orders do not take into account the total number of Covid-19 shots available to children in the state. For example, pharmacies and federal medical centers may order vaccines through different channels.

But federal health officials expect parents are more likely to get their younger children vaccinated during visits to a trusted pediatrician, family doctor or nurse. The U.S. Centers for Disease Control and Prevention (CDC) is urging practitioners to vaccinate more children and help correct widespread misconceptions, including that vaccines are unsafe or that Covid-19 does not affect young children.

The agency also encouraged states to register health care providers participating in the Vaccines for Children program—a federal program that provides free shots for Medicaid-eligible, uninsured or underinsured children, and American Indians or Alaska Natives—to administer vaccines against Covid- 19.

Many practitioners are on board. Recent Poll Children’s vaccine providers, for example, found that nearly three-quarters of respondents intended to administer the Covid-19 vaccine in the under-5 age group.

But in some parts of the country, getting their help can be more difficult.

In Louisiana, where Covid-19 vaccination rates among older children are also low, a group of pediatricians in the Shreveport area, in a recent survey by the Pediatric Society of Northwest Louisiana, raised many concerns about introducing vaccines at age 5 and younger. They were concerned about compensation, logistical problems and opposition from parents who do not want to vaccinate their children.

“About half of the responding agencies plan to offer a vaccine for the younger age group. That means half of them aren’t,” said John A. Vanchier, pediatric infectious disease specialist and deputy director of communications at the Center for Emerging Virus Threats at LSU Health Shreveport.

While this hasn’t created an immediate hurdle for parents seeking a vaccine, Vanchier said it does reflect a problem. “Parents who want to do this can, but the vast majority of parents are still hesitant to vaccinate their young children.”

Doctors in rural areas of the country are less likely to recommend childhood Covid-19 vaccines. according to March CDC MMWR report. It found that nearly 40 percent of rural parents said their child’s pediatrician did not recommend a Covid-19 vaccine, compared with 8 percent of parents in urban areas.

The federal government’s focus on medical practitioners could also have unintended consequences, as some small pharmacies that have served as community immunization centers for Covid-19 are discouraging vaccinations.

Ritch’s pharmacy in Mountain Brook, Alabama, is not administering the vaccine to the youngest children because co-owner Rebecca Sorrell has decided pediatricians have to deal with it, given the complicated multi-dose courses. The Pfizer vaccine requires three doses, with the first two given three to eight weeks apart and the third at least eight weeks after the second. The two Moderna shots were taken four to eight weeks apart.

“In the first week, we got quite a few phone calls,” Sorrell said, referring to the period after the FDA approved vaccines. As soon as people in the city found out where vaccines were available, the calls stopped, she said.

Child vaccination case

The CDC is trying to better explain to skeptical parents why they should vaccinate their children. Spreading the message as the Omicron BA.5 sub-variant rolls out across the US becomes more relevant, epidemiologists say.

The strain is causing a spike in cases that disproportionately affect the unvaccinated and the under-vaccinated, including children, according to Buddy Creech, a pediatric infectious disease specialist and principal pediatric research investigator for Moderna.

“We are seeing more children die of Covid than in the worst year of the flu, and we don’t know how to predict which children it will happen to,” he said.

Creech said that it is mostly children with comorbidities who get severely ill and die from Covid-19, but this is not the case for children who have developed fatal cases of Covid-19-related polyinflammatory syndrome. “Some of them are healthy children.”

CDC says 70 children died syndrome since May 2020.

Since 2020, there have been more than 2 million cases of Covid-19 in children aged 6 months to 4 years, as well as more than 20,000 hospitalizations and more than 200 deaths. There have been 10 million cases, more than 45,000 hospitalizations and more than 600 deaths in children aged 5 to 17, according to the CDC.

In comparison, in 2020, firearms were the leading cause of death for Americans aged 1 to 19, with 4,357 deaths, according to the data. analysis data from the CDC Kaiser Family Foundation. The leading natural cause was congenital disease, which claimed the lives of 3166 people in this age group, followed by cancer (1767) and heart disease (687).

Long Covid also poses a threat to children. Although estimates of the proportion of children infected with the virus who develop long-term Covid symptoms vary widely, some long-term Covid pediatric clinics around the country have monthly waiting lists for children suffering from a wide range of symptoms.

Jason Newland, a University of Washington infectious disease physician at St. Louis Children’s Hospital, says his concerns have shifted from the immediate chaos of a major outbreak to thinking about the long-term and wider implications of children being infected.

“I’m not as worried about being captured as I was in January 2022,” he said. “Am I afraid that there will be many people with serious illnesses? Yes… We need to keep pushing for more people to be vaccinated.”