In some pediatric practices, shots are already going in the arms. Children’s Medical Group, a private practice in Atlanta, ordered doses as soon as allowed and received their first shipment on Monday, June 10th. They started vaccinating at lunchtime. “We’ve had tremendous demand,” says Jennifer Shu, a pediatrician in practice and editor of the American Academy of Pediatrics. “We have even received calls from patients in other practices whose doctors do not carry any Covid vaccine for this age group.”
As it suggests – and as parents are reporting on Twitter– availability varies. This may be due to these predictions of low recording; practices and hospitals may not want to invest freezing space and staff time if they do not expect much interest. But it may also be due to a bureaucratic hurdle that has haunted Covid vaccination since its earliest days. Unlike almost all other vaccines, this one does not come from a commercial distributor; it is handed out by the federal government and sent through the state health departments. So to receive it, healthcare providers need to fill out CDC papers. This is true even though they are already participating in other public programs, including Vaccines for Children (known as VFC), which guarantee shots to families without private health insurance.
“The turnout from the providers who normally participate in the VFC program has been pretty good,” says Marcus Plescia, a physician and chief physician at the Association of State and Territorial Health Officials. “Getting it out on private practice sites has been a slower process. They are not used to being part of government-run vaccine programs. Some of them do not want to do it because of the paperwork and hassle.”
The childhood vaccination program may also be hampered by another long-standing problem: the size of the vaccine vials. Each can hold 10 doses, and once thawed and opened, it must be used within 12 hours. “Pediatricians in particular do not like to spill vaccine. They see it as a valuable commodity,” says Hannan. person and discard nine doses because you do not have nine other children – that’s a challenge. “
Another complication is that all Covid protections so far, including vaccination, have been unequally distributed. Half of those 19 million children under 5 are colored children, according to one Kaiser analysis; 41 percent are dependent on Medicaid for insurance and 4.5 percent are uninsured. With public websites, pharmacies and schools not available to help the youngest children, there will be extra pressure on local and federally qualified health centers to reach children near them. “We know from all parts of the rollout that some of the most disadvantaged groups were not vaccinated at the same rate early,” said 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 poorer access to this intervention.”
At this point, experts are hoping for a slow recording rather than none recording. Parents whose children will soon have a visit from a good child, or summer appointments to get them ready for sports, may choose to wait a few months instead of going on a special trip. It has pros and cons: It leaves children vulnerable to Covid for extended periods of time, but it normalizes the vaccine as just one among the many shots they receive in their early years.
For some parents, the problem will not be planning, but trust. They need extra patience from people in the medical system as they work through it, perhaps as they worked through it themselves last year. “At their next pediatrician appointment, they can ask for an interview – which is different from calling the office” to arrange the shot, says Angela K. Shen, a visiting researcher at the Children’s Hospital of Philadelphia who studies attitudes toward vaccination. “It may take several conversations with their brother, their sister, their pharmacist as well as their pediatrician. These people in the middle are, as public health message strategies will want to go after, to answer their questions in a non-paternalistic way.”