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OPINION

For a safe return to school, children must be vaccinated

The COVID-19 vaccines are safe and effective in children, but they are only effective when shots are put in arms.

Hamilton Bermudez, 14, receives his Pfizer COVID-19 vaccine, administered by medical assistant Karina Cisneros from St. John's Well Child & Family Center, at Abraham Lincoln High School, in Los Angeles in May.
Hamilton Bermudez, 14, receives his Pfizer COVID-19 vaccine, administered by medical assistant Karina Cisneros from St. John's Well Child & Family Center, at Abraham Lincoln High School, in Los Angeles in May.FREDERIC J. BROWN/AFP via Getty Images

The United States has a narrow window to prepare for a safe and productive school year.

On May 10, the Food and Drug Administration expanded the Emergency Use Authorization of the Pfizer COVID-19 vaccine to children ages 12 to 15. This added 17 million people to the eligibility pool for vaccination. Combined with 16- and 17-year-olds, who were previously eligible for Pfizer’s vaccine, the 25 million people in this age group are critical to slowing the spread of COVID-19. Yet this age group has among the lowest vaccination rates nationally.

Opening schools this fall is essential. School start dates are just weeks away for many school districts. Given that the Delta variant now accounts for 83 percent of the cases in the United States, the Centers for Disease Control and Prevention needed to adjust its strategy on masking. The CDC now recommends that everyone in K-12 schools wear a mask indoors, including teachers, staff, students, and visitors, regardless of vaccination status.

The science is evolving and states need to adapt proven strategies to ensure adequate vaccination levels. We also need to galvanize support for vaccinating kids and set goals to advance vaccine access and acceptance for children.

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While much of the focus around vaccination has been on vaccinating adults, data from the CDC show that, nationally, 41 percent of children ages 12 to 17 have received one dose of the vaccine, with only 28 percent fully vaccinated. Vaccination rates vary dramatically across states, with 70 percent of children in Vermont having received at least one dose, compared with 16 percent in Mississippi.

Percentage of population age 12 to 17 with at least one dose of a COVID-19 vaccine
Percentage of population age 12 to 17 with at least one dose of a COVID-19 vaccineBenjy Renton/ Ariadne Lads; CDC dataset access date - July 28, 2021

It is essential to vaccinate children as soon as possible in order to prepare for the upcoming school year. The CDC emphasizes vaccination as the leading public health strategy to minimize transmission in schools, saying that “promoting vaccination can help schools safely return to in-person learning as well as extracurricular activities and sports.”

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Across the country there is a troubling pattern: Children in counties with low vaccination rates are at increased risk of getting infected. While there are pockets of vaccinated children living in highly vaccinated counties, the majority are unvaccinated and may be living with unvaccinated adults.

Despite the benefits of vaccination, little emphasis has been placed on vaccinating children in time for the start of school.

At the current pace of vaccination for this age group in each state, our analysis shows that just three states — Vermont, Massachusetts, and Connecticut — would meet the target of 70 percent of kids with at least one dose by Sept. 1. Some states would meet the goal in summer 2022 or later.

States must do better.

The United States is fortunate to have the supply and distribution capacity to vaccinate all children in this age group in a matter of weeks; it is imperative that states accelerate their current pace. In the absence of mandates, at least eight states have enacted legislation that would prohibit public schools from requiring vaccines or documentation of vaccination status.

In order to increase uptake in vaccinations among this age group, states must work with existing delivery channels and increase access. A survey by the Kaiser Family Foundation found that 85 percent of parents trust their child’s pediatrician for reliable information about the COVID-19 vaccine. Providers must be equipped with the systems needed to administer COVID vaccine and make up for missed routine vaccination. In addition, messaging surrounding children and the vaccine must be accurate and updated. Both parents and their children need tailored messages to explain the increased risks of infection, especially with the Delta variant, and the unknowns of long-term sequelae of COVID-19 in children.

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Finally, the most powerful conversations around the vaccine can be held in our homes. We encourage all families to read and learn about vaccines, how immunity works, and how they can reduce their personal risk and community risk with vaccination. There need to be local, state, and national goals to gain momentum and decrease transmission in communities.

While this summer we can spend time outdoors, the rising case counts and potential transmission this fall are worrisome. The vaccines are safe and effective in children, but they are only effective when shots are put in arms.

Dr. Rebecca Weintraub is an assistant professor at Harvard Medical School and Ariadne Labs and associate physician at Brigham and Women’s Hospital. Benjy Renton is an analyst at Ariadne Labs. Dr. Georges C. Benjamin is executive director at the American Public Health Association and professorial lecturer at Milken Institute School of Public Health, The George Washington University.