Access to pediatric COVID vaccines has been hampered by dose shortages, higher prices for providers, and parental skepticism.
By Carlos Schmidt
Yuri Arcurs/Alay Stock Photo
The number of people hospitalized with COVID is much lower than at the beginning of the year, but the disease remains a significant health threat. In September, the Centers for Disease Control and Prevention said anyone six months or older receives one of the newly updated COVID vaccines, which protects against newly circulating variants of SARS-CoV-2, the virus that causes the COVID. But getting those vaccines into children’s arms has proven difficult.
In much of the U. S. , and in rural areas in particular, access to pediatric COVID vaccines is severely limited. Parents travel long distances to get them and, in many cases, are turned away at pharmacies that refuse to vaccinate young children and doctors’ offices. who have not asked for pediatric doses. Experts are concerned that the lack of access to vaccines is especially precarious for infants and young children, especially those who have never received a COVID vaccine. Young children have small lungs and limited energy reserves, so they may find it difficult to cough up respiratory secretions, putting them at risk for secondary infections and other complications of COVID. “Children under the age of 4 have one of the highest rates of COVID hospitalization in the U. S. Paul Offit, a pediatrician at Children’s Hospital Philadelphia, says. And that’s because they’re not getting vaccinated. “
A complex set of points contributes to the challenge. But at the heart of the challenge are the demanding situations of “transitioning from a government-provided product to one where suppliers will also have to procure COVID vaccines from advertising markets,” says Claire Hannan, executive director of the Association of Immunization Managers. AIM), a nonprofit organization that coordinates with public fitness agencies to increase vaccination rates. “There have been some bumps in the road. “
During the pandemic public health emergency, everyone was paid for their vaccines, courtesy of the federal government. But after the Department of Health and Human Services declared an end to this emergency on May 11, 2023, much of that money disappeared. CDC data shows that at that time, only 6% of American children under the age of five were fully vaccinated against the disease. Children covered by Medicaid and other types of government assistance are still eligible to receive individual vaccines provided through the CDC’s Vaccines for Children program. But to participate in the program, providers must also vaccinate children with consistent personal insurance and must purchase vaccines in advance at an average cost of $120 per dose. This is a significant investment, given the unpredictable demands for COVID vaccines, Hannan says. “Parents are increasingly fatigued by COVID and many do not see it as a risk to their children,” she says. Some parents will become hostile if pediatricians propose COVID vaccines, and considerations about the vaccines’ rare side effects are fueling their skepticism. The Food and Drug Administration has warned that the mRNA vaccines produced by Pfizer and Moderna pose small but not zero risks of central inflammation, especially in adolescent and young adult men. But symptoms often go away without treatment, and a CDC study found that those effects are more likely to occur after SARS-CoV-2 infection than as a reaction to the vaccine.
The FDA has stated that the benefits of COVID vaccines outweigh the potential health risks, but pediatricians worried about running out of unused materials are forgoing administering COVID vaccines. Evidence collected through the CDC shows that, as of Nov. 9, only about one-third of pediatric providers had procured the doses needed to vaccinate young people in the youngest age groups. The numbers aren’t surprising, “given what we expect from the system,” says Michelle Fiscus, IAM’s chief medical officer. “We are asking medical providers to purchase expensive vaccines upfront in the hope that they will be reimbursed within 30 days or forever. It’s the worst style of business ever known. Rebecca Weintraub, an assistant professor at Harvard Medical School, agrees. Pharmaceutical corporations are churning out gigantic amounts of COVID vaccines. “So the problem is not the origin,” he says. “What’s happening is that acquisitions at clinical centers are decreasing. “
Pharmacies also supply vaccines. Under federal law, they can vaccinate children over 3 years old (younger ones seek medical attention). But in many cases, they only offer COVID vaccines at limited times, such as weekdays, “which means taking young children out of school. ” school,” adds Dora Mills, a medical epidemiologist at MaineHealth, Maine’s largest provider of physical care services. The drawbacks are largely the result of inadequate workforce. “Like everyone else in the physical care industry , pharmacies are suffering from staff shortages,” Mills said. “They are too under pressure and busy and searching for vaccines between prescriptions. The COVID vaccines are in addition to the flu vaccines and now breathe against the syncytial virus,” he adds, and many pharmacy technicians are also not comfortable with the concept of vaccinating young people. “A five-year-old child twisting is not in their comfort zone,” says Mills.
Fiscus fears that disruptions related to access to pediatric COVID vaccines will have alarming implications not only for children’s health, but also potentially for population herd immunity. Right now, most people around the world have had COVID or have been immune to it. or both. ” But every day, 10,000 young children in this country are eligible to receive the COVID vaccine,” Fiscus says. “And when they’re unvaccinated and infected, those viruses have a greater chance of mutating and causing the disease to get worse in all of us. “
Part of the solution to expanding COVID vaccination rates among young people lies in the message, says Brian Zikmund-Fisher, a professor of habits and physical education at the University of Michigan School of Public Health. Parents would possibly be more susceptible to vaccinating a child if a doctor raised the option of wasting work days to care for a physically ill child, “it’s a more compelling argument than the popular public message about fitness,” he says, “which is that even though very few young people die from COVID, We want to do what we can with them. “
Mills insists that the government wants to ensure greater quantity and convenience of vaccines, for example by providing them in schools, nurseries and other network settings. “I find it mind-boggling that here in the U. S. “We want the U. S. Department of Health to continue to distribute vaccines based on their safe status,” he says. “Vaccines are like water on fire. Why not give them [for free] at all levels?”
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