Millions of exhausted parents, educators, and health care providers have been anxiously awaiting COVID-19 vaccines for young children. The Federal Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC) approved COVID-19 vaccines for children aged 5-11. The Biden Administration and state and Orange County communities are embarking on a long awaited effort to vaccinate 5 to 11 year old children. At question is whether we have learned from this year’s inequitable rollout of the COVID-19 vaccine for adults in Orange County. Wealthier, whiter communities (mostly in south Orange County) had earlier access to the COVID-19 vaccine compared to low-income communities and communities of color who had been hit hardest by the pandemic. This includes residents in north Orange County cities of Santa Ana, Anaheim, Westminster, and Garden Grove and households with low-wage workers whose work was classified as “essential work” while employers and customers took little action to promote workers’ workplace safety and health. As a public health practitioner and professor, I call upon our public health leaders to put equity top of mind in the COVID-19 vaccine rollout effort for children 5 to 11 years of age.
It appears that there is a better strategy by the federal government to rollout vaccines to kids 5 to 11 years of age, including engaging parents in discussions about vaccines, explaining the science behind COVID-19 vaccines and addressing potential vaccine side effects. The Administration is also making the vaccine available to children through smaller settings, such as doctor’s offices, rather than major points of vaccine distribution such as Disneyland, sports centers, and Soka University – an elite, private university – as we previously saw in the early phases of vaccine distribution in Orange County. By making the vaccine available at local doctor’s offices, we are leveraging the trusted relationships between families of young children and providers. While these are all promising approaches, missing so far from the discussion is how governmental officials will ensure that communities of color and low-income communities are a key focus of vaccine rollout plans.
Now, an estimated 28 million children are eligible to receive the COVID-19 vaccine. In Orange County, more than two-thirds of children under 18 years of age are children of color. Latino children represent about half (47.0%) of Orange County children, followed by Asian (16.3%) and Black (1.5%) children. Another 9.5% of California children younger than 18 are American Indian/Alaska Native, Native Hawaiian or Pacific Islander, or multi-racial. Additionally, 1 in 6 Orange County children 5-17 years of age live at or below the federal poverty level.
Recently, there has been controversy about organizations that the Health Care Agency has funded to support COVID activities. When it comes to distributing vital health resources, the Orange County Health Care Agency needs to fund trusted community-based institutions in low-income communities and communities of color to implement a more effective local vaccine rollout campaign. This involves tapping into the wisdom of cultural organizers to activate community-level discussions about the COVID-19 vaccine and vaccine concerns through storytelling, listening sessions, and information sharing. This will also involve supporting a series of one-on-one discussions between parents, children, and trusted community members who are skilled at listening to residents’ vaccine concerns and equipped with evidence-based and culturally and contextually sensitive information about COVID-19 vaccines.
During the initial COVID-19 vaccine rollout in Orange County, information about vaccines and vaccine registration sites were first available only in English and via apps. Moreover, misinformation campaigns have capitalized on the segregation of COVID-19 and vaccine information by language. COVID-19 vaccine information must be accessible to both parents and children, including in the primary languages spoken by parents and children, at a reading level appropriate for young children, with appropriate visuals, and via a range of modes such as information packets distributed by schools and other community institutions, websites, local radio tailored to communities of color, at cultural events, and via social media.
Finally, this next phase of the fight against COVID-19 could be used as an opportunity to connect young children to a medical home where they can have regular and stable access to a primary care doctor – placing them on a trajectory to live a healthier life. Regular visits help build a trusted relationship with medical providers, which is an important foundation for addressing vaccine concerns and misinformation. When the next epidemic or pandemic comes around, we will be in a better position to protect Orange County residents from a major health crisis because we will have raised a generation of informed and empowered Americans.
I implore my fellow public health leaders to turn a new page in the COVID-19 pandemic and apply the lessons learned from inequities in COVID testing and vaccines by working in partnership with and adequately funding trusted local community institutions to guide the design of local vaccine implementation efforts for our youngest children. This is the moment we have been waiting for – let’s do it right, let’s do it equitably.
Alana M.W. LeBrón, Ph.D., is assistant professor of Chicano/Latino studies, UCI School of Social Sciences, and assistant professor, public health, UCI Program of Public Health. Her scholarship centers on how structural racism shapes health inequities for low-income communities of color and community-driven solutions to interrupting these inequities. In line with her scholarship, much of LeBrón’s research involves a community-based participatory approach.
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