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December 15, 2021


ENSURING COVID-19 VACCINE EQUITY FOR CHILDREN: CONSIDERATIONS FOR PEDIATRIC
TEAMS AND COMMUNITY PARTNERS


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Authors: Lauren Scannelli, Center for Health Care Strategies


The pediatric COVID-19 vaccine for 5- to 11-year-old children is being rolled
out — a monumental milestone nearly two years into the pandemic. Early data
relating to the rollout for 12- to 18-year-old children, however, indicate
vaccination gaps — in distribution, access, and uptake — between white children
and children of color, particularly Black children. Little data are available
yet for the roll-out for 5- to 11-year-old children, but there are persistent
disparities in immunization rates for other preventable childhood diseases. How
can the child health field ensure this disparity isn’t perpetuated in rolling
out the COVID-19 vaccine to younger children?  

COVID-19 has disproportionately affected the health of Black, Latino, and
American Indian and Alaska Native (AIAN) children, resulting in higher infection
and hospitalization rates as well as increased death rates when compared with
white children. While the Biden Administration has secured enough vaccines to
supply all 28 million children in the U.S. who are now eligible, Black, Latino,
and AIAN children may still experience delays and other obstacles in receiving
the vaccine in the absence of careful planning and coordination.

This blog post offers considerations for pediatric medical care teams and
community partners to ensure more equitable COVID-19 vaccine distribution among
children. These recommendations fall under four broad categories and draw from
conversations with pediatric practices, family advisors, and core partners
engaged in Accelerating Child Health Transformation, a national initiative led
by the Center for Health Care Strategies with support from the Robert Wood
Johnson Foundation.


1. LEVERAGE EXISTING ASSETS TO REDUCE HURDLES TO VACCINATION ACCESS

 * Listen to families and communities. Through trusted and authentic
   partnerships with families and communities of color, pediatric medical care
   teams can co-identify barriers to equitable vaccination rollouts and
   innovative solutions alongside families. For example, community partners and
   leaders can co-design modes of engagement, as well as non-coercive and
   empowering incentives tailored to families in specific communities.
   
 * Review current practices through an equity lens to help alleviate unintended
   consequences. Pediatric medical care teams can use a strengths-based approach
   to assess the existing resources to which they have access. Practices can
   also lean on relationships with families and community partners to co-create
   family-driven solutions aimed at reducing barriers, such as flexible
   scheduling practices. For example, families may have an easier time getting
   their child vaccinated if the office offers appointments during non-business
   hours with no penalties for tardiness or no-shows.
   
 * Leverage community partnerships with schools, school-based health centers,
   community social workers, and faith-based organizations to connect with
   children and families who may have reduced access to the vaccine. Other
   community partners can also serve as a resource to offer additional
   convenient locations and times, mobile or pop-up clinics that are staffed by
   trusted community partners and in under-resourced communities, no-cost
   transportation to and from vaccination sites, and support navigating online
   appointment portals.


2. SHARE INFORMATION EFFECTIVELY TO BUILD VACCINE CONFIDENCE

 * Use clear, concise, and accessible messaging to discuss vaccine efficacy with
   families and counteract persistent misinformation campaigns. One way to
   quickly incorporate effective communication is to adapt language that has
   already been crafted to address families concerns about the COVID-19 vaccine
   and other recommended immunizations.
   
 * Ensure ample time for parents to ask questions. The medical care team can
   bring up the importance of vaccination for the entire family and make sure
   that family concerns are addressed and that they have the information needed
   to make their decision. In addition, care teams can provide vaccine
   counseling to foster supportive conversations around the COVID-19 vaccine.
   
 * Use culturally sensitive language and tailor existing community engagement
   resources (including core messaging, infographics, social media posts, and
   campaign tools) to reach specific communities, including Black and Latino
   communities, as well as refugee, immigrant, and migrant communities.


3. FOCUS ON THE MEDICAL CARE TEAM

 * Ensure that the medical care team is comfortable addressing vaccine hesitancy
   and other family concerns to foster an environment where all families feel
   supported during a stressful time. Practices can offer trainings such as the
   teach-back method, which assists with clear communication, or show their
   commitment by crafting a statement or joining local initiatives like the
   Power of Providers initiative in Washington State.
   
 * Help staff vaccinate their own families by offering vaccine drives or
   additional paid time off. Offering opportunities for the medical team to
   vaccinate their own families provides a space for staff to talk about the
   experience of vaccinating their families with the community they serve and
   signals the practice’s commitment to vaccination.  


4. MEASURE EQUITY PROGRESS AND ADVOCATE FOR EQUITY

 * Track vaccination data in real time and collect disaggregated data by race
   and ethnicity, as well as by language spoken and geographies, whenever
   possible. There are various tools available to assist health care systems and
   practices think through metrics, including this toolkit, which offers a
   framework for tracking vaccine equity metrics.
   
 * Advocate for anti-racist practices and policies that drive vaccine equity and
   benefit all families. Joint efforts with families and community leaders can
   be used to inform policymakers and advocate for local, state, and federal
   policies to help dismantle racist systems that impede equitable preventable
   care, including immunizations.


LOOKING AHEAD

An estimated 25,000 pediatric and other primary care sites are involved in the
roll-out of the COVID-19 vaccines for 5- to 11-year-old children. As a main
provider of care for children and trusted messengers with policymakers,
pediatricians have a key role to play with ensuring vaccine equity both in this
phase and the future roll-out of a vaccine for children under 5 years old.
Pediatric medical care teams can meaningfully engage with families and
communities of color and can use existing resources and expertise to co-create
solutions to ensure vaccine access for all families. Vaccination efforts have
direct impacts on the health outcomes for all children and their families,
especially for those who have already been disproportionately affected by the
pandemic. Ensuring that all children have equitable access is essential.


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Project
Accelerating Child Health Transformation
Focus Areas
Child & Family Health
Community, Family, & Patient Engagement
COVID-19
Health Equity


RELATED

Report
August 2021

Accelerating Child Health Care Transformation: Key Opportunities for Improving
Pediatric Care


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