Virginia families should expect some delays in vaccinating 5 to 11-year-olds, officials say

The state is expecting enough supply, but there will likely be bottlenecks in scheduling appointments

By: - November 3, 2021 12:03 am

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After months of anticipation from families, Pfizer’s COVID-19 vaccines for five to 11-year-olds were authorized Tuesday after a sign-off from Dr. Rochelle Walensky, director of the U.S. Centers for Disease Control and Prevention.

But doctors and local health officials are urging patience even as thousands of vaccines, specially formulated for pediatric patients, flow into Virginia. State vaccine coordinator Dr. Danny Avula said supply isn’t a concern for health officials. But the first shipment of doses will be divided across the state and, in many cases, redistributed to local providers, likely creating some backlogs when it comes to booking appointments. 

“The availability is a little constrained because this is a new vial, it’s new packaging, it’s a new buffer,” said Breanne Forbes Hubbard, population health manager for the Mount Rogers Health District in southwestern Virginia. “So, we can’t just draw up from existing adult vials, unfortunately, because we have plenty of those ready to go.”

According to Avula, a total of 377,000 pediatric doses are expected to be delivered to Virginia in the first week of shipments — 252,000 of which will go to health departments, private practices and health systems. Another 125,000 will be delivered to pharmacies through a partnership with the federal government.

That supply is enough to vaccinate more than half of the 723,000 children across Virginia who became eligible after Tuesday’s decision. And national polling by the Kaiser Family Foundation indicates only 27 percent of parents plan to get their 5 to 11-year-olds vaccinated “right away,” making it even less likely that the state won’t have enough shots to meet demand, Avula said (the same poll suggests that three in 10 parents “definitely” don’t plan to get their children vaccinated at all).

“The supply is not going to be a concern,” he added. But state health officials will again be tasked with matching shots to geographic demand. That was a challenge much earlier in the initial vaccine rollout, before doses became widely available to all adults in Virginia. At some points, clinics in rural areas with lower uptake were swamped with out-of-town visitors who weren’t yet eligible for appointments in their own home health districts.  

In an effort to meet demand, Avula said the state is tracking its initial distribution of pediatric vaccines to uptake among 12 to 15-year-olds, Roughly 57.5 percent of children in that age group have been fully vaccinated, according to data from the Virginia Department of Health, but numbers are highest in regions including Northern Virginia and Albemarle County (which have seen some of the highest uptake among all ages).

Those areas will also receive the largest distribution of doses for five to 11-year-olds, a decision that at least some preliminary surveys seem to support. In Fairfax County, for example, 76 percent of parents with children in that age group planned to get them vaccinated, based on a survey conducted by the local school system (though only 36 percent of families responded to the poll). 

In parts of Southwest Virginia, just under 60 percent of families planned to have their children receive the shots, according to Dr. Noelle Bissell, who currently directs the New River, Cumberland Plateau, Lenowisco and Mount Rogers health districts. Still, both she and Forbes Hubbard said a rush of demand from some families could create bottlenecks. 

Some shipments still have to be broken down into smaller allotments and distributed to local doctor’s offices. And while parents won’t have to pre-register their children with the state — a process that defined the earliest days of the vaccine rollout — many health districts are requiring appointments for five to 11-year-olds at local clinics to make sure they have the supply.

“There will be enough vaccine, but in these first weeks, everyone might not be able to get that appointment when they want it,” Bissell said. “We do ask that people have some patience. You’ll be able to get your child vaccinated, but it might not be right away.”

A worker with UVA Health moves doses of the Pfizer COVID-19 vaccine into ultra-cold storage. (Courtesy of UVA Health)

Even in districts receiving larger shipments, there could be delays in booking appointments over the next few weeks. Dr. Michael Martin, president of the Virginia chapter of the American Academy of Pediatrics, said that’s largely due to where most parents will seek out appointments. 

Pediatric vaccines will largely be available through the same providers offering shots to adults and adolescents, including pharmacies and local health departments. In most areas, health districts are also coordinating with public schools to offer clinics. 

But some polling, including Fairfax County’s survey, indicated that most parents preferred to have younger children vaccinated by their pediatricians. And Martin, who’s based in Northern Virginia, said many practices are still struggling with staffing and a huge demand for services as COVID-19 continues to circulate through schools. 

“I think over the next few weeks everyone who wants it will get it,” he said. “But we’re talking in the range of weeks, not days. We’re still backlogged, so there is going to be a bottleneck, even if a practice could get all the supply they wanted.”

Even with some expected delays, doctors and health officials are urging families not to wait on scheduling appointments. At the start of the pandemic, cases among children aged 0 to 17 accounted for less than two percent of COVID-19 infections in Virginia. Over the last three months, children have made up more than 20 percent of new infections, with some of the highest numbers among five to 11-year-olds who weren’t previously eligible for the vaccine.

Ten children have died from the disease, according to reporting from VDH, including six under the age of 10. And while there’s currently no evidence the delta variant is more dangerous to children than earlier versions of the virus, Forbes Hubbard pointed out that pediatric hospitalizations spiked during the latest surge.

“There are substantial health concerns, which is why the vaccine was authorized for this age group,” she said. Experts currently don’t know if contracting COVID-19 can have long-term effects on children, and at least 103 patients in Virginia have developed multisystem inflammatory syndrome, or MIS-C, which can lead to serious inflammation in various parts of the body.

There are also practical reasons for children to get vaccinated, she said. Under current public health guidelines, vaccinated individuals aren’t required to quarantine after potential exposures. And with spread still occurring in schools, immunizing children can help them avoid missing classes, sports and other events.

“It helps us get back to a more normal school life, a normal activity life,” Forbes Hubbard said. “Parents don’t have to miss as much work. And of course it helps us cut down on disease transmission overall, which helps prevent COVID from getting back into the community.”

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Kate Masters
Kate Masters

Kate grew up in Northern Virginia before moving to the Midwest, earning her degree in journalism from the University of Missouri. She spent a year covering gun violence and public health for The Trace in Boston before joining The Frederick News-Post in Frederick County, Md. Before joining the Mercury in 2020, she covered state and county politics for the Bethesda Beat in Montgomery County, Md. She was named Virginia's outstanding young journalist for 2021 by the Virginia Press Association.