Kids under 5 being left behind with COVID-19 vaccines

Black and Latino children in Los Angeles County under the age of 5 have COVID-19 vaccination rates in the single digits, reflecting a nationwide trend that has public health professionals concerned and looking for ways to increase those rates.

According to LA County data, only 12% of children ages 6 months to 4 years have received at least one dose of a COVID-19 vaccine, and only 7% are fully vaccinated.

According to the county’s Vaccine Dashboard, Black and Hispanic children under age 5 have the lowest rates: Only 6% of Black children and 5% of Hispanic children had at least one dose, compared to 22% of Asian children and nearly 19% of White children and nearly 15% of Alaskan Indian and Native American children.

LA County Public Health Director Barbara Ferrer said the “sobering data” on vaccination rates in young children showed “we still have a lot of work to do.”

A report from the US Centers for Disease Control and Prevention last week showed that by the end of 2022, only 10% of children between the ages of 6 months and 4 years nationwide had received at least one dose of COVID-19 vaccine, and only 5% were fully vaccinated.

Children under the age of 5 are receiving COVID-19 vaccinations at a “substantially lower” rate than older children, raising concerns among health officials about the potential impact on future immunization efforts. The report found that two months after the vaccine was approved for older children, 24% of 5- to 11-year-olds and 33.3% of 12- to 15-year-olds had been vaccinated.

The low rates for young children nationwide are “worrying and may indicate challenges for future immunization coverage, particularly given that bivalent booster doses are now also approved for this pediatric population,” the report said.

The CDC report found that race and ethnicity were known for about 71% of vaccinated children under the age of 5. Among children of known race and ethnicity who received at least the first dose of COVID-19, 55% were White, 20% Latino, 13% Asian, and 7% Black.

The report comes as public health officials struggle to balance messages encouraging people to remain cautious about COVID-19 and stay up to date on immunizations, even as pandemic precautions such as mask and vaccination requirements are on the rise keep track.

Public health officials, in particular, have had to grapple with the ongoing question of how to convince families to vaccinate their youngest children against COVID-19.

Beginning in December, children 6 months to 5 years of age who have previously completed a Moderna primary series are eligible to receive a moderna bivalent booster vaccine two months after their last dose of the primary series. Children aged 6 months to 4 years who are currently completing a Pfizer primary series will receive a third primary dose of a bivalent Pfizer vaccine.

According to the CDC, nearly 3.5 million COVID-19 cases have been reported in children under the age of 5, with 689 deaths from the virus in that age group. Public health officials and healthcare providers have also been monitoring rare cases of pediatric multisystem inflammatory syndrome, or MIS-C, in children recently infected with COVID-19.

Getting parents and carers on board to vaccinate their eligible children has been a constant concern throughout the pandemic. While some parents took their children to appointments right away, some have chosen to wait until they understand the potential side effects.

dr Ilan Shapiro, chief health correspondent and medical affairs officer at AltaMed Health Services, which has clinics in Los Angeles and Orange County, said logistics are the biggest hurdle families face when vaccinating their young children.

Most of the families he works with are already asking about eligibility for the booster and how soon they can get their young children vaccinated, Shapiro said. Many of them know that this would mean potentially losing hours and wages, having to organize childcare, or finding time to get vaccinated between working multiple jobs.

But Shapiro said some families have told him that “kids don’t get sick” or that COVID-19 is “just like the flu” to explain why they didn’t get their kids vaccinated. He said he often reminds them that the flu is dangerous for younger children too.

Most families have questions about potential side effects of the COVID-19 vaccines in young children or are still afraid of what they’ve heard about infertility, hormone changes and heart inflammation, Shapiro said.

While young male teens and young adults with the vaccine “could have a lower chance of developing heart inflammation,” he told families the risk of COVID infection and its side effects could be even worse.

“When you start getting the information straight, they tend to actually get the vaccine,” Shapiro said.

dr Shanika Boyce, a pediatrician and assistant professor at Charles R. Drew University of Medicine and Science in Willowbrook, said she was thinking of a mother who came with her son who had a fever, dehydration, poor diet and breathing problems weeks after COVID-19 .

“For me, what really struck was the fact that we definitely need to continue letting parents know that it’s the effects of the virus itself, but sometimes the complications that can arise afterwards,” Boyce said.

She said she often tries to ask families what their concerns are and where they come from, especially after learning they’ve lost family members to COVID-19 or seen how others in their community are doing. She is also emphasizing to families of color who are uncertain about the vaccine that children of color have been included in the COVID-19 vaccine trials.

“They tend to hesitate and make decisions about whether to vaccinate themselves, and if they vaccinate older children in the household then there is some protection that will ensure that the younger generation gets the virus,” Boyce said. “Unfortunately, this is not the case.”

LA County public health officials have made efforts to work with 600 pediatric care providers to encourage more households to vaccinate young children.

Ferrer said they have urged health care providers who work with children and families to speak out about the importance of vaccines and stressing that they are safe for young children.

“I know some families have just been waiting to make sure there are no unforeseen or unknown side effects,” Ferrer said. “We now have a lot more data. Millions of young children have been vaccinated, so I urge people to have this conversation with their healthcare provider.”