Parents of young children are faced with the challenging task of securing limited supplies of the updated Covid-19 vaccine, which has been recommended for all individuals aged 6 months and older since mid-September.

Upon locating the vaccine, some parents encounter additional obstacles that hinder their children from receiving the shot. Problems with scheduling appointments, age restrictions at pharmacies, confusion regarding insurance reimbursements, and guidelines discouraging the mixing of different vaccine brands for young children have all caused headaches for families.

This frantic pursuit comes as the hospitalization rates of young children with Covid-19 have sparked fresh concerns. Data compiled by the American Academy of Pediatrics reveal that hospital admissions in individuals under 18 have increased by five times since June, rising from 237 to nearly 1,200 in the week ending September 9. In comparison, hospitalization rates in adults have only tripled over the same period. Children under 5 are at the highest risk.

In light of these circumstances, parents like Kristin Kessler strive to ensure that their young ones obtain the vaccine promptly. Kessler's 3-year-old son, Jackson, suffers from asthma triggered by respiratory infections. While he received his initial shots for Covid-19, he is now due for an update.

Kessler, who resides in the Washington area, turned to her pediatrician, who is part of a large medical group with multiple locations in northern Virginia. Regrettably, when Kessler inquired about the availability of Covid-19 vaccines, the staff informed her that the office did not offer them and advised her to consult the Vaccines.gov site, a federal government resource that assists individuals in locating available shots.

Although pharmacies in her area administer vaccines to children as young as 3, and some in-store clinics even vaccinate kids as young as 18 months, Kessler scoured pharmacy and clinic websites to no avail.

The nearest vaccine appointments for children of Jackson's age require a two- to three-hour travel time. Despite this inconvenience, Kessler remains determined to find a closer option.

Both Kessler and her husband work full-time, while Jackson attends day care. Whenever he catches a cold, Kessler diligently monitors his blood oxygen levels and counts his breaths to ensure his well-being.

"It's disconcerting to see the extent of this struggle, where I have to invest so much effort just to secure a vaccine for him," Kessler remarked.

Similarly, Jennifer Coleman and her family in the Minneapolis area take extensive precautions due to her husband's year-long battle with long Covid following an early infection during the pandemic.

In uncertain circumstances regarding the availability of updated Covid-19 vaccines at their pediatrician's office, Coleman started exploring alternative options. While she successfully scheduled an appointment for her teenager next week, finding a shot for her 4-year-old proved significantly more challenging.

Coleman expressed disappointment at the lack of priority given to pediatric vaccines. She emphasized that these children, who spend time in daycare centers, are particularly vulnerable to viral outbreaks. Her daughter's daycare center recently experienced a significant outbreak.

During the health emergency, the US Department of Health and Human Services granted nationwide authorization for pharmacists to immunize children as young as 3. However, since the emergency ended, pharmacies in Minnesota are no longer able to vaccinate children under the age of 6.

"We are completely excluded from all pharmacies," Coleman lamented.

Coleman attempted to secure appointments at several local children's hospitals conducting vaccination events, but they exclusively offered Pfizer vaccines. Her daughter had previously received Moderna shots, and the US Centers for Disease Control and Prevention recommends that children under 5 receive the same product for all vaccine doses. Consequently, Coleman continues her search.

"Honestly, it's frustrating," Coleman voiced. "We are simply trying to protect these children from the potentially severe consequences of the virus using modern science that should be accessible to them."

"We can't help but feel that the rollout has been poorly planned, and unfortunately, it is the children who are suffering the consequences," she concluded.

Some doctors are hesitant to stock the new Covid-19 vaccines for children due to various factors. While adults faced similar challenges with scheduling and insurance issues when the updated vaccines were initially released, government and insurance officials claim that those problems have been mostly resolved.

However, for children, the obstacles to vaccine rollout are numerous. Firstly, there is the issue of cash flow. Pediatricians, who serve as the primary healthcare providers for children and administer routine immunizations, operate on narrow profit margins. Some physicians argue that the economics of these vaccines don't make sense for them. According to the health policy think tank KFF, the updated Covid-19 vaccines now cost about four to five times more than what the government was previously paying for them.

When the government was covering the costs of the vaccines, doctors only needed to consider storage requirements, as the shots required ultra-cold storage or refrigeration for up to a month. However, since commercialization, when the vaccines became available on the open market, some pediatric offices have been hesitant to purchase them. Dr. Jesse Hackell, a pediatrician in Pomona, New York, explains that doctors now have to invest money in advance to obtain the vaccine, which creates significant financial burdens.

In addition, pediatric offices bear the risk of uncertain demand for the vaccine. Dr. Hackell reveals that some pediatricians he knows have decided not to offer the shots because of these concerns. Unlike adults, who typically experience two to four bouts of respiratory illnesses each year, children undergo six episodes annually.

The vaccination rates among children for Covid-19 have consistently lagged behind those of other age groups. CDC data from May, when the public health emergency was lifted, shows that less than 1% of children under 5 received the bivalent booster, and less than 10% of children aged 5 to 17 received it. While hesitancy among parents is often cited as the reason for these low numbers, Fatima Khan, co-founder of the nonprofit advocacy group Protect Their Futures, believes that limited access and the difficulty of vaccinating young children also play a significant role.

Khan emphasizes that many parents want to protect their children and do the right thing, but they face challenges due to bureaucratic hurdles. She finds it frustrating that public health officials urge people to get vaccinated while parents are struggling to access the vaccine for their kids. Khan calls for more transparency from leaders to shed light on why the situation is so complex and what can be done to address it.

The struggle to secure vaccinations continues for parents like Kaley Beins from Rockville, Maryland. Despite actively searching websites in the hopes of getting her toddler vaccinated, she faces challenges. At 23 months old, Petra is too young to receive the vaccine at a pharmacy.

Complicating matters further, Beins discovered that her pediatrician's office experienced issues with insurance reimbursement. While the doctor's office agreed to carry the updated Covid-19 vaccine for children, it was only available through their cash-only travel clinic. Patients had to pay out of pocket for the vaccine and then seek reimbursement from their insurance companies independently.

Beins and her husband discussed the situation and decided to pay $150 out of pocket for the vaccine. They planned to utilize their healthcare savings account for this purpose. However, they encountered another obstacle when they tried to schedule Petra's appointment. The clinic only had Pfizer shots in stock, and since Petra had previously received the Moderna vaccine, they opted to wait due to CDC guidance against mixing and matching.

Beins then reached out to the Maryland Department of Health but faced difficulties in finding a resolution. She was transferred from one line to another until eventually reaching a dead-end line that didn't accept messages.

She attempted to contact the CDC number listed on the Vaccines.gov website, and it provided her with the names of three local clinics that supposedly had pediatric vaccines available. However, upon contacting these clinics, she discovered that none of them actually had the necessary doses, and they were unaware of why the CDC was misinforming people.

Frustrated, she took to Facebook and shared a lengthy post expressing her difficulties. Fortunately, another member of the Protect Their Futures group shared a link to the CDC's Vaccine Administration Management System, which assists in scheduling appointments. Through this system, she found a health fair offering Moderna shots for children. Both she and several other group members eagerly secured appointments.

Unfortunately, their attempts to confirm their appointments via phone calls proved fruitless.

"There's been a lot of discussion among us on Facebook, asking each other if we have received any updates. We are left in the dark. There's a rumor floating around suggesting a refrigeration problem, but we're unable to obtain any official answers," she explained.

Not wanting to take any chances of missing out on the vaccination for her daughter, she made the decision to attend the health fair anyway.

"With my nearly 2-year-old daughter, who despises car rides, it took us about an hour to get there," Beins recounted. "Upon arriving at the health fair, we were informed that their on-site refrigeration capacity was insufficient to handle the Covid vaccines. Instead, I was offered a flu shot. Needless to say, I left feeling disappointed."

Later that evening, long after the health fair had concluded, she received an email from the CDC canceling her appointment at 7 p.m.

A sign promoting COVID-19 vaccine shots at a Walgreens Pharmacy in Somerville, Massachusetts, caught the attention of passersby on August 14, 2023. REUTERS/Brian Snyder

Supply and insurance complications have hindered the fall Covid-19 vaccine campaign for certain individuals.

Petra is registered for another clinic in Manassas, Virginia, scheduled for Tuesday. However, upon receiving the confirmation email, she encountered yet another surprise. The email stated that the clinic did not administer vaccines to children under the age of 3. Yet, when she called the clinic, she received a contradicting response, assuring her that vaccinating Petra wouldn't be an issue.

"We have no clue if we'll actually be able to obtain this vaccine," Beins expressed. Nevertheless, her husband will be taking time off work and driving their daughter to the clinic, just to be safe.

Curiously enough, Beins is a toxicologist who specializes in public health. One would assume she possesses an understanding of how these systems should operate.

"If even I struggle to navigate this process, how can the administration expect parents to do so and ensure widespread vaccine acceptance?" she questioned.

She also harbors concerns that this "disastrous" vaccine rollout will culminate in reduced vaccine resources for children in the future.

"They will leverage this data to claim that parents are uninterested in vaccinating their children, when in reality, the shortcomings are too significant to facilitate widespread vaccination."

"Access is a problem," stated Hackell, a pediatrician.

Approximately half of the children in the United States receive free vaccinations through the CDC's Vaccines for Children (VFC) program, which many doctors participate in. However, according to Hackell, the ordering of these vaccines varies on a state-by-state basis.

Deb Wityk, a resident of the Spurgeon Manor nursing home in Dallas Center, Iowa, expressed her intention to receive an updated COVID-19 vaccination at the earliest opportunity. "COVID-19 is particularly devastating in a nursing home," she remarked. 

As COVID-19 infections continue to rise, nursing homes are still awaiting the arrival of vaccines. Hackell noted, "Some states allowed ordering even before the vaccine was released, whereas others only recently opened up their ordering supply."

While some pediatricians have expressed their plans to administer the vaccine, they have not yet received any doses, and the timeline for their arrival remains uncertain.

According to Hackell, some of his colleagues across the country have received their allotment of free vaccines, while others are still waiting. This creates an equity problem as children dependent on the VFC program, who are covered by Medicaid or uninsured, often encounter difficulties in accessing the vaccine.

During a briefing sponsored by the National Foundation of Infectious Diseases on Friday, CDC Director Dr. Mandy Cohen explained that adult doses were initially prioritized over pediatric vaccines.

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Dr. Mandy Cohen stated, "Our manufacturers and distributors initially focused on delivering the adult vaccines first. As a result, they shipped the pediatric vaccine a few days after the initial distribution."

One vaccine manufacturer confirmed on Monday that they are fulfilling orders as soon as they are received. However, it is important to note that while some orders are sent directly to individual purchasers, others are funneled through large distributors, who must process and dispatch them, which takes additional time.

Kit Longley, a spokesperson for Pfizer, affirmed, "All orders are being fulfilled promptly, and 100% of orders are shipped within days after they are placed."

Longley also disclosed that the drug manufacturer has already shipped over 10 million doses of its COVID-19 vaccine, including more than 1 million pediatric doses.