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Pandemic Puzzle: Vaccinating children

A Stanford Medicine researcher discusses COVID-19 vaccination for children and why it's important for them to get the shot.

The rapid development of COVID-19 vaccines is an astonishing example of scientific innovation and discovery under pressure. On Nov. 19, Grace Lee, MD, the associate chief medical officer for practice innovation at Stanford Children's Health and Paul King, the president and CEO of Stanford Children's Health discussed the recent approval of the use of the vaccine in children ages 5 to 12.

Lee is the chair of the Centers for Disease Control's Advisory Committee on Immunization Practices, or ACIP, and the virtual symposium - "Agile Discovery and Innovation: Advancing Tomorrow's Vaccines, Treatments, and Cures"-- was the last in a four-part Pandemic Puzzle series, hosted by the Stanford School of Medicine and the  Stanford Graduate School of Business, that examines how the United States -- and the world -- responded to the health crisis. After the event, I caught up with Lee to talk about the ACIP and the pressing need to protect children from the virus

You described the role of ACIP and the importance of maintaining public trust. What were some considerations around COVID-19 vaccine recommendations for children?

The pandemic has created a situation where nothing is normal, everything moves quickly, and data are constantly evolving. Priorities for the ACIP have always been to ensure that we apply a consistent process for reviewing the data, and that we are doing it in public view so there is transparency.

During a pandemic, speed and process are incredibly important. Ensuring that the public understands the rationale behind any recommendation is critical for maintaining ongoing public trust. The committee reviewed data on the health impact of COVID-19 infection in children -- including infection, hospitalization, multi-inflammatory syndrome in children, long COVID and death -- when considering the potential benefits and risks of vaccination.

Also, we recognized the broader impact COVID-19 infection has had in our children, including worsening educational disparities and the increased need for mental health,  social and emotional support for children.   

Is vaccine hesitancy in adults affecting COVID-19 vaccination rates in children? Are some groups more affected?

Similar to our experience with the adult vaccination program, I've had parents who have been overjoyed to have a vaccine available for their kids, parents who have questions and want to learn more, and parents who do not wish to vaccinate their kids and are also unvaccinated themselves. Among fully vaccinated parents, 82% reported their intent to have their child vaccinated, compared with 1% of parents who are unvaccinated, which means we need to address vaccine hesitancy in parents before we can reach kids. 

And the disparities in adults are also evident in children.  Sixty-eight percent of children hospitalized with COVID-19 are Black or Latino, and 61% of multi-inflammatory syndrome cases also occurred in Black or Latino children.

There's a common misconception that kids typically fare better than adults when infected with COVID-19? Why is it still necessary to vaccinate them?

COVID-19 infection is now the eighth-leading cause of death among children 5-11 years of age, and it's now preventable. If we simply compare pediatric outcomes to those of adults, we are undervaluing the importance of health in children.

In pediatrics, we don't make these comparisons for childhood cancer, type 1 diabetes, or congenital heart disease. Instead, we focus on what we can do to provide the best care for children with these conditions. My hope is that we can do the same for COVID-19.

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