The Executive Suite: 3 Considerations for vaccinating young patients against COVID-19

Prior to the COVID-19 pandemic, childhood vaccinations were considered largely unremarkable and uncontroversial. However, throughout this ongoing public health crisis, the topic of vaccinating young patients has come into question.

Some parents have asked whether children should be vaccinated against COVID-19 and tried to evaluate the danger posed by the spread of the omicron variant. Challenges to local school boards and state legislatures opposing vaccine mandates have yielded concerning results.

Look no further than Tennessee, where pressure from legislators led to the state health department banning all child vaccination outreach efforts including vaccinations for rotavirus, hepatitis A, influenza, and other diseases.

The need to vaccinate our children is urgent. According to a recent update from the American Academy of Pediatrics, as of December 16, "nearly 7.4 million children have tested positive for COVID-19 since the onset of the pandemic."

“COVID cases among children are extremely high: nearly 170,000 child cases were added the past week, an increase of nearly 28% over the last 2 weeks. For the 19th week in a row child COVID-19 cases are above 100,000. Since the first week of September, there have been over 2.3 million additional child cases.”

Currently, the Pfizer vaccine is approved and available for everyone 5 years of age and older. Both Moderna and Johnson & Johnson are awaiting clinical results and federal approval for their respective vaccines for children, but the good news is that one modern medical miracle is available for most minors across the country.

In light of these troubling trends and with a vaccine in the arsenal, it's incumbent upon physicians to make sure eligible children are vaccinated. Below are three considerations to help ensure minors nationwide receive needed, protective care.

1) Physicians should compile a registry of their pediatric patients eligible to receive the COVID-19 vaccination. Using surveys, emailed questionnaires, and text outreach programs, physicians should then determine which children have been fully or partially vaccinated and which have not.

Avoid overwhelming the parents with information or demands that they get vaccinated. They're likely feeling pressured or beleaguered, so they will not react well to an ultimatum from their physician.

A key part of this strategy is listening to their concerns, asking them what they are worried about, and responding to their questions with simple, dispassionate, and factual answers. If they are still reluctant, ask if you can revisit the topic with them again in another month or so; this can be a lengthy process.

2) Next, physicians should contact the parents of minors who are unvaccinated or partly vaccinated and attempt to persuade them that their children need to be vaccinated.

Several digital tools exist which can make this outreach more efficient and less labor-intensive than mailing postcards or conducting phone calls. Automated text messages and emails allow multiple, repeated points of contact and can direct parents to online sites with the most relevant information on why their children should be vaccinated.

While opposition to the vaccine may be hardening, pediatricians enjoy an advantage public health officials may not: namely, they are liked and trusted by patients. Generally, parents look to family physicians for guidance and follow their advice on care options for their children. Doctors can leverage that trust to convince skeptical parents to get their children vaccinated.

Even the medical office setting can be an advantage. Unlike a busy pharmacy or a crowded mass vaccination site, a doctor’s office offers a gentle, unobtrusive environment where a parent might be more open to counseling.

3) Finally, it's possible that a trusting relationship will not suffice. Some parents who wouldn’t balk at MMR or DTaP vaccinations will oppose COVID-19 shots. This is due to a variety of reasons, such as doubts about the virus' potency, the presumed danger it poses to children, or political ideologies and religious beliefs.

The initial outreach to parents is likely to yield the most significant results. Some parents will only require a reminder or gentle persuasion to agree to vaccination. Meanwhile, others may be convinced by the restrictions that schools place on unvaccinated students. However, as the vaccinated population grows, the holdouts could remain unreceptive and harden their resolve to not comply.

In the short term, pediatricians should update their vaccine registry monthly to stay current and to concentrate efforts on the vaccine holdouts. These clinicians may realize that they’re not going to succeed in every case, due to limits on the power of persuasion, but they shouldn't be discouraged. Rather every physician and nurse should treasure the victories gathered along the way because they are providing commendable services at a critical moment in history.