Pediatricians and Schools Will Play Key Role in Vaccinating Children 5-11

Now that the Pfizer COVID-19 vaccine is officially authorized for children 5 to 11 years old, the White House is ready to begin the rollout.

On October 29, the Food and Drug Administration (FDA) authorized vaccines for children in this age group. Soon after, a Centers for Disease Control and Prevention (CDC) advisory panel voted November 3 to recommend the shot. Thanks to CDC Director Rochelle Walensky's subsequent sign-off on the decision, 28 million children are now eligible for the shot.

After the FDA authorization, the Biden administration ordered 15 million Pfizer doses to prepare for the demand.

“Our planning efforts mean that we will be ready to begin getting shots in arms in the days following a final CDC recommendation,” the White House said in a statement.

Children in this age group will have the option to be vaccinated at their doctor's offices, school clinics, community health centers or pharmacies.

“To get children vaccinated will take a village,” Amy Wimpey Knight, MHA, president of the Children’s Hospital Association, tells Verywell. “Everyone has a role. Locking arms, moving together, and making sure that families feel informed, can make good decisions, and can have their kids safely vaccinated is all of our goal.”

Meeting Kids Where They're Comfortable

Different from the rollout for adults and teens, children will not have the option to go to a mass vaccination site.

Instead, the White House is calling on pediatric and general practitioners to administer shots to their patients and answer any questions they have. Many families rely on these care teams to provide accurate and dependable information about health concerns related to COVID-19 and beyond.

“Signing up on an unfamiliar website for an unfamiliar vaccination location from unfamiliar staff has been a barrier for many people," Anne Liu, MD, pediatric immunologist and infectious diseases physician at Stanford Children’s Health, tells Verywell in an email. "Many people have more trust in their own primary doctors and pediatricians to administer a vaccine. I hope this will improve equity and access to the vaccines, compared to the earlier rollout for adults."

Schools can also be key sites for increasing vaccine access and equity.

Nava Yeganeh, MD, MPH, a pediatrics and infectious disease specialist at University of California Los Angeles, has been supporting the LA Department of Health with its school-based vaccine clinics for more than a year. In many communities, schools are spaces that are easy to access and familiar to children.

“We're looking at ways to design clinics to really minimize anxiety in young children,” Yeganeh tells Verywell.

Reducing the wait time prior to vaccination is one way to do that, she says. Clinics might also offer quiet spaces for kids who are nervous about getting shots. They could set up play areas or activities for children to keep occupied during the 15-minute waiting period after receiving the shot, while providers ensure they don’t have any severe adverse reactions.

The privacy of a doctor’s office can also create a more comfortable environment for families to ask questions and for children to receive the shot, Knight adds. But offering shots at more intimate spaces rather than mass vaccination sites adds a new layer of logistical complexity.

“It is very different not to have mass vaccination sites and really rely on this broad distribution,” Knight says. “Now we're going to have to be a little more strategic to make sure that families have access somewhere close to them.”

The vaccines will be administered with smaller needles than those used for the adult shots. As with the previous vaccination campaigns, shots will be free to all Americans and the federal government will reimburse vaccination operations and outreach programs.

Mobilizing Health Systems

More than 25,000 pediatric and primary care provider sites will offer vaccinations for children, the White House said. Working with community-based organizations and schools will also allow families to access vaccination sites at times that are convenient for them.

The Biden administration will partner with the Children’s Hospital Association to educate health care professionals and families about the vaccines. Providers in these health systems are also positioned to reach the most at-risk children, like those with obesity, diabetes, asthma, and immunosuppression. 

“Many of them take care of the most vulnerable kids in our communities—those that are high risk, given a chronic or complex healthcare condition,” Knight says. “Ensuring that those patients have access to vaccination is very high on their list in addition to making sure that children have access no matter where they live or what their situation is.”

Addressing Vaccine Hesitancy

An October poll found that only a quarter of parents would vaccinate their kids 5 to 11 years old right away. A third said they would wait and see, and another third said they would definitely not vaccinate their children.

Deborah Lehman, MD, pediatric and infectious disease specialist at University of California, Los Angeles, says that children remaining unprotected from COVID-19 would affect people around them.

“Children who are 5 to 11 definitely infect other vulnerable household members, even those that have been immunized. Children who get infected are then out of school and have to quarantine at home and parents have to take time off work,” Lehman tells Verywell. “It has this sort of ripple effect.”

Yeganeh says that her team in LA focuses its outreach efforts in areas with low vaccination and high COVID-19 case rates. This includes holding town halls with health professionals who can answer questions about the benefits and risks of vaccinating this age group.

Throughout the pandemic, clinics have effectively stopped giving shots when regulators indicated they may pose a risk, she adds.

“We are constantly looking for these different types of safety signals and trying to make sure we get this information to the public as soon as possible,” she says. “It’s worked really well through this through this vaccine campaign.”

Knight notes that health providers can create messaging to address the specific concerns in their communities. This includes providing information in multiple languages and offering interpretation services. She expects to see a “domino effect”—as some kids begin to return to normal activities, other families will feel motivated to have their children vaccinated as well.

“Hopefully we will see, as we've seen with each prior group, that people emerge from the vaccination a little bit healthier and their mental health a little bit better, because they feel safer as well as they as they go about,” Knight says. “As long as we're seeing healthy kids returning somewhat to normal, I think we're all moving in the right direction.”

Vaccinating Children is a Group Effort

One hurdle for some places might be mustering the collective energy to open up clinics and vaccination sites again. For instance, staff at school-based clinics may experience COVID-19 fatigue as some vaccine outreach campaigns stretch into their 11th month, Yeganeh says.

“We're asking them again, to open up their schools to provide childcare staff, to provide guidance and signs and work on a day or an evening where they usually wouldn't be at school. I do recognize that we are asking schools to take on even more of a burden,” Yeganeh says. “We're so thankful that so many schools are willing to do this.”

Knight says that health providers understand the importance of vaccinating children to protect that population and other vulnerable people.

“It's a huge turning point for our country in terms of moving out of this pandemic,” Knight says. “I think everyone's going to bust through the wherewithal and figure out how to get it done.”