Coronavirus (Covid-19) and the vaccine: More details on the rollout for children age 5 to 11

Filed Under: Costs, Health plans, Patients

The rollout of the Covid vaccine for children 5 through 11 years old, expected this week, is full of uncertainty. Will my pediatrician give it? What are the chances at CVS? My local independent pharmacy? What about a school clinic for all the kids at our school? Or the big state- and city-run sites? There’s not a lot of clarity.

We have sought wisdom from any number of interested people — doctors, pharmacists, school officials, government officials and the like. The most consistent answer seems to be some variant of “we don’t know yet” or “check back later this week.”

A Southern Westchester woman who worked on the rollouts previously spoke to us on condition of anonymity about what she had heard from associates with experience. While many people would prefer to have their kids vaccinated at the pediatrician’s office, she said in a phone interview that “some doctors want responsibility for the vaccinations, and some do not.” (See our earlier post on this topic, a question-and-answer piece with more resources, here.)

She said one independent pharmacy and one other location told her “they were expecting the rollout will be approved by Wednesday and that everyone would have the correct doses by Thursday to start giving out. And I know that my kids’ pediatrician said that there is talk of many pediatric offices giving them out to the kids directly from their offices — but some doctors’ offices want the responsibility, some do not.”

Follow the money

She said part of the reason is that doctors are paid for the vaccine, but not for the staff members doing the actual shots. It’s very similar in Covid testing, she said; the actual tests are reimbursed by the government, but the people taking swabs are not. “They pay for the actual vaccine, but they’re not paying for someone to distribute it,” she said.

For some pharmacies, it’s the same problem, she said.

“So if I’m a doctor, and I’m giving the test, and I’m getting paid for the test, I’m still paying for my staff to be doing all the work and I have to pay out of pocket to pay them,” she said. This is true both of tests and vaccine delivery.

“If I’m paying three nurses on my staff to do whatever we do throughout the day, plus we have patients being tested, and they’re putting in to have those patients tested, and it’s coming out of my pocket, nobody’s paying for it,” she said. “It’s a little loophole that nobody kind of saw. Now all these doctors are saying, you know, it’s been like a year and a half, we’re doing vaccines, we’re doing testing, we’re doing all these things. And we’re not getting paid for the time to do it, only for the actual items.

“That’s why you’re seeing some of the pharmacies and others trying to do pop-ups at the school and things like that, where people are being paid specifically to give out the vaccine,” she said.

Pediatrician says ‘try a pharmacy’

One mom on Facebook wrote about her pediatric practice: “They are currently saying they have no plans to order the vaccine as they can’t see how they can manage sick appointments, well appointments, and vaccine appointments. They say it’s a ‘pick two’ situation, and that don’t want to turn sick patients away, which is what they would have to do to run Covid vaccine clinics. They run limited flu vaccine clinics, but encourage those of us with older kids to utilize pharmacies, because they can’t handle all of us.”

She said pharmacies near her are scheduling 3-6 appointments per hour for grownups, which makes it difficult to see how a large volume of children can obtain vaccines easily at pharmacies.

Another mom wrote that she went to a large city site at CityPointe in Downtown Brooklyn. “They said that they will have it; so I would assume that all of the pop-up City sites will have it,” she wrote.

Update, Nov. 2: My former pediatrics practice sent out this email: “Pediatric Group of New Rochelle is happy to announce that we are now taking appointments for the Pfizer COVID-19 vaccine for children ages 5-11 years old. The following dates and times are now available to book for the first dose. Please contact the office at 914-235-3800 to make an appointment as spots are limited.

“Please keep in mind, these appointments are only available to active PGNR patients who meet the age requirement as of the date of appointment.” Three clinics are listed in November, on two Saturdays and one Monday. The email says further clinics will be scheduled.

Record-keeping

The Southern Westchester woman said that another big issue is keeping the records organized. Spelling names properly will avoid some of the problems people have encountered with getting an Excelsior pass, the New York State vaccination guarantee pass, if their name is misspelled, she said. Also vaccine records can be kept more easily in the same place at the pediatrician’s office.

“They’re really trying to make sure that does not happen with these kids, and that everything is entered in the office’s system,” she said. “That would be ideal. So if it’s done, it’s done just like your regular immunizations. I don’t know if many pediatrician offices are going to do it. But what we have heard is they should be prepared for Thursday.”

She also said she had heard of popup vaccine sites by school, but details are just now being finalized so there’s not a specific list of schools  planning to do this.

She also said that any potential allergy issues with children need to be strictly monitored. She has a child with allergy issues, which were uncovered when she was extremely young and had a severe and sudden reaction to a shot that resulted in an emergency room visit. Pharmacies will be ill-equipped to manage such issues, she noted.

“You never know if you’re going to have a reaction to something,” she said.

Also note that some children hate needles, and the idea of a lot of children in the CVS wailing about needles is unwelcome for parents, pharmacists and customers.

Separately, she mentioned that one pharmacy she knows of is giving Moderna third shot or booster shots only on Tuesdays and Thursdays. (Readers know how hard it was for me to get my Moderna booster.) She didn’t realize until she read my posts that this was a scheduling anomaly that was fairly widespread.

She also mentioned that her husband, who was in line for a Pfizer booster but does not qualify under current rules, learned that a local Target store was accepting walk-ins after 5 p.m. He was told to call at 5, and if they anticipated having extras, he could walk in — much as the “leftovers” early in the rollout were available if you know where to ask and how.

School questionnaire

My local moms Facebook group in southern Westchester reported on Friday: “Elementary parents, fill out the survey the school just sent out via email. They want to gauge interest in a pop-up vaccination site at one of the schools.” I couldn’t get a copy of the email; I am told the superintendent sent an email asking parents “to click on a link to indicate interest in pop up vaccinations for kids.”

Tribeca Pediatrics, a big New York City practice, emailed its patrons that it planned to do vaccine administration at its offices, and would open scheduling in the future: “The committee advising the Food and Drug Administration recommended approval of the Pfizer COVID vaccine for children ages 5 to 11 year old. The FDA and CDC is expected to give final approval and recommendations of the vaccine for the use in this age group on November 2-3. This is great news for our patients, their families, and the community. We are working with the NYC Department of Health to secure a supply of the vaccine to administer to our NY and NJ patients. Due to logistics, we will only administer the vaccine at our Tribeca (15 Warren St, Manhattan), Prospect Heights (257 Flatbush Ave, Brooklyn), and Sunnyside (43-12 43rd St, Queens) offices. We hope to receive a supply within the next few weeks and will open online scheduling.” They followed up with a question and answer series.

Texas Children’s Hospital is scheduling: “We are now scheduling free COVID-19 vaccines at our three hospital locations and also at select Texas Children’s Pediatrics offices throughout Houston, College Station and Austin; The Center for Children and Women; and Houston area schools and churches. We want you to be able to pick the location that is most convenient for your family, and welcome you to pick any available location in our TCP network, or at our system locations. We have made scheduling available only for our patients, through MyChart.”

Meanwhile, the White House is warning parents that their children might not get vaccinated the very day or even the very week the vaccine is approved for children.

Patience may be needed, as it could take several days before shots are readily available,” NPR reported on Saturday. “We’re talking about a specialized vaccine for children,” said Jeff Zients, the White House’s COVID-19 response coordinator, in an exclusive interview with NPR. “We are hard at work, planning the logistics and making sure that vaccines will be available at tens of thousands of sites that parents and kids know and trust.”

Wait and see

While a lot of parents on social media are urgently asking how quickly they can get their children vaccinated, a lot of parents are in the “no thanks” and the “wait-and-see” crowds.

“Only 27% of parents in the latest poll from the Kaiser Family Foundation said they were eager to get their young children vaccinated against COVID-19 if the Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC) authorize the use of the Pfizer-BioNTech vaccine in children ages 5 to 11,” CIDRAP wrote on Oct. 28. “Thirty percent said they would definitely not get their child vaccinated, and 33% said they would take a wait-and-see approach.”

Parents have expressed many concerns about the vaccine, the same ones that have been expressed before: The vaccine came to market too fast (it was fully tested in a serious and thoughtful scientific effort to combat the pandemic), it might harm fertility (scientists say it won’t), it will change your DNA (that’s scientifically impossible), my kid had Covid and doesn’t need the vaccine (there is no proof of longlasting and robust “natural immunity”) and so on.

Here’s a handy one-page list of top parental concerns and explanations by Katelyn Jetelina, an epidemiologist who writes in a down-to-earth and accessible manner.

And Britain is seeing a Covid surge driven by a high proportion of illness in children, The New York Times reported.

“The current surge is being primarily driven by high levels of infection in school-age children, with more than a third of all recent cases being reported in those under 15 years old,” Josh Holder wrote. “Unlike most of Europe, the U.K. was slow to approve vaccines for adolescents. The recommendation of a single dose of the Pfizer-BioNTech vaccine for 12- to 15-year-olds was not announced until mid-September — weeks after many students had returned to school from summer vacation. So far, just 21 percent of 12- to 15-year-olds are vaccinated in England, compared with 80 percent of adults.”

“School-age children were about 15 times as likely to be infected as 80-year-olds on Oct. 19,” the graphic with the story said.

What you can do

Jane Duncan, a vaccine angel who has helped people make appointments for months, has posted a list of links to vaccine sites beyond what you might find at your local pediatrician or pop-up for kids. Here is a list.

Vaccines.gov, the nationwide federal site

CVS.com booking site

Rite-Aid booking site

Costco booking site

Northwell Health booking site

Vaccinefinder.nyc.gov for New York City sites

School vaccine clinics in New York City

Also, from the previous rollouts, starting last December, some of the best sources of information were Facebook groups of “vaccine angels” — people who could understand and play the system, and volunteered to make appointments for people who found it challenging. We understand that Facebook is a complicated thing, and that the ideal source of information on such topics is government, but this is not an ideal situation. These Facebook groups were an amazing resource. Here are some; to find one near you, you could search Facebook Groups for something like “covid vaccine (Florida/Louisiana).” Or maybe there’s a community group like our partner Epicenter-NYC or Bronx Mama.

Covid Vaccine Resource – New York State

Helping NYC Get Vaccinated – Covid-19

 New York / Connecticut / Massachusetts / Florida / Texas Vaccine Angels

Vaccine Hunters/Angels Massachusetts

Chicago Vaccine Hunters

San Diego Vaccine Angels

Maryland Vaccine Hunters