In the three months since regulators approved a COVID vaccine for young children, Dr. Mike Cascarina and his colleagues at his Ocean County family practice have been trying with mixed results to convince parents about the benefits of getting the shots — as have doctors throughout the state.
Yes, it is rare for a healthy child to become severely ill from COVID — but it does happen and vaccines reduce that risk significantly, pediatric doctors tell resistant parents. Yes, the vaccinated can still transmit the virus — but vaccines can shorten the window for transmission, which helps prevent kids from infecting older, more susceptible people. And severe side effects from the vaccine are extremely rare.
Despite those arguments in favor of getting children vaccinated, just over 1 of 4 New Jersey children are fully vaccinated against COVID three months into the campaign, according to data from the state Health Department. And only 1 out of 3 have received at least one shot.
Even as the latest COVID wave is waning, pediatricians and public health officials have raised concern about the long-term implications of the low vaccination rate in New Jersey and elsewhere among 5- to 11-year-olds, especially if another variant emerges as deadly and contagious as the delta and omicron strains.
“It’s concerning but it’s not surprising,” Cascarina, president of the New Jersey Academy of Family Physicians, said of the rates. “There is this large undercurrent of vaccine hesitancy especially among the young … not young children, but young parents.”
Even with the low rates, Gov. Phil Murphy plans to eliminate his statewide mask mandate in New Jersey schools on March 7 leaving the decision in the hands of local school officials. Murphy is expected to make that announcement on Monday.
Now that initial problems with vaccine distribution have subsided, the low vaccination rate among children is mostly driven by the spread of misinformation and a general sense of complacency among parents, pediatricians say. It bears out in the statistics.
As of Feb. 1:
- 203,995 of approximately 761,000 5- to 11-year-olds in New Jersey have gotten two shots.
- That means 26.8% in that age group are fully vaccinated.
- 36.4% of 5- to 11-year-olds have received at least one dose.
Like many Northeast states, New Jersey’s vaccination rate among children is above the national average. As of Feb. 2, about 22% of 5- to 11-year-olds were fully vaccinated in the U.S., and 30% had received at least one shot.
The low rate comes as the federal government appears poised to expand vaccinations to even younger children. The federal Food and Drug Administration took the unusual step last week of asking Pfizer to apply for vaccine approval for children 6 months to 4 years old because of a recent increase in illnesses and hospitalizations in this youngest age group.
“This is the age range that is getting their full slate of vaccines each year so I’m hopeful the COVID vaccine will just be another shot that is given,” said Dr. Mona Rigaud, chief of pediatric services at NYU Langone Hospital-Brooklyn. “But the numbers have to pick up across the board. Having such a low rate will continue to make children susceptible to COVID and will help fuel the cycle of transmission as well.”
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Young children in New Jersey began receiving shots on Nov. 3, a day after federal regulators approved a two-shot regimen for 5- to 11-year-olds that is a third of the dose of the adult vaccine. There was a rush for shots during the first few weeks but that dropped off considerably in December — just as cases, hospitalizations and deaths began to surge due to the delta and omicron variants.
A common reason parents give for not having their children vaccinated is that COVID is not nearly as dangerous to children as it is to older adults.
Of New Jersey’s 31,000 COVID deaths, only 12 have been among those younger than 18.
More than 320,000 in that age group have tested positive, representing about 18% of all COVID cases in New Jersey.
But Health Commissioner Judy Persichilli reported in late January four “COVID-associated” child deaths, including three infants since Christmas.
The deaths are “a reminder that COVID-19 isn’t always a benign illness in children,” she said.
Wait and see
Some parents said at the beginning of the vaccination campaign that they would adopt a wait-and-see approach, and have still not gotten their kids vaccinated, even though there have been no reports of widespread, serious side effects.
“We’ve had more than 8 million children in this country get at least one dose so far and that’s a really good data set,” said Dr. Melissa Stockwell, a practicing pediatrician and chief of the Division of Child and Adolescent Health at Columbia University’s Vagelos College of Physicians and Surgeons.
“Add in the trials,” she said. “Add in the vaccines we’ve given to millions of adolescents. We now have more experience with this vaccine than so many others.”
But pediatricians are also fighting a disinformation campaign waged on social media. Within an hour of one of the first New Jersey kids receiving a shot in November, a wave of mostly anonymous anti-vaccine Twitter users belittled the child’s parents, suggesting they be arrested on child abuse charges and that the boy would soon die from side effects.
Some younger parents adopt anti-vaccine stances based on what they see on social media, Cascarina said.
“They think a child’s immune system is weak and can’t handle the vaccine. It’s not,” he said. “In fact, it’s probably a lot better than their parents. They haven’t smoked. They haven’t had a drink. They’re not obese. They don’t have a chronic illness.”
One factor that may be slowing down the child vaccination rate somewhat is the large number of children who became infected over the holidays due to the highly-contagious omicron variant and who therefore must delay getting shots.
Of the 11.4 million children nationwide who have tested positive since the pandemic began nearly two years ago, almost 2 million of those cases occurred over two weeks in January 2022, at the height of the omicron surge, according to the American Academy of Pediatrics. Children were being tested at a much higher rate than ever before due to indoor gatherings, holiday travel and more robust testing in schools at the start of the New Year.
Cascarina said he has had some luck convincing reluctant parents and adult patients to get the vaccine in part because he’s known many of them for years, if not decades. So far, 13,000 of his 16,000 patients have been vaccinated and only one person had significant side effects, a woman who developed hives on her face. Not one of his vaccinated patients has died from COVID. But he has two unvaccinated adult patients in very serious condition in the hospital, he said.
“Trust is very important between doctor and patient, even more so when it involves children,” he said. “That’s why we’re still telling them, get your kid vaccinated.”
COVID vaccine doses are given at different amounts according to age.
- Everyone 12 and over gets a 30-microgram dose.
- Children 5 to 11 years old get a 10-microgram dose.
- If the new vaccine proposal is approved, children under 5 would receive a 3-microgram dose.
Scott Fallon has covered the COVID-19 pandemic since its onset in March 2020. To get unlimited access to the latest news about the pandemic’s impact on New Jersey, please subscribe or activate your digital account today.
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