The right teen vaccine is harder to manage in the rural United States


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Dr. Laurel Desnick, a health officer from Park County, Montana, administers a covetous vaccine to a Park High School senior.

As states expand eligibility for the covid-19 vaccine to allow shots to 16- and 17-year-olds, rural American teens may have trouble getting them.

Of the three vaccines authorized in the US, currently only one can go to this age group: the Pfizer-BioNTech shot. This vaccine comes in packs of at least 1,170 doses and expires after five days in the refrigerator, which means too many doses in too tight a timeframe for many rural communities.

“We keep trying to get people to accept the vaccine,” said Aurelia Jones-Taylor, CEO of Aaron E. Henry Community Health Services Center, which serves remote regions of the Mississippi Delta. “If we have to run to give 1,100 doses in five days, that’s unsustainable.”

Some health experts say vaccinating children (more than a fifth of the country’s population) is key to ending the pandemic. Meanwhile, pressure is mounting to eliminate vaccines as health officials mark more waves of cases, this time with more contagious variants that appear to affect children more than the initial strain of the virus that swept the United States.

“The infection can continue to spread until we vaccinate all the people in the population, and that includes younger people,” he said. Gypsyamber D’Souza, epidemiologist at the Johns Hopkins Bloomberg School of Public Health.

The logistical challenges of getting shootings at rural children of all ages are likely to continue, at least in the short term. This is because the companies behind the only approved vaccine for 16- and 17-year-olds, Pfizer and BioNTech, have also been the first to apply for federal approval vaccinating younger ages after a trial showed that the vaccine was effective in children 12 to 15 years old. Pfizer spokesman Steve Danehy said the company expects to get regulatory approval for this age group before the start of the next school year.

For some families, the shootings are so coveted that they will travel the required distance. Dr. Jeannette Wagner Waldron, 45, of Park County, Montana, said the nearest place where she could find a vaccine for her 17-year-old daughter, Julie Waldron, was Billings, which meant a round trip of almost four hours to a CVS pharmacy there for the first shot of the teenager.

“I’m more than willing to drive two hours to vaccinate my kids,” Wagner Waldron said. “They have given up a lot, of their activities and of seeing their friends, to protect people from the virus.”

Not everyone can travel that far for vaccines once, let alone twice to get both doses. All this with some reluctance in rural communities to get vaccinated. A recent one KFF survey showed a higher proportion of rural residents (21%) said they would not get a covida vaccine compared to urban and suburban respondents. This could mean that there is not enough remaining demand for vaccines to consume a 1,170-dose package of Pfizer in rural communities. Even if demand exists, rural health departments may not have enough workers to administer doses quickly enough.

Karen Sullivan, a health officer in the Butte-Silver Bow Department of Health, said Butte will serve as the primary immunization base for 16- and 17-year-olds in five southwestern Montana counties that together cover as much area as all Maryland. He said he worries that delivering Pfizer shots to every community could risk losing doses, but his department can make a new plan if too many people can’t get to Butte.

Health officials have tried to convince teens and their guardians because the shots are safe and worth traveling since Montana opened vaccines coveted to everyone from the age of 16. The new Butte-Silver Bow vaccination campaign includes sharing photos of school pets in the jab area and prize draws for those who get vaccinated.

“What we’re trying to do is get ahead of the variants,” Sullivan said. “In my mind, we can’t vaccinate our 16- and 17-year-olds fast enough.”

Registered nurse Kristina Pierson is preparing a classic shot at a high school vaccination clinic in Park County, Montana.

Finding Pfizer vaccines can be a challenge even in cities, which serve as medical centers for rural communities. To help with this, some providers have set up online vaccine registration systems specifically for 16- and 17-year-olds. such as a through Stanford Children’s Health for clinics in San Jose, California.

In Mississippi, Jones-Taylor said her center hopes to reach children through outreach clinics based on schools and cell phones. But he said it depends on the Modern or Johnson & Johnson vaccine, each of which has minimum shipments of 100 doses, getting regulatory approval for minors. Both manufacturers are testing the operation of their shots on children.

The Children’s Health Fund, a national non-profit organization, has advocated “continuation” urgent inclusion of children of all ages in vaccine trials ”and to prioritize an easy-to-store single-dose vaccine.

Dr. Cody Meissner, a pediatrician on the Food and Drug Administration’s vaccine advisory committee, questions the rush to extend vaccines to younger ages without more time to study possible impacts, adding that so far children have had less likely to transmit the virus or die of infection.

The debate over whether vaccinating younger children as a means to end the pandemic may soon be debatable, however, Dr. Monica Gandhi, head of the Division of HIV, Infectious Diseases and Global Medicine at the University of California-San Francisco. He noted a recent study conducted on Israel, a nation that stands ahead of the rest of the world in its vaccine, which showed that infection rates decreased even without immunizing children under 16 years of age. This study not yet peer-reviewed.

“We can achieve herd immunity without vaccinating all children,” Gandhi said. “But as long as it’s a safe vaccine, the more people get it, the more people will develop immunity, the better.”

Back in Park County, which has a population of less than 17,000, health authorities have seen an increase in cases of cohabitation among younger people in recent weeks, some related to middle and high school sports.

Ava Braham, who turned 16 two days before Montana extended her eligibility for the covida vaccine to include her age group, was shot at a vaccine clinic at her school in Park County.

Dr. Laurel Desnick, the county health officer, said the county set up vaccine clinics in high schools working with the state and neighboring counties to split a shipment of Pfizer vaccines, though that took a while to organize. -se. Until mid-April, the county directed 16- and 17-year-olds like Julie Waldron to a county more than 100 miles away for a shot.

“Some of our kids could do it, but not all of them,” Desnick said. “The farther you are from a big center, the harder that is. We’re rural, but we’re not as remote as many of the counties in central or eastern Montana, and I’m sorry for them.”

For Ava Braham, who turned 16 two days before Montana extended her eligibility to her age, a vaccine clinic at her Park County school means she only needed 20 minutes of class to shoot her this year. but instead of having to drive more than 50 miles back and forth. on a mountain pass.

“The most important thing for me with the vaccine is to be able to see my family more often. My grandparents have already received the shot, but I will feel more comfortable visiting them,” Braham said. “It’s a kind of moral obligation to help the whole country and the world get the shot.”

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