Children of color lack access to COVID-19 vaccines, and that's sadly 'not a surprise,' experts say
- Pfizer and BioNTech have determined their COVID-19 vaccine is safe for children 5 to 11 – a population about three times as large as the 12-to-17 year-olds currently eligible – and submitted its findings to the FDA for review.
- Children of color experienced higher rates of infection, hospitalization and death from COVID-19, according to CDC data.
- What can we do? "I want us to do what we didn't do for adults: Get the messaging right, right now,” one expert says.
COVID-19 vaccine could be available for younger children in a matter of weeks – but experts worry whether communities of color will have an equal shot at protecting their kids.
Though a lack of data on pediatric vaccinations by race persists, disparities are seen between Black and white kids in most of the few states providing public information. Clinicians fear hesitancy and a lack of access to vaccine among poorer children and children of color because of their higher risk.
"It's not a surprise that this is happening. We obviously had disparities with their parents, so why shouldn't we have disparities with their kids?" said Dr. Georges Benjamin, executive director of the American Public Health Association.
Children made up more than a quarter of all weekly cases as of Sept. 23, according to the American Academy of Pediatrics, as the highly contagious delta variant spreads.
Children of color experienced higher rates of infection, hospitalization and death from COVID-19, according to the Centers for Disease Control and Prevention. They’re also more likely to develop multi-system inflammatory syndrome, a sometimes deadly condition.
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Since the start of the pandemic through Sept. 18, children who are Indigenous, Black, Hispanic or Latino were all hospitalized about three times more often than white children and teens, according to the CDC.
Pfizer and BioNTech determined their COVID-19 vaccine is safe for children 5 to 11 – a population about three times as large as the 12-to-17-year-olds eligible – and submitted their findings to the FDA for review.
Shots for kids as young as 12 have been available since around May. National data on vaccination rates among children and teens isn’t available by race. An analysis by the Kaiser Family Foundation found only seven states reporting that breakdown.
'We just don’t have good data on race'
Pediatricians told USA TODAY they are “frustrated,” “disappointed” and “disheartened” with the lack of transparency.
Dr. Sabrina Assoumou, a public health expert and professor of medicine at Boston University, specializes in infectious disease, pediatrics and internal medicine. She said more data on children vaccinated by race is critical for equity.
“I’m actually disappointed that at this point, we just don’t have good data on race,” she said. “I need to see the full picture. Back in spring of 2020, we were talking about the lack of data for adults … I mean, we should’ve learned from that.”
States publicly releasing that information offer a concerning glimpse.
Researchers found in Connecticut that slightly more than a third of Black children ages 12 to 15 got the shot versus 66% of white children.
There's a similar wide disparity in Washington, D.C., where, as of Sept. 7, about 25% of Black children 12 to 17 were vaccinated, compared with almost 75% of white and 83% of Hispanic children.
In Michigan, 27% of Black children were vaccinated, compared with 42% of white children, KFF's analysis shows.
Dr. Sharon Marshall, an adolescent medicine specialist in downtown Detroit, said she's concerned for her patients, a majority of whom are Black and at high risk. Many have chronic kidney disease or other illnesses, and most have Medicaid and are low-income. Citing fear of complications or lack of trust in the government, many of her teen patients refuse the shot.
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She sighed deeply recalling patient after patient who passed on the shot. One was at greater risk because of a chronic illness but was afraid to get the shot. Another was sent to the emergency room several times after contracting the virus. Others lost family members but feared complications from vaccines.
"I can see the same trend continuing," she said. "It's been really sobering."
Other states showed smaller gaps. In Minnesota, the percentage of Black children vaccinated is 7 percentage points lower than their white peers. In Kansas, Black children are vaccinated 5 percentage points less.
In South Carolina, the rates were roughly equal – about 30% and 29% of white and Black children, respectively, getting the shot. The state's overall vaccinated rate is 43%.
North Carolina wasn't included in KFF's analysis, but in figures provided by state health officials, Black and white children were vaccinated at around the same rates.
In all but two of the seven states, Hispanic children around the same or higher vaccination rates compared with white children.
'Get the messaging right, right now'
Although extensive outreach efforts have helped to narrow racial disparities among adults, Benjamin said structural barriers remain.
Kids rely on their parents' help and permission. "It's not something where the kid can just get up and go to the CVS and get their shot," he said.
Benjamin called for better public health messaging and campaigns for hesitant parents.
"I want us to do what we didn't do for adults: Get the messaging right, right now," he said. "Start talking about the importance of vaccinating their kids."
Assoumou said the few available figures on race and vaccines show that "we're stumbling."
“We as medical professionals haven’t done the work to provide information and answer questions,” she said. “We have a lot of work to do.”
Assoumou and others speculated a lack of access and hesitancy among parents may drive the vaccine disparities in kids. She encounters friends, patients and colleagues who say they’re OK with getting the shot themselves – but are concerned about their children's safety.
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Yasmin Tyler-Hill, a pediatrician of more than three decades and professor at the Morehouse School of Medicine in Atlanta, said schools and pharmacies with flexible hours will be essential to ensuring younger kids get vaccinated.
Parents of color, who are overrepresented in certain industries, may not be able to get a weekday off work to take their child to a 9-to-5 clinic to get the shot, Tyler-Hill said.
“Access becomes an issue – locations who will take their insurance, distance from home, locations of the clinics,” she said. “What are the hours? How far are the local places where a child can get a vaccine in Black neighborhood versus a white neighborhood?"
She said certain areas lack pediatric experts to answer parents’ questions. Surveys have found pediatricians are a top trusted source for parents.
“We see a lot of rural kids in Georgia, for instance, where we are,” she said, where many counties don’t have pediatrics. “Taking your kids to get the vaccine – it’s work. ... Taking the vaccine to where the kids are always works better.”
Dr. Lee Beers, American Academy of Pediatrics president and professor of pediatrics at Children's National Hospital, said, "In areas where there are lots of inequities or historical difficulties in accessing health care or trusting health care, the pediatrician is even more crucial for families."
Dr. Kendra Liljenquist, a professor of pediatrics at the University of Washington and principal investigator at Seattle Children’s Hospital, said she worries kids’ barriers to vaccines will mirror those encountered by adults of color during the initial rollout.
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“I am worried,” she said. “We’ll see a lot of the same parallels for the reason of why these disparities exist. Kids are a part of a family unit, and so they’re very reliant on what the adults in their lives are able to access.”
Liljenquist said communities need to advocate for better data by race for kids at the local level, so they can determine where to target resources.
“Some of my own research work is looking at how we can create more transparency around reporting and really track what’s happening,” she said. “I’m frustrated that this is not reported as often as it needs to be.”