Parents are key to ending the pandemic — but will they vaccinate their children?

The U.S. may finally be seeing the light at the end of the COVID-19 tunnel. To reach herd immunity and return to full societal activity and productivity, we will need America’s parents to allow the vaccination of their children.

The CDC has relaxed masking and other preventive guidelines, as cases, hospitalizations and deaths are significantly down in most states. The back-to-normal index of U.S. economic activity now stands at 89 percent of its pre-pandemic level and is rapidly increasing. This turnaround is due to rapid development, access and administration of highly effective vaccines now reaching nearly 60 percent of the adult population with at least one dose.

Although everyone wants to get back to normal, there is a worrisome polarization on the role of vaccination in achieving this goal. A blue state-red state divide in vaccination rates is emerging across the country.

The nation’s 75 million children are about to enter this battlefield. Those under 18 comprise about one-quarter of the population and generally require parental consent to be vaccinated under state law. With current vaccination trends nearing demand saturation in adults, it’s likely that children will occupy the last national vaccination combat zone that determines whether 75 to 80 percent of the population has the immunity that allows a safe reopening of the country.

Children are the last in line for vaccine eligibility. Until recent FDA emergency use authorization (EUA) of the Pfizer vaccine for ages 12 to 15, children under 16 were ineligible for vaccination. Nearly all children will eventually become eligible through EUAs as vaccine trial results allow. As the country waits for such approvals, more communicable variants and seasonal upturn of virus infection in fall and winter will emerge, right when children return to school and in-person day care. Even if the absolute likelihood of severe illness in children is low (and some get long COVID-19 or multi-inflammatory syndrome), the asymptomatic carriage of the virus presents a significant transmission risk in multi-generational households. Unvaccinated adults may suffer the consequences of living with unvaccinated schoolchildren. How will parents, whose risk tolerance for their children is typically very low, respond to this complex shifting landscape?

A new COVID-19 Collaborative poll of parental views on vaccinating their children provides cause for both concern and hope. While 61 percent of parents plan to vaccinate all their children, 27 percent will not and 12 percent are undecided. Unsurprisingly, parents do for their children as they do for themselves. The poll finds 84 percent of parents who have or will be vaccinated also intend to do the same for their children. A similar percentage who will not be vaccinated also will not vaccinate their children.

Mothers more than fathers tend to be the “deciders” for their children and vaccine hesitancy is higher for parents with younger children. Those with the highest hesitancy are people living in rural areas, Black and white mothers, women without a college education, lower-income households, independents and Republicans. 

The survey also revealed practical steps to increase children’s vaccination uptake. Pediatricians are the most trusted parental voice and their offices are a desired and convenient administration platform. Parents fear the risk of virus to their children, and view protecting them as an important reason to vaccinate the entire family. 

 But it is school districts across the country that will play a central role in COVID-19 response. There is widespread parental support for making vaccines and information about them available at public schools (80 percent). Most parents (59 percent) of school children support mandatory vaccination for in-person attendance. Nearly three-quarters would be more likely to vaccinate their own children if such a requirement were in place.

History’s lessons from the school-based polio vaccine distribution of six decades ago underscore the importance of achieving and maintaining public trust in the process. Their success ultimately resulted in the elimination of domestically acquired polio in the U.S. There are now many examples across the country of school districts stepping up as COVID-19 vaccination sites.

Other polls have indicated that incentives could be powerful drivers for parental intent. Single dose vaccines, airline, sporting and entertainment event entrance requirements could successfully encourage parents to vaccinate themselves and their children. 

Perhaps it was inevitable that concern for the health of our children would be a final test of national resolve. The vaccination of children is a litmus test of a fractious country’s path to addressing the closing chapter of our pandemic. It’s a fortuitous irony that parental concern for the safety of their children may do more to motivate their own vaccine intention. With carefully crafted local incentives, mandates and trusted voices, the whole family may get vaccinated. And America could put the pandemic behind us. 

Steven Phillips is vice president of science and strategy at Covid Collaborative.

John Bridgeland is CEO of the Covid Collaborative 

Michael Casserly is executive director of the Council of the Great City Schools.