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The Guardian - US
The Guardian - US
World
Melody Schreiber

After the long wait, US parents seeking under-5s’ vaccine face yet more hurdles

Luca Moore, 11 months, sits on his mother Dr Danielle Smith's lap before receiving a Covid vaccine in New Hyde Park, New York on 22 June 2022.
Luca Moore, 11 months, sits on his mother Dr Danielle Smith's lap before receiving a Covid vaccine in New Hyde Park, New York, on 22 June 2022. Photograph: Shannon Stapleton/Reuters

Ashley Comegys, a parent of two young children in Florida, was ecstatic when the Covid vaccines were authorized for children above the age of six months in the US. “We’ve been waiting for this for so long,” she said. “We can finally start to spread our wings again.”

But then she learned that Florida had missed two deadlines to preorder vaccines and would not make them available through state and local health departments, delaying the rollout by several weeks and significantly limiting access.

“Rage does not adequately describe how I felt that they were basically inhibiting me from being able to make a choice to protect my children,” Comegys said.

Families with young kids encountered months of delays after the pediatric trials were expanded and regulators pushed back meetings in order to evaluate the data closely. Vaccines for adults were rolled out a year and a half ago.

Now new challenges to vaccinating some of America’s youngest are cropping up.

“I called probably 20 pharmacies and pediatricians in our area” – including across the state line, said Sheryl Peters, a parent of an 18-month-old and a four-year-old in Tennessee.

Even after the vaccines were authorized for this age group, her local health officials didn’t know when they would arrive, and they directed her to the state health department, who told her it would be a few weeks, she said. She was crying on the phone, begging for help, but “nobody knew anything,” she said. “It was so, so disorganized.”

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While Tennessee did pre-order vaccines, the rollout has been slow and complicated. And the confusion could deepen.

Four Republican lawmakers in Tennessee are petitioning the governor, Bill Lee, to ignore the federal recommendations on vaccinating children under five and to ban state health departments from “distributing, promoting or recommending” the vaccines, creating uncertainty in the state’s approach to vaccinating some of its youngest residents.

Tennessee stopped all vaccination outreach to teens – not just around the Covid vaccines – in 2021.

The actions by leaders in states like Florida and Tennessee may contribute to existing hesitancy some families feel toward the vaccines, as well as hampering efforts to vaccinate children across the states – particularly those who have been marginalized in the health system, who are also at higher risk of getting sick.

“Departments of health, by and large, assist people who don’t have insurance or are on Medicaid or don’t have access to healthcare or live in rural areas where there are no providers,” said Michelle Fiscus, a pediatrician and Tennessee’s former top vaccines official who was fired in July 2021 after promoting vaccines. She was “absolutely furious” to read the lawmakers’ request for a ban.

“For an elected body and a governor in a state who has continued to beat the drum of everybody can make their own choice, whether it’s about wearing a mask or gathering in a church or getting a vaccine, to decide for these parents that they are no longer going to have access to these vaccines is really antithetical to everything that they have been preaching,” Fiscus said.

“Everything has always been, ‘It’s your choice. You don’t have to quarantine or isolate – it’s your choice. You don’t have to wear a mask – it’s your choice. You don’t have to stay away – it’s your choice.’ But when it comes to getting a vaccine that can actually save lives and prevent hospitalization, then they’re going to make the decision to take that choice away from you.”

That’s been one of the hardest parts about this process for Comegys.

“If you don’t want to get vaccinated, if you don’t want to mask, OK,” she said. “You can choose that. But why do you then get to make that choice for my family and the way that we want to protect our kids? It doesn’t feel fair.”

Some officials continue to spread the narrative that kids aren’t affected by Covid, Fiscus said, even after more than 440 deaths and thousands of hospitalizations among children under five.

In March, Florida’s department of health recommended against Covid vaccines for all healthy children. Florida is “affirmatively against the Covid vaccine for young kids”, DeSantis said at a press conference on 16 June, despite ample evidence of the vaccines’ safety and efficacy.

The Biden administration soon announced that Florida “reversed course” and would allow doctors to order vaccines directly. State officials disputed the idea of a pivot, saying doctors were already allowed to order the vaccines on their own, but doctors pointed out that the portal to do so was not in place until after the initial shipments had already gone out to every other state.

“The state of Florida intentionally missed multiple deadlines to order vaccines to protect its youngest kids,” said Dr Ashish K Jha, the White House’s coronavirus response coordinator.

With the delays and the confusion, many doctors and health systems haven’t received doses yet.

Only federally qualified health centers and pharmacies participating in the national pharmacy program could order vaccines directly in Florida. But most pharmacies can only vaccinate kids three and older, leaving significant access gaps for younger children. (CVS can administer the vaccine to kids as young as 18 months through its Minute Clinic.) And some opted out entirely, with the grocery chain Publix announcing it will not offer the vaccine to children under five through its pharmacies.

In Tennessee, Lee has not yet signaled whether he is considering limiting the vaccines. And even if vaccinations and information isn’t limited in Tennessee, the lawmakers’ request could add to hesitancy around the vaccines.

“That seems to be their goal, to continue to spread vaccine misinformation and disinformation and to continue to erode confidence around these vaccines,” Fiscus said.

In Florida, vaccinations will probably stall amid the message that Covid vaccines for kids aren’t recommended and the confusion around how to find them, especially because Florida isn’t offering the pediatric vaccines at state and local health departments and because pharmacies usually only vaccinate kids above the age of three.

“I genuinely don’t know, if you have a child under three, where you will go for that here if your pediatrician’s not getting it,” Comegys said. “Unless you’re on top of it, it’s going to be really hard to find.”

Many pediatricians in her area are short-staffed and aren’t able to reach out to families to let them know the vaccines have been authorized and how to get them.

Her pediatrician was able to place an order for the under-five vaccines a week ago, but it’s going to take several weeks before they arrive. Her two children were placed on the waitlist.

It’s been difficult to know the vaccines are rolling out in other states while her family still can’t access them, Comegys said. “The fact that it is available, and I can’t access it – that’s where I get really angry and really upset.”

Families that want to vaccinate their kids are eager to get the shots as soon as possible, as the US faces another potential wave from the Omicron subvariants BA.4 and BA.5, and with the return to school rapidly approaching.

But many families feel like they put their lives on hold while much of the rest of the world moved on. Peters had a family cruise planned for May that they canceled because the shots weren’t available yet, while Comegys is canceling a vacation planned for July.

“The finish line has been so close,” Comegys said. “And then to hear, ‘Oh no, it’s going to be another couple of weeks or a couple of months.’ I’m so angry. We’re so close, and now you’re not going to let me get there.”

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