Tag Archives: #vaccinehesitancy

Will They? Won’t They? What Parents Think About Giving Kids A Covid Shot

By September this year, children as young as two may be eligible for a Covid vaccine. While many parents welcome the prospect of protection against a deadly virus, some parents aren’t so sure.

What do parents think about vaccinating their children?

“In my circle”, says Anjana Nagarajan, a Los Altos parent with two high school age children, “parents are gung-ho.” Her 16-year-old daughter is fully vaccinated while her 14-year-old son just received his first shot.  Her view is largely shared by parents in her area where, according to CA data, almost 87% of the population have received one or more doses of the vaccine.

But for Priya Nair Flores, a management consultant in San Antonio, TX, the vaccine is still out of reach for her son who just graduated fifth grade. “My son is 11 years old,” says Flores, “so he’s one year from the age at which CDC recommends children start getting the COVID vaccine, which is 12 years old. I and other parents of his friends talk about how much we wish they could get the vaccine. I believe in science.”

The science says that the vaccine is safe. Clinical trials have demonstrated even higher efficacy rate among adolescents than young adults (16-25 years old). The FDA just approved the Pfizer-BioNTech coronavirus vaccine for emergency use in adolescents 12 to 15 years old. Moderna just announced that its TeenCove study was highly effective at preventing COVID-19 in adolescents ages 12 to less than 18 and will request FDA emergency authorization in early June. By this fall, children ages 2-11 could potentially be eligible for a COVID-19 vaccine. It will be the next major milestone in containing the coronavirus pandemic.

Even so, though vaccine availability across the US is going up, some parents are refusing to vaccinate their children, citing concerns about the newness of the vaccine and its potential side effects in the future. Public health experts fear that vaccine hesitancy will prolong the fight against Covid19.

In a White House briefing on May 19, US Surgeon General Vivek Murthy urged parents to protect their children from Covid 19 and help turn the pandemic around.

Why Parents are Hesitant

Scientists and doctors emphasize that vaccinations are safe and offer protection from COVID-19. The CDC reports that some people may experience short-term side effects which subside after a few days but are normal signs that the body is building protection.

However, at an Ethnic Media briefing on May 21, Dr. Jose Perez, Chief Medical Officer at the South-Central Medical Center in LA, identified misinformation spreading on the Internet as a troubling cause of vaccine hesitancy in his patients.

Dr. Perez’ view was supported by surveys which found that fear and uncertainty about the Covid 19 vaccine ranged from its safety and efficacy to myths about infertility, and fetal cells in vaccines that could change DNA. Among 48% of people ages 18-49 , fear of future infertility was a top concern.

There was uneasiness that the vaccine was created too quickly, even though the technology for mRNA vaccines has been in development for decades and processed through the same FDA clinical trials for all other vaccines.

The Institute for Policy Research reported that young mothers aged 18 – 35 were largely driving the resistance among parents who indicated they were ‘extremely unlikely’ to get their children vaccinated. In contrast, said Matthew Simonson, a researcher with the COVID States project, fathers have become less resistant to the idea of vaccinating their kids.

A KFF survey found that while 30% of parents with children aged 12 to 15 will get them vaccinated right away, nearly 23% definitely will not.

 

When it comes to vaccinating their children, households which have an annual income of under $25,000 or people who have only high school diplomas are the most vaccine resistant, added Simonsen, compared to most pro-vaccine people who tend to live in households making $150,000+ a year or hold a graduate degree.

But, for many parents explained Dr. Perez, whose clinic serves primarily Latino and African American working families, vaccination hesitancy is not a choice. Rather, socio-economic barriers keep many from getting the vaccine.

“One of the major reasons for lack of vaccination, is access to time off from work,” he explained. Parents who have just returned to work low-income jobs as day laborers or in restaurants, have to juggle taking an extra half day off to get their children to a clinic. Most of Dr. Perez’ patients use the bus, so it’s difficult to access public vaccine centers without a car.

“It’s a tremendous barrier,” he stated when “our patients are being asked to choose between earning a day’s living and or vaccinating their children.”

The KFF survey also confirms that underlying socio-economic factors cause vaccine hesitancy. People worry they may have to pay out-of-pocket costs for the vaccine. Fears about immigration status and vaccine eligibility have created vaccine hesitancy because of requirements for a social security number or government-issued identification to get vaccinated (34%), a lack of trust in the provider (32%), or travel difficulties reaching vaccination sites (15%).

Allison Winnike of Texas-based Immunization Partnership told KERA news that their data showed increased vaccination rates in communities of color who were initially skeptical, but that there were higher hesitancy rates among some people that self-identify as more conservative or evangelical.

As a parent himself, with children aged 3 and 4, Vivek Murthy empathized with the challenges of parenting kids in a pandemic which has percolated into kids’ lives in an extraordinary way. “Parents have had to have difficult conversations with their kids about why they can’t see friends and family or have to go to virtual classes.” But parents also worry about the risks of taking their children to the playground or back to school, he said, which is why vaccinating them should be the highest priority.

Why Parents Should Worry

A joint report from the American Academy of Pediatrics and the Children’s Hospital Association found that Covid is now one of ten leading causes of death among young people who make up 22% of all new Covid cases, compared to only 3% a year ago.

“It’s a significant disease. Kids are also at risk,” said Dr. Grace Lee, Professor of Pediatrics at Stanford University School of Medicine. She has personally seen children hospitalized and dying from the virus. Lee pointed out that less attention had been paid to the ‘burden of infection’ on children, though AAP data has confirmed that 4 million children have tested positive for Covid 19 since the onset of the pandemic. She warned that the CDC noted that when adjusting for under-reporting or under-testing on children, at least “22 million children and adolescents 5 to 17 years have been infected in the US since the pandemic began.” Forty percent of children who are hospitalized have no high-risk conditions like asthma, diabetes, obesity or developmental delay or immune compromise issues, said Dr. Lee, “So, we cannot predict who will be hit more severely by Covid 19 infection.”

“We have to protect children from Covid disease,” Dr. Yvonne Maldonado, a principal investigator at Stanford Pfizer trials told NBC. She reiterated that vaccines are necessary for herd immunity. Reports of long-term side effects in teens are only rumors spread by anti-vaxers she added. “There is no evidence that vaccines cause fertility issues – it’s an idea that “has been disproven over and over again.”

In Texas, Priya Flores agrees. “We are a family of scientists and I strongly believe that facts should impact your decision making.” As a healthcare professional, she was in the early wave of those vaccinated . “I felt lucky and grateful I could access the best of what science could offer.  When my extended family who wasn’t vaccinated got sick with Covid, I was able to help them because I was better protected by the vaccine. It was challenging because I wanted my husband and kid to get it too.”

How to Move Forward

Getting that shot in the arms of adults and children means that “The role of people of color like me and professionals like me becomes very important,” said Dr. Perez. Providers who are POC need to dispel misinformation and encourage parents to vaccinate themselves and their children, because when “patients trust people that look like them, the more likely they are to listen to our voices.”

“We have paid a heavy price” said Dr. Murthy, referring to the unprecedented toll on human lives by the virus, but the US has a pathway out of the pandemic with its arsenal of vaccines that time and again, have proven effective.

In Texas, the CDC reports that 51.73% of Texans are fully vaccinated. But Priya Flores says her family is only ‘half protected’ from the virus as she waits for her son’s age group to be approved.  “I often tell my husband our job has shifted from constant vigilance in general to vigilance for our son. We have relaxed a bit, but once again, …the virus hasn’t disappeared, and our fellow Americans haven’t decided to help our children gain herd immunity. So here we are again.”

“If someone asked my son to be part of a vaccine trial I would say yes. I believe in this vaccine and that it is safe and effective for almost all, with the understanding that there will always be vulnerable populations that need higher monitoring and consideration before deciding to take it.”


Meera Kymal is the Contributing Editor at India Currents
image source: CDC


 

Did It Feel Like A Truck Hit You After Your Covid Vaccination?

If you think vaccination is an ordeal now, consider the 18th-century version. After having pus from a smallpox boil scratched into your arm, you would be subject to three weeks of fever, sweats, chills, bleeding and purging with dangerous medicines, accompanied by hymns, prayers and hell-fire sermons by dour preachers.

That was smallpox vaccination, back then. The process generally worked and was preferred to enduring “natural” smallpox, which killed around a third of those who got it. Patients were often grateful for trial-by-immunization — once it was over, anyway.

“Thus through the Mercy of God, I have been preserved through the Distemper of the Small Pox,” wrote one Peter Thatcher in 1764, after undergoing the process in a Boston inoculation hospital. “Many and heinous have been my sins, but I hope they will be washed away.”

Today, Americans are once again surprisingly willing, even eager, to suffer a little for the reward of immunity from a virus that has turned the world upside down.

Roughly half of those vaccinated with the Moderna or Pfizer-BioNTech vaccines, and in particular women, experience unpleasantness, from hot, sore arms to chills, headache, fever and exhaustion. Sometimes they boast about the symptoms. They often welcome them.

Suspicion about what was in the shots grew in the mind of Patricia Mandatori, an Argentine immigrant in Los Angeles, when she hardly felt the needle going in after her first dose of the Moderna vaccine at a March appointment.

A day later, though, with satisfaction, she “felt like a truck hit me,” Mandatori said. “When I started to feel rotten I said, ‘Yay, I got the vaccination.’ I was happy. I felt relieved.”

While the symptoms show your immune system is responding to the vaccine in a way that will protect against disease, evidence from clinical trials showed that people with few or no symptoms were also protected. Don’t feel bad if you don’t feel bad, the experts say.

“This is the first vaccine in history where anyone has ever complained about not having symptoms,” said immunologist Dr. Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia.

To be sure, there is some evidence of stronger immune response in younger people — and in those who get sick when vaccinated. A small study at the University of Pennsylvania showed that people who reported systemic side effects such as fever, chills and headache may have had somewhat higher levels of antibodies. The large trial for Pfizer’s vaccine showed the same trend in younger patients.

But that doesn’t mean people who don’t react to the vaccine severely are less protected, said Dr. Joanna Schaenman, an expert on infectious diseases and the immunology of aging at the David Geffen School of Medicine at UCLA. While the symptoms of illness are undoubtedly part of the immune response, the immune response that counts is protection, she said. “That is preserved across age groups and likely to be independent of whether you had local or systemic side effects or not.”

The immune system responses that produce post-vaccination symptoms are thought to be triggered by proteins called toll-like receptors, which reside on certain immune cells. These receptors are less functional in older people, who are also likely to have chronic, low-grade activation of their immune systems that paradoxically mutes the more rapid response to a vaccine.

But other parts of their immune systems are responding more gradually to the vaccine by creating the specific types of cells needed to protect against the coronavirus. These are the so-called memory B cells, which make antibodies to attack the virus, and “killer T cells” that track and destroy virus-infected cells.

Many other vaccines, including those that prevent hepatitis B and bacterial pneumonia, are highly effective while having relatively mild side effect profiles, Schaenman noted.

Whether you have a strong reaction to the vaccine “is an interesting but, in a sense, not vital question,” said Dr. William Schaffner, a professor of infectious disease at Vanderbilt University Medical Center. The bottom line, he said: “Don’t worry about it.”

There was a time when doctors prescribed cod-liver oil and people thought medicine had to taste bad to be effective. People who get sick after covid vaccination “feel like we’ve had a tiny bit of suffering, we’ve girded our loins against the real thing,” said Schaenman (who had a slight fever). “When people don’t have the side effects, they feel they’ve been robbed” of the experience.

Still, side effects can be a hopeful sign, especially when they end, says McCarty Memorial Christian Church leader Eddie Anderson, who has led efforts to vaccinate Black churchgoers in Los Angeles. He helps them through the rocky period by reminding them of the joyful reunions with children and grandchildren that will be possible post-vaccination.

“I’m a Christian pastor,’’ he said. “I tell them, ‘If you make it through the pain and discomfort, healing is on the other side. You can be fully human again.”


This story was produced by Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.

image credit: getty images at KHN

In Santa Clara County, Nearly 67% Of Residents 16 + Have Had A Vaccine Shot

The Number of Californians With at Least One Covid Vaccine Dose Continues to Rise.

More than 75% of California’s seniors have had at least one dose, which makes epidemiologists hopeful that other age groups will follow suit

Demand for covid vaccines is slowing across most of California, but as traffic at vaccination sites eases, the vaccination rates across the state are showing wide disparities.

In Santa Clara County, home to Silicon Valley, nearly 67% of residents 16 and older have had at least one dose as of Wednesday, compared with about 43% in San Bernardino County, east of Los Angeles. Statewide, about 58% of eligible residents have received at least one dose.

The differences reflect regional trends in vaccine hesitancy and resistance that researchers have been tracking for months, said Dean Bonner, associate survey director at the Public Policy Institute of California, a nonpartisan think tank.

In a PPIC survey released Wednesday, only 5% of respondents in the San Francisco Bay Area and 6% of those in Los Angeles said they wouldn’t be getting vaccinated. But that share is 19% in the Inland Empire and 20% in the Central Valley.

“More urban areas might be hitting a wall, but their number of shots given is higher,” said Bonner. “The rural areas might be hitting a wall maybe even before, but their shots given isn’t quite as high.”

Infectious disease experts estimate that anywhere from 50% to 85% of the populationwould need to get vaccinated to put a damper on the spread of the virus. But overall state numbers may mask pockets of unvaccinated Californians, concentrated inland, that will prevent these regions from achieving “herd immunity,” the point at which the unvaccinated are protected by the vaccinated. Epidemiologists worry that the virus may continue to circulate in these communities, threatening everyone.

The regional differences could be attributed, at least in part, to political opposition to the vaccine, said Bonner, as about 22% of Republicans and 17% of independents in the survey said they wouldn’t be getting the vaccine, compared with 3% of Democrats.

But officials and epidemiologists see some encouraging signs that the state has yet to hit a wall of vaccine refusal. “As a strongly blue state, one would expect that California is less likely than red states to hit a relatively low ceiling of vaccination, assuming that the access is good and the messaging is strong,” said Dr. Robert Wachter, chair of the department of medicine at the University of California-San Francisco School of Medicine.

As of Wednesday, 77% of seniors in California, and 68% of those ages 50 to 64, had received at least one dose of covid vaccine, according to a KHN analysis. These large percentages reflect the early vaccine eligibility of these age groups and are a hopeful sign considering how difficult it was to get a shot in the beginning of the year, said Rebecca Fielding-Miller, an assistant professor at the University of California-San Diego specializing in infectious diseases and public health.

“I’m very hopeful that addressing access would pick up at least another 10-15% before we need to really start addressing myths and hesitancy issues,” she said.

The state could see a new jump in vaccinations as workplaces, schools and event organizers begin to require the shots, Wachter said. For example, the University of California and California State University systems announced April 22 that their 1 million-plus students and staff members will be required to get vaccinated against covid once the shots are formally licensed by the Food and Drug Administration, likely to occur this summer.

Still, the red-blue political distinction on vaccination is meaningful within California as well as nationally. Despite depressed vaccine demand across the board, counties that lean conservative have lower rates of vaccinations.

In true-blue Los Angeles, 4.5 million first covid vaccine doses have been administered, meaning that about 55% of eligible Angelenos have gotten at least one shot.

But first-dose appointments at county-run sites were down at least 50% last week, said public health director Barbara Ferrer on Thursday. The county has opened several sites where people can walk in and get vaccinated without an appointment, but these walk-ins don’t make up for all of the unfilled spots.

Last week probably marked the first time the county did not administer 95% of the doses distributed to it, she said.

In San Diego and Orange counties, meanwhile, vaccination appointments are going unfilled or taking days to get booked up.

About 20% of appointments in Orange County started going unclaimed on April 25 and the slack has persisted, said Dr. Regina Chinsio-Kwong, deputy health officer.

However, based on survey data from last winter indicating that about 58% of Orange County residents plan to get vaccinated against the coronavirus, the county is still expecting more residents to seek out appointments. As of Sunday, about 49% of residents had received at least one dose.

In San Diego, officials expect all appointments to be filled despite the slowdown, said county spokesperson Michael Workman. About 54% of eligible residents had received at least one dose as of Wednesday.

In San Bernardino, the slowdown started in late March, said county spokesperson David Wert. Only 42% of county residents had gotten at least one dose as of Monday.

Across the state, officials are unclear on the extent to which hesitancy or lack of access to a vaccine are responsible for the slowdown.

Campaigns to educate, convince and reach out to people have started to pick up throughout the country, including targeted messaging for conservatives. Ten GOP doctors in Congress recently issued an ad urging their constituents to get vaccinated.

Santa Clara is shifting most county-run sites to enable walk-ins and expanding evening and weekend hours to make it easier for working people to get a shot. San Diego and San Bernardino are also allowing walk-ins.

Other counties are returning unused doses to the state to be redistributed, a bounty from which Los Angeles County has benefited, according to Barbara Ferrer, director of the county public health department. Representatives from Blue Shield and the California Department of Public Health would not say which counties are sending doses back.

California’s good pandemic news, which has enabled counties to reopen many businesses, is one of the challenges to getting less-than-enthusiastic people in for their shots right now, said Wachter of UCSF.

As of Thursday, California has one of the lowest case rates in the U.S. at 31.3 cases per 100,000 and a covid-test positivity rate of 1.3%.

“My hope is that a strong communication campaign, perhaps coupled with some degree of vaccine requirements, will get some people to jump off the fence,” Wachter said.


This story was produced by Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.

Image: County of Santa Clara Public Health Department

To book your appointment go to https://covid19.sccgov.org/covid-19-vaccine-information