The Checkup With Dr. Wen: What will it take to increase vaccination rates in children?

Clearly, fear of infection alone is not enough to motivate parents. ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌  ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌  ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌  ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌  ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌  ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌  ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌  ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌  ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌  ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌

Sign up for this newsletter Read online Guidance on navigating the pandemic and other public health challenges       By Leana S. Wen Opinions columnist  Email There's potentially great news on the horizon for parents like me who have little kids: Pfizer has applied to the Food and Drug Administration to grant emergency use authorization for their vaccine for children under 5. While we await the FDA's determination later this month, let's talk about the startlingly low vaccination rate in the 5- to 11-year-old group — of which only about 1 in 5 are fully vaccinated. What will it take to increase vaccine uptake in children? During the week ending Jan. 20, the American Academy of Pediatrics and Children's Hospital Association reported more than 1.1 million new pediatric coronavirus infections. Many of these infections, and subsequent hospitalizations, could have been prevented with vaccination. Yet, a Kaiser Family Foundation survey found that about 8 in 10 parents of unvaccinated kids said that omicron has not made them more likely to inoculate their kids. Clearly, fear of infection alone is not enough.  ADVERTISEMENT   This doesn't mean we should stop outreach efforts. In fact, I urge health-care providers, educators and community organizations to double down on identifying parents of unvaccinated kids and speaking to them. Adults who have not been vaccinated are unlikely to be open about inoculating their children, but families in which parents and grandparents are vaccinated but kids are not need space to ask questions and have trusted individuals address their concerns. We need to spread the word about just how safe vaccines for younger children are. A study by the Centers for Disease Control and Prevention and the FDA found that serious side effects are extremely rare. Only 11 cases of myocarditis — a serious but treatable inflammation of the heart muscle —  were identified out of approximately 8 million doses given. That rate is even lower than for the adolescent age group. Some parents have held off inoculation because of potential for long-term side effects, but there is no medical or scientific reason for this belief. There are many vaccines routinely given to children. Side effects only occur in the first few days, or at most, a few weeks following administration. Recent studies have also debunked the myth that vaccines cause infertility. On the other hand, the coronavirus itself harms kids. About 900 children under 18 have died from covid-19 since the start of the pandemic. More than 6,400 kids have been diagnosed with multisystem inflammatory syndrome in children (MIS-C), which has resulted in at least 55 deaths. For parents who remain on the fence despite the overwhelming evidence that vaccines are safe and effective in reducing infection, severe disease and MIS-C, I believe we need to clearly tie vaccination to removal of pandemic restrictions. I wrote this week's column on the need to return to normal while we can, starting with a rapid off-ramp for mask mandates. ADVERTISEMENT   If children are fully vaccinated, I think it's reasonable to have them opt out of masking in schools. Vaccinated kids shouldn't have additional restrictions placed on them, such as limiting extracurriculars. They should also be exempt from quarantine policies if they are exposed to keep them in school. What about instituting vaccine mandates in schools? While they could work to increase vaccine uptake, I'd be concerned that they will backfire and instigate resistance to other routine childhood immunizations. Instead of going down that route, I think we should make the case that vaccines are key to our children returning to their full pre-pandemic lives. That will help move parents of school-age children, and, in time, those with toddlers and younger kids, too.   My latest column Yes, more variants may emerge in the future. That's why we should lift restrictions now. Opinion ●  By Leana S. Wen ●  Read more »     Ask Dr. Wen Submit your question and I may answer it in a future edition of this newsletter.  Not subscribed yet? Questions to Dr. Wen from Washington Post subscribers are prioritized. Subscribe   "I'm a small town pastor in central Pennsylvania. Where I live, there is a pretty even divide between covid cautious people and the anti-vax/anti-mask folks. My church has been good about masking and distancing for worship. It's gotten way past time that I visit some who cannot attend. Can you suggest how to handle personal protocols for these visits? I am fully vaccinated and boosted; my concern is for others in the community and the person I am visiting. Right now, I am masking during these visits, testing before leaving and spacing them to only one a week. Where I can, I try not to do any chores in the three days before an unvaccinated (or unknown) parishioner. Is this good enough? Not visiting, I think, hurts more than the risk of visiting, especially the isolated, homebound folks." — Julie from Pennsylvania Thank you for your work and your ministry. No doubt, your visits will bring much joy and connection. It sounds like you are concerned about two things: the risk you could pose to the people you are visiting, and the risk that you'd contract covid-19 during the visits and spread it to others in the community. Since you are vaccinated and boosted, if you wear a high-quality mask (N95, KN95 or KF94) during your entire visit, the risk of either is extremely low.  Indeed, this is what health-care providers have been doing, even with patients we know to be actively infectious with covid-19. If you are masked the entire time, you are extremely unlikely to spread or contract the coronavirus. You do not need to quarantine in advance, test after or limit your visits. "I am stationed overseas and haven't seen my family since before the pandemic. I am finally visiting family in the States after this winter and plan to wear an N95/KN95 mask during transit. But due to flight cancellations, my travel time has now been extended to 10+ hours with multiple long-haul flights and long layovers. I can't possibly keep a mask on that entire time, and there will likely be many times when I can't socially distance from passengers and crowds. Do you have any recommendations for how to safely consume food and especially water during this trip?" — Chloe from Japan Plan out your trip in advance, including a plan to have food and keep hydrated. Try to eat a large meal and drink plenty of fluids as close to departure as possible. That may involve eating in the car on the way to the airport (assuming you are driving by yourself or with someone in your household). If that's not possible, eat right before you leave your house. Then, once you arrive at the airport, find a space where you are distanced from others to have a snack and drink more liquids. Try to wear your mask the entire time while you are seated close to others. If you have to eat or drink while in flight, do it at a time when the passengers around you have their masks on. That means opting out of the meal service or at least waiting until the people around have already eaten before you do so. Consider packing high-calorie protein bars that can be consumed in a few minutes. Bring straws — you can easily drink through a straw while lowering just part of your mask. And have contingency plans, in case your trip ends up being even longer than it already is.  "I know you have at least one child under 5, who is too young to be vaccinated. Given the benefits of vaccines, I wonder if you have an opinion on the 'off-label' use of the Pfizer pediatric vaccine (10 mcg) in this age group. I have a 4-and-a-half-year-old, who I would love to have immunized before a long-delayed plane flight at the end of March." — Scott from Michigan I also have a 4-and-a-half-year-old, as well as an almost 2-year-old. I would not recommend for younger kids to receive the dose that's been authorized for the 5- to 11-year-old group. Rather, I'd urge continued caution during the plane trip. Hopefully, it will only be a matter of a month or so before a vaccine for younger kids — at the appropriate dosage — will be authorized. The Post has also compiled Q&As from my previous newsletters. You can read them here.   What I'm reading New research published in the journal Cell identified four factors that correlate with increased risk of having long-haul covid. These four factors include the level of virus, presence of certain auto-antibodies, reactivation of the Epstein-Barr virus and — importantly — having Type 2 diabetes. How this research will apply clinically remains to be seen, as most people do not have extensive blood work following their initial coronavirus diagnosis. But such studies help us understand what causes lasting effects from covid-19 and why some people are more susceptible to them than others. Two Israeli studies published in Science last week found that unvaccinated children who live in households with vaccinated parents are less likely to contract covid-19 than if their family members are unvaccinated. Parental vaccination provides a "cocoon" effect around their children, giving indirect protection from vaccines. This doesn't negate the need for kids to be vaccinated, but rather provides additional impetus for everyone eligible to get the shot. Vaccines protect the individual as well as those around us. An analysis by the Financial Times found that nearly half of covid-19 hospitalizations in the United States this winter could have been averted if our country had the vaccination coverage of leading European countries. The unvaccinated remain the greatest barrier to a return to normalcy, as the strain they could place on our health-care system could trigger restrictions in the future.   More from The Post Pfizer and BioNTech seek emergency use authorization of the first coronavirus vaccine for children under 5 By Carolyn Y. Johnson and Laurie McGinley ●  Read more »   Lack of Medicare coverage for at-home coronavirus tests sparks outcry By Amy Goldstein and Christopher Rowland ●  Read more »   Anthony Fauci is up against more than a virus By Dan Zak and Roxanne Roberts ●  Read more »   He's declining a coronavirus vaccine at the expense of a lifesaving transplant: 'I was born free, I'll die free' By Julian Mark ●  Read more »   When should the government lift pandemic restrictions? These four metrics can provide the answer. Opinion ●  By Joseph G. Allen ●  Read more »   Biden deserves a lot more credit on covid-19 than he's getting Opinion ●  By Robert Gebelhoff ●  Read more »     We think you'll like this newsletter Check out Must Reads for a curated selection of our best journalism in your inbox every Saturday, plus a peek behind the scenes into how one story came together. Sign up »

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