The CDC’s recent approval of the Pfizer vaccine for children aged 5-11 is an important milestone in the fight against COVID-19. But the most important group’s approval of the vaccine still hangs in the balance: the parents. In order to convince them to vaccinate their children, parents need to have their concerns heard and addressed not by politicians, but by their trusted pediatricians.
The challenge is significant — parents have actually become more hesitant about vaccinating their children. A Kaiser Family Foundation’s (KFF) Vaccine Monitor poll found that the share of parents who would not get the vaccine for their child rose from 24 percent last month to 30 percent this month. Even more ominous, a new ABC News-Washington Post poll finds just 46% of parents are confident the vaccine is safe for 5- to 17-year-olds.
The issues underlying this hesitancy are neither surprising nor new. The value proposition of vaccines for adults has always been clear — vaccines lower the risk of infection, hospitalization, and death. But the risk-benefit calculation is less clear when it comes to children, where less than 2 percent have been hospitalized and fewer than 0.03 percent have died. David Leonhardt from the New York Times estimates that an unvaccinated child is at less risk of serious Covid illness than a vaccinated 70-year-old.
That lower risk is enough to cause some parents to pause as they evaluate whether the risks of a new vaccine are greater than the risks of their child catching a mild case of COVID. Indeed, according to the KFF poll, more than seven in ten parents of 5-11 year-olds say they are concerned that not enough is known about the long-term effects of the COVID-19 vaccine in children.
Convincing these parents will take a sustained effort from doctors, not politicians. It will be important to stress that while COVID seems to pose a lower risk for children compared to adults, it still accounts among the top 10 leading causes of death for children under 18. Vaccines are a powerful tool to help lower these preventable deaths. Follow-on studies using real world data of the vaccine’s efficacy will be even more important in reassuring nervous parents.
The Biden administration has also missed opportunities to depolarize the debate in order to increase trust around the vaccines. Imagine President Biden announcing the approval of vaccine during a press conference surrounded by all former FDA and CDC commissioners, state health commissioners, and pediatricians. It would have communicated a strong, bipartisan support for the vaccine and crossed over the narrow media channels people receive their information through. Instead, the administration adopted a go it alone approach despite more than 53 percent of adults not having much trust in Biden to provide accurate information about the coronavirus.
Where federal leadership is needed is in outlining the criteria that would begin to relax some of the layered mitigation measures recommended for schools. The messaging around this has been muddled at best leaving many schools to develop their own approaches. And it has also undercut confidence in the vaccine as parents question the value of vaccination if their children will have to continue wearing masks and distancing themselves from one another. We cannot ask parents to keep up these efforts indefinitely without an end in sight.
It’s unclear why the CDC hasn’t provided a framework to guide these decisions or even a sense of when to expect one. I asked two former senior health officials from the Obama Administration who are working with the White House what might signal that we’ve entered the endemic phase of COVID, meaning a time when the coronavirus is not necessarily defeated but largely manageable with lower risks of infection, hospitalization, and death. They both shrugged with one suggesting it was a judgement call.
At this point in the pandemic, that doesn’t quite cut it.
We need clear, easy to understand indicators that help orient individual and community actions. This will of course depend on community transmission and other contextual information, but we already do this in managing other risks — be it hurricane warnings or air quality alerts. People can respond to information when it is clear and actionable. In fact, knowing what metrics a community needs to reach in order to exit from more intensive mitigation measures might actually create an incentive for vaccinations.
Without a doubt, the administration deserves credit and our thanks for ensuring there was enough supply of the vaccine available for children the moment the CDC granted final approval. This was by no means an easy feat, nor was it guaranteed. It took months of careful planning and coordination with governors, pharmacies, and hospitals. Now, it’s time for them to put in the same amount of effort to fill in the crucial piece: gaining parents’ confidence and earning their trust as they face the difficult decisions that lie ahead.
John Bailey is a nonresident senior fellow at the American Enterprise Institute.