COVID vaccination in kids under 5 remain low as US hospital admissions steadily rise

Although a recent study from Pfizer showed its COVID-19 vaccine is effective at protecting children younger than 5, pediatricians are having a hard time persuading parents to vaccinate their youngest kids.

The summer saw hospitalizations steadily climb in this age group, and health experts worry the trend will continue as children return to school and day care facilities.

“We’ve seen a little uptick in hospitalizations across the board in children,” said Dr. Kathryn Moffett, chief of pediatric infectious diseases at West Virginia University Medicine Children’s Hospital. “The estimate is that there is a child every day dying of COVID in the U.S.”

Vaccinations for babies, toddlers and preschoolers opened in June after months of delay. But only about 3.4% of children under 2 and 5.7% of children ages 2 to 4 have gotten at least one dose of the vaccine, according to the Centers for Disease Control and Prevention.

Meanwhile, hospitalizations in kids 4 and under have increased since the spring. CDC data shows about 20 children a week were hospitalized in April, and the number had risen to about 100 children a week in July.

Hospitalizations of infants and toddlers exceed those of children and teens ages 5 to 17, which in July saw about 50 weekly admissions, according to the CDC.

“For really young children and babies, the main reason they get admitted with COVID is for fever, dehydration and trouble breathing,” Moffett said. “These are preventable infections.”

Pfizer announced Tuesday that its COVID-19 vaccine was 73% effective in protecting children younger than 5.

The company's study analyzed COVID-19 diagnoses between March and June in Pfizer’s ongoing study of the three-dose vaccine. There were 21 COVID-19 cases among the 351 babies and younger children who got dummy shots compared with 13 among the 794 given three vaccine doses.

The child cases primarily were caused by the BA.2 omicron version circulating in the spring. Today, another omicron relative, BA.5, is causing nearly 90% of COVID-19 cases in the U.S. and much of the world, according to the CDC. Pfizer said in Tuesday's press release that efficacy data against the latest dominant strain remains inconclusive. 

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Although the Pfizer data should be reassuring, health experts say, parents are still hesitant to vaccinate their youngest children against COVID-19.

“Any hesitation that a parent has always get multiplied when the child is younger,” said Dr. Daniel Blatt, an infectious diseases specialist at Norton Children’s Hospital in Louisville, Kentucky. “There’s a perception among some parents of young children that COVID is always mild and the vaccine is untested, but both ideas are untrue.”

Many parents believe a recent infection will protect their child against another bout of COVID-19, but health experts say that’s not always the case. Research shows getting vaccinated after recovering from the virus provides additional protection.

Misinformation is still playing a part in people's hesitancy, said Dr. Marc Mestre, chief medical officer of Nicklaus Children’s Health System in Miami.

“There’s always going to be stories you read online that something coincidentally happened after receiving a vaccine, and it’s tough to overcome that,” he said.

Hospitalizations may not be as high in children as they are in adults, but parents should still consider getting their child vaccinated to reduce the risk of post-infection conditions, such as multisystem inflammatory syndrome (MIS-C) or long COVID, health experts say.

Moffett, in West Virginia, says she’s seeing more children come into the hospital’s long COVID clinic for prolonged fever, cough, fatigue and joint and body aches.

“Children who get COVID and aren’t hospitalized can still have these conditions,” she said. “There’s clearly evidence that those who are vaccinated have a much lower risk of developing long haul (symptoms) after developing COVID." 

Vaccinating younger children protects against infection and transmission. Experts worry that as students return to school, they’ll bring the virus back home and infect their vulnerable family members.

The U.S. continues to report about 400 COVID-19 deaths a day, primarily among the elderly and immunocompromised. CDC hospitalization data also shows about 1,500 Americans over 65 are admitted for COVID-19 every week.

“Children historically for most illnesses have been a vector for disease transmission. That’s just the nature of children,” Blatt said. “And COVID is no different.”

If parents are still hesitant, health experts encourage them to talk with a trusted pediatrician or primary care physician about the risk and benefits of the COVID-19 vaccine along with other childhood immunizations.

“It’s just helpful to talk about this as something that reduces the risk of your kid having an adverse outcome, and it’s part of the recommended healthy lifestyle protocol,” Blatt said.

Contributing: The Associated Press. Follow Adrianna Rodriguez on Twitter: @AdriannaUSAT.

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