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Teens Can Get Vaccinated, but It May Be a Tough Sell to Some Parents

U.S. News & World Report logo U.S. News & World Report 5/14/2021 Chelsea Cirruzzo
a group of people in a room: A mother (R) looks on as her son gets a Covid-19 vaccination at the Fairfax Government Center vaccination clinic in Fairfax, Virginia on May 13, 2021. - The campaign to immunize America's 17 million adolescents aged 12-to-15 kicked off in full force on May 13, a key part of President Joe Biden's strategy to push the country close to herd immunity. (Photo by ANDREW CABALLERO-REYNOLDS / AFP) (Photo by ANDREW CABALLERO-REYNOLDS/AFP via Getty Images) © (ANDREW CABALLERO-REYNOLDS/AFP via Getty Images) A mother (R) looks on as her son gets a Covid-19 vaccination at the Fairfax Government Center vaccination clinic in Fairfax, Virginia on May 13, 2021. - The campaign to immunize America's 17 million adolescents aged 12-to-15 kicked off in full force on May 13, a key part of President Joe Biden's strategy to push the country close to herd immunity. (Photo by ANDREW CABALLERO-REYNOLDS / AFP) (Photo by ANDREW CABALLERO-REYNOLDS/AFP via Getty Images)

Advisers to the Centers for Disease Control and Prevention have endorsed Pfizer's COVID-19 vaccine for use in 12- to 15-year-olds, but getting shots into kids' arms may be a tough sell for some parents.

The Pfizer vaccine was authorized for emergency use in ages 12-15 earlier this week by the Food and Drug Administration after clinical trial results found the shot to be 100% effective and well-tolerated in teens with few safety concerns.

However, despite its promising trial data and authorization, only 3 in 10 parents said they'd get their children ages 12-15 vaccinated as soon as a vaccine is available, according to the Kaiser Family Foundation's Vaccine Monitor. A quarter said they'd wait and see how the vaccine is working and nearly a quarter said they wouldn't get their kids the vaccine at all.

"Perhaps unsurprisingly, parents' intentions for vaccinating their kids largely line up with their own intentions for getting the COVID-19 vaccine themselves," KFF researchers wrote.

Other KFF researchers say offering vaccines to younger age groups is a big step toward general herd immunity.

And while children are much less likely to die from contracting COVID-19, public health experts say children can still get and spread the virus. Additionally, a dangerous condition, called multi-system inflammatory syndrome in children, has been identified in some cases following a COVID-19 infection. According to the CDC, 3,742 cases had been reported as of May 3. Sixty-three percent of those cases were in Hispanic and Black children. Twenty-one percent of the cases occurred among ages 12-17.

There are almost 17 million adolescents aged 12-15 in the U.S. and nearly half of them are people of color. One in 4 are Hispanic, 13.4% are Black and 4.8% are Asian. More than a third live in families with incomes 200% below the federal poverty line. This means reaching teens requires an equitable approach, KFF researchers say.

Jennifer Kates, senior vice president and director of global health & HIV policy at KFF, says vaccinating kids plays a big role in curbing the pandemic, but reaching them may be a challenge.

"We did find that some of their use of regular and preventive care has declined during the pandemic. And so, that raises questions about how easy we'll be able to reach kids," she says. "I think it's going to be a concerted effort to reach parents."

Other vaccines for children appeared to decline during the pandemic, worrying the Centers for Disease Control and Prevention as well as pediatricians.

This decline in regular and preventive care "likely reflects parents delaying care due to concerns about potential exposure to coronavirus or due to cost if they experienced negative financial impacts from the pandemic," Kates wrote along with other KFF researchers, adding that it's important in outreach efforts to tell parents that the vaccine is free. They also said schools can be an important hub for children and their families to receive vaccine information.

But misinformation may also present a challenge. On Wednesday afternoon, several mothers spoke at the CDC's Advisory Committee for Immunization Practices meeting on the Pfizer vaccine, urging the panel not to approve the vaccine and peddling misinformation about the vaccine's side effects, despite researchers saying none of the more than a thousand clinical trial participants suffered serious side effects.

Dr. Michael Smith, a Duke University pediatrician and infectious disease specialist involved in the pediatric trials of the Pfizer COVID-19 vaccine, says there's always a "laundry list of rumors'' surrounding any vaccine. In particular, he notes that concerns over the COVID-19 vaccine have included the false claim that it can impact fertility. Parents speaking at the ACIP panel Wednesday also brought up fertility.

As Smith points out, there is no link between COVID-19 vaccines and infertility and research and data have affirmed the safety and efficacy of the mRNA vaccines in pregnant and postpartum people.


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Smith says pediatricians looking to combat misinformation and encourage uptake of the vaccine should familiarize themselves with what concerns parents have. "There are great resources on the CDC. The Vaccine Education Center at the Children's Hospital of Philadelphia has a great list of questions," parents might ask, he says.

He also encourages pediatricians to be honest with parents and teens about potential side effects, which were reported to be similar to those in adults.

"Yeah, the second dose may hurt," he says, adding that safety data has not identified any serious risks. "So there's no reason to expect ... any kind of smoking gun here."

Kates adds that there's another trusted messenger for skeptical parents: other parents and friends.

"Some of the best messengers will be their own peers," Kates says. "So other parents who are supportive about getting their kids vaccinated, I think, will be helpful." She says trusted doctors can play a role, but parents speaking to other parents can make a huge difference.

Both Kates and Smith also say kids, especially kids who participated in clinical trials, can be good messengers to their peers.

Kates notes that reluctance by parents may ease once doses are more widely distributed among the age group. She says earlier KFF studies in December found more people reluctant to get a vaccine before shots were approved; after approval, she says, more people seemed willing to go for it.

But public health experts are already working to combat hesitancy. An official with the White House told reporters this week that the CDC has launched a focused effort to enroll more pediatricians and family practitioners as COVID-19 vaccine providers, and plans to partner with local pharmacies to ensure their Pfizer shipments can be made available to the new age group.

The Centers for Medicare and Medicaid Services is partnering with state Medicaid programs to conduct outreach and answer parent questions as 40% of the nation's children are enrolled in Medicaid. The Biden administration is also planning a number of informational campaigns to reach teens and their families, including webinars with the American Academy of Pediatrics and teacher organizations. And town halls are expected to be held with public health experts to answer questions.

The Health and Human Services Administration will also be holding a roundtable with Surgeon General Vivek Murthy to answer parents' questions.

Meanwhile, states and providers are ready to vaccinate, and some started to do so on Thursday. Children's National Hospital in Washington, D.C., has a full waitlist for parents seeking to vaccinate their teens.

In Maine, Dr. Nirav Shah, director of the Maine Center for Disease Control and Prevention, told reporters during a press briefing that messaging on the vaccine for teenagers requires nuance.

"Much of our messaging has been directed to patients," he said. "But here, we have to speak not only to the patients, the adolescents, but also their parents and guardians to make the case [to get vaccinated]."

He said the conversation on adolescent and teen vaccines has centered around hesitancy, referencing the KFF study, and said family doctors and pediatricians being on the front lines is critical.

"The same approach that we've been taking with adult vaccinations applies here, which is to say some parents are extremely eager to get their kids vaccinated. Some parents and other groups are motivated by convenience, but that group has a lot of questions that they want answered first," he said.

In Washington state, there are approximately 378,000 kids now eligible for the vaccine, said Dr. Umair Shah, the state's secretary of health. According to Shah, Washington is working on bringing vaccines directly into the offices of pediatricians.

"We want to make it easy for parents to be able to get information, talk to the provider and also ultimately vaccinate their children," he said.

In Alaska, which notably had one of the more successful vaccination programs overall in the early months of vaccine rollout, a state official says that COVID-19 vaccines are the way to safer school years. Dr. Anne Zink, Alaska's chief medical officer, said vaccinating teens is a collaborative decision with parents and their children, and the state wants to find "ways that we make sure that parents and kids at the same time can get that information" that would address concerns.

Requiring parental consent is a question that varies across states. In Maine, Shah said parents are not required to be on-site during the vaccination itself. However, at school-based clinics, parents might need to sign forms or give verbal consent over the phone, Shah said. In Washington, parental consent is also needed. "We've been working on what that looks like," Shah said, to avoid making that a hindrance for teens.

It's not yet clear if any states would require students to be vaccinated before returning to class. None of the three state officials Alaska, Maine and Washington said that it would be a requirement, although some higher education institutions in their states say they will be requiring vaccines.

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