Editorial: To get kids vaccinated, listen to parents

Jun. 25, 2021
Young boy gets vaccine

Children ages two to 11 could potentially be eligible for the Pfizer Covid-19 vaccine this fall, just in time for the start of in-person school. In early May, Pfizer’s CEO said he expects to request emergency use authorization (EUA) from the Food and Drug Administration (FDA) in September, with an EUA request for ages six months to two years to follow in the fourth quarter.

In an editorial for the New York Daily News, CUNY SPH Dean Ayman El-Mohandes says persuading parents to get their young children vaccinated by the time school starts will be a crucial test of the U.S. public health community.

To get kids vaccinated, listen to parents

By Dr. Ayman El-Mohandes
Jun 24, 2021

Ayman El-Mohandes horizontal crop
Dean Ayman El-Mohandes

Persuading parents to get children ages 2-11 vaccinated against COVID-19 by the time school starts in September, and even younger by the end of the year, will be a crucial test of the U.S. public health community in protecting the most vulnerable among us in advance of a potentially grave winter.

Amidst the relief of a social reopening, we must not ignore the fact that COVID-19 and its variants are raging among children in populous countries like Brazil with single-digit immunization rates. In the U.S., kids make up 19% of new COVID-19 cases. We have a window of opportunity now to build parents’ confidence in the vaccine by alleviating their fears and guiding them through their own risk/benefit analysis.

Having worked as a pediatrician in emergency and under-resourced facilities around the world, I am familiar with the complicated and sometimes confounding perceptions and beliefs that get in the way of childhood vaccinations. I have also learned that the most effective health-care solutions are those that respond to the most pressing needs in people’s lives.

A mother who must journey six hours to take her children to a North African clinic may care more about their dehydration and nutrition than the preventive effects of a polio vaccine. It’s up to health-care professionals to meet her immediate concerns before expecting her to sign on to a broader community health solution, such as providing vaccinations at a nutrition clinic.

Today, there is a plethora of misinformation about the COVID-19 vaccine being consumed by parents, and especially young mothers — such as the link to infertility that has been resoundingly refuted. We need to counter these myths with careful listening and individualized counsel by pediatricians and public health advocates with lived community experience.

Already, a quarter of parents with children under 12 say they will get them a shot when the vaccines are available. One quarter will not, and in between are those who are waiting for more information (33%) or will comply with school requirements (14%).

To credibly reach this crucial segment of parents, we must communicate the vaccine’s known benefits for children, create incentives for their use, and promote a sense of civic duty to protect unvaccinated children and adults.

First, the facts on benefits. Although children tend to have less severe symptoms than adults, they are still at risk. The American Academy of Pediatrics has estimated that more than 300 children have died of COVID-19, greater than for influenza this past year. Those who contracted the virus are susceptible to multisystem inflammatory syndrome in children, or MIS-C, a rare but serious condition that can cause painful organ inflammation, confusion, hallucinations and memory problems.

India saw a recent spike in MIS-C. In Brazil, at least 1,000 children have perished from the virus this year, and the Gamma variant is killing a high number of pregnant women and unborn babies. If COVID-19 continues to spread unmitigated throughout the world, who is to say that a variant that impacts children here will not emerge?

Second, incentives. The CDC’s announcement that children can go mask-free to camps where staff and campers are fully vaccinated is a good example of an incentive that can vastly improve children’s mental health and well-being.

CUNY School of Public Health’s national survey of 6,000 people across the country showed that the majority support vaccine mandates:

62% thought universities could require vaccinations, and now those requiring students to be vaccinated for the fall is rising by the day; 58% said that employers can require vaccines. If employers were also to provide free transportation to a vaccination site, that would help remove a barrier that one-third of our respondents face in lack of proximity;
70% believe vaccinations should be required for international travel, revealing a broad awareness that our nation is vulnerable to COVID-19′s persistence abroad.

This leads to the third prong of our approach: a campaign for civic duty. This is founded on the social contract to protect the most susceptible: unvaccinated babies, pregnant mothers or immunocompromised adults. That’s why schools require them.

If we are to weather the long-term consequences of a recurring COVID-19 virus or variant, we must likewise galvanize as many people as possible in an apolitical movement to be vaccinated and get booster shots, if needed. Successful education campaigns — from hand-washing to recycling — have overcome pushback to create measurable change. So can this one.

We as doctors pledge to deliver knowledge with compassion, and this summer is our moment to lead.

El-Mohandes is dean of the City University of New York Graduate School of Public Health and Health Policy.