MCH Bridges: The Official AMCHP Podcast

Episode #2: Protecting Our Future: Vaccinating Children & Youth

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The episode features a panel of a parent, teenager, and pediatrician in a conversation on the importance of the COVID-19 vaccine for children and adolescents and strategies to increase the confidence of parents and caregivers in the COVID-19 vaccine for their children.

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Maura Leahy:

Hello and thank you for joining us for this episode of MCH Bridges. I'm your host Maura Leahy, Program Analyst in Child and Adolescent Health, and this is MCH Bridges, the official podcast of the Association of Maternal and Child Health Programs also known as AMCHP. AMCHP hopes that MCH Bridges will help our listeners create new connections to maternal and child health leaders, organizations, and ideas, as well as inspire and guide listeners towards actions that will improve the systems that impact MCH populations. MCH bridges aims to lift up stories and people from the MCH field by centering the voices of the public health workforce, people and communities most impacted by inequities, and individuals and families with lived experiences. Welcome back to MCH Bridges. This episode, we are talking about the COVID vaccine. Specifically. We are diving into the challenge of increasing COVID vaccinations among adolescents and young adults, a nd now that the vaccine is approved for children, ages five to 11, how those in the public health community can build trust and confidence in the vaccine safety with parents and caregivers. Let's go ahead and have our guests introduce themselves.

Abby Melton:

Hi, my name is Abby Melton. I am a teenager from North Carolina. I am a member of AMCHP's youth voice amplified committee, and I'm also a co-leader of t he North Carolina's division of public health youth health advisory board.

Ben Hoffman:

My name is Ben Hoffman. I'm a pediatrician based in Portland, Oregon at Oregon health and science university, and then the state title V director for children and youth with special health needs.

Kate Robinson:

And hi, my name is Kate Robinson. I am a parent of two children, a proud parent of one who is medically complex, and I live in Austin, Texas.

Maura Leahy:

Great, thank you all so much for those introductions and just thank you for being here with us today. Now, before we dive into the topic of COVID vaccines, we wanted to take a step back for a moment. The COVID-19 pandemic has taken a toll on all of us in different ways. Let's talk a little about the effects the pandemic has had on you, your families, or the systems that you work in. What would you like public health and maternal and child health professionals to know about how the pandemic has affected you and your loved ones. Let's go ahead and start with Kate for this one.

Kate Robinson:

Yeah, I think it's almost impossible to overstate the amount of stress that parents are under, especially in this stage of the pandemic. We are fatigued and exhausted and scared, and you know, we're at a place where it feels like it may not end and certainly the normal is shifting. It's an incredibly challenging time I think to be parenting and, you know, not just to lose the security financially, but to lose pieces of community and people in our lives. And it's a lot of layers and layers and layers of intense stress. So I think just being aware that parents, a lot of us are at a nine out of 10 and you don't want parents at a 10. You don't want them anywhere at nine, but, I don't think you can overstate that the challenge,

Maura Leahy:

Thanks for sharing that, Kate. I can only imagine what this has been like for you all. So I just, I really appreciate you sharing. Ben, did you want to go next?

Ben Hoffman:

Sure. So I will echo what Kate said. In my role as a pediatrician, working with lots of kids, lots of families, lots of parents, the stress on everybody has been just incredible. And we've seen that manifest most horribly in the behavioral health crisis that we find ourselves in. Prior to the pandemic, it was, estimated that one in 10 kids suffered from a diagnosable mental illness a nd two a nd 10 adolescents. And we have seen that just explode as everybody is dealing with the stress and the difference in access to resources and things like that. And one of the good things that I have seen is the ability to actually be, to do virtual visits on the up and up. It's made that part easier. I think the impact on schools and what that has meant for the wellbeing and resilience of kids and families... That to me is among the saddest losses. We've essentially all lost a year of optimal brain development and learning for kids, which I think we're going to be paying for as a society for a long time.

Maura Leahy:

Thanks for sharing that. It's scary, I think when we think about that loss and also just the kids' mental health, adolescents, and young adults, how their mental health is deteriorating. But that's why we're talking today because we have a solution that can get us back to that. Um, Abby, do you want to round us out and share some of your experiences?

Abby Melton:

Yeah, totally. So obviously there's a physical difference in schools with masking and social distancing. It's easy to take that and now we feel kind of like out of touch with one another, cause we physically cannot come like, not cannot come in contact, but we can't really get as close as we used to. There's that physical barriers and it's led a lot of people to feeling like isolated from their friends, isolated from people they previously had close relationships from. Plus that year of mainly virtual learning from a lot of people really put some barriers up to kind of like those formative relationships. Also, one thing I've noticed, especially in my high school is it's really exacerbated a lot of rifts between people. Right now, we're living through a really tumultuous social climate and at a school where a lot of youth are more politically active than they've ever been, it's l ike a lot more cynical than we've ever been you're with o ur mask. You're really kind of wearing a symbol of your political affiliation on you. So that's been something I've been observing in my school a lot.

Maura Leahy:

Thanks for sharing that. And I think that's one thing we've seen, you know, month after month after month is just unnecessary politicization of all of this, when we should be working together to try to get out of this. So thank you all so much for sharing. Next we're going to shift gears a little bit. So each of you brings a unique perspective to the table during our discussion today, I'd love to hear more about your experiences regarding COVID vaccines for children and adolescents. Ben, could you tell us what you're seeing from a healthcare perspective?

Ben Hoffman:

Yeah, so what we've seen as each iteration of the vaccine has rolled out, there are a lot of families that are really impatient and really excited. And, you know, they're fairly easy to get. In the the weeks leading up to the approval of the vaccine for five to 12 year olds, I was getting six to 12 contacts about"what was my opinion, what should they do?", people with questions. I spent last night at our, at a vaccination clinic, and people were lined up. We had people there, there were a lot of families that are really excited about this, including a lot of families of kids with special health needs. I think that the families that have reservations, the questions are around just the quality of the science and the trustworthiness of the analysis. And I feel like there was not due diligence done on the early end of the vaccine development to instill confidence in the way that it deserved. What I have told parents is that we know, I can be as confident about this vaccine as I can be about any of the other vaccines that we have, because not only do we have good science that underpins it going to the adults, but we have the experience and the adults. And the biggest question mark I think many of us had was around just making sure that the dosing differences for the younger kids was optimal. But again, looking at it, I think we know as much as we need to know. And I really urge parents and caregivers to not be afraid of it. The community in which I live, we have the highest proportion of generally unimmunized kindergarteners in the country. So this is a place where there was a lot of skepticism around vaccines. And part of my routine practice is dealing with people who are hesitant, or frankly hostile, sometimes towards vaccine. There's only so much that we can do in terms of conversation, but I always appreciate when families are willing to ask questions. I know that as a pediatrician, I have the honor of being trusted by families and I would hope that anybody who has questions about whether or not they should make this available to their child, that they would talk to somebody they could trust who comes from a background that understands the issue.

Maura Leahy:

Thanks, Ben. No, I think the trust piece is such a huge piece of all of this. And we're going to get into that a little bit later. Abby, what has your experience been like as a young adult with regards to the vaccine? You've already talked a little bit about masks, so I can kind of get a sense of what it might be like, but what are some of the reasons that your peers may be choosing not to get vaccinated? What have you been seeing and hearing?

Abby Melton:

So myself, I was personally very enthusiastic about getting the vaccine as soon as I was able to. And I have a lot of friends who shared that same sentiment, which is really exciting, but I have definitely witnessed a lot of hesitancy and a lot of skepticism around it. I know at a high school age, and even when you get a little bit younger too, like middle school to high school where these kids, it's hard to kind of get across the idea of like civic duty or the responsibility of doing something for the betterment of your community as a whole, rather than just purely being self-involved. That's a mentality that's kind of hard to convey. And sometimes the messaging behind it gets a little garbled when you're trying to reach these people. There's definitely a lot of the mentality of"If I got COVID, I don't think it would affect me, therefore, why should I get the vaccine?" So that's kind of a hard point to prove to them and I think it's really one of the most important points. Even if you don't think you would, A. that's not necessarily the case, you might seriously be affected by it, and B. even if that is the case, it's still your responsibility for the whole of your community to get the vaccine. Also, as I mentioned earlier, the whole political association, there's a lot of parts in rhetoric that kind of has swayed people like the need to keep up appearances."I don't want people to know I got the vaccine, or I don't want to get the vaccine because I don't want people to think I'm a certain way". That's definitely been a struggle.

Maura Leahy:

Thanks so much for sharing Abby. And Kate, can you tell us about your decision from the parents' perspective about your decision to get your children vaccinated when it was approved and what influenced that decision? For example, what concerns do you hear from other parents about the COVID vaccine for children that public health professionals could do a better job to address?

Kate Robinson:

So for us, we were very excited to be able to get the vaccine for both children. I was a little nervous about my child who is medically complex and does get acutely ill intermittently. I was glad Dr. Hoffman mentioned reaching out and speaking to your doctor if you have questions, because that was actually, even for someone like my child, it was a pretty brief conversation. What the head of his medical team said to me was look, the research is very clear. The exclusions are clear and he doesn't doesn't fall in that category. Very few children do fall in that category. It's very specific, very clear who the exclusions are. And so you're safe to go. She even suggested getting the flu vaccine at the same time. And so, sort of back to being able to have legit tele-health, I mean that was a very quick, easy appointment to, to have. And so I kind of highly recommend that. I think with all the misinformation, speaking to your doctor is the way to go. I feel so grateful for vaccines in general. I'm glad we don't have to worry about polio. I'm so happy not to worry about smallpox. I mean, even chickenpox now! I remember having chickenpox. So for me, it was clear. And I do hear worry from parents of children with special healthcare needs and they're valid concerns. I think that the answer lies in speaking to your doctor. And I think that the one thing with the messaging that I think could really be helpful is to make it more clear, to be a little more specific, about the research and that there are exclusions. And that those, again, are very specific. Sort of back to the trustworthiness of the process and the science that's underpinning all of this, that I think if we could maybe have a little more transparency about what that research bore out, it, I think it might help. And I realize that's challenging to do because it's a lot of information. Again, I think those specific pieces of the details around who's excluded could actually allay some fears.

Maura Leahy:

Thanks Kate, and that's a great segue to get us starting to talk more about what some of those strategies are, how public health can do a better job. Young adults have the lowest COVID-19 vaccine rate of all adults. What do you think public health needs to do differently to build confidence and trust among adolescents and young adults? Abby, I feel like I'm gonna throw this ball to you first because you've already started to touch on some of these points.

Abby Melton:

Yeah, totally. I know one thing that I haven't seen a lot of, that I've heard a lot of about amongst my peers, is feeling as though they are kind of underestimated by a lot of adults. Teens are smarter than I feel like sometimes they're perceived to be in that they feel as though they're not getting all of the information they need to make their own informed decision. A lot of the times the content that's being pushed out to teenagers is pretty simplified and pretty face value because it is attention catching and it does get your point across. But I feel like it's led a lot of people to feel as though they aren't getting everything they need to be able to make their own informed decision, which young adults definitely, in this age, are really seeking to do. So, in my opinion, that's why I think it's incredibly important to get youth guidance on messaging. Getting the influence and hearing the voices of the teens and young adults that your are going to be g iving this messaging t o will hopefully get i t more in touch. Maybe have them be more receptive to it. Where in a lot of cases, sometimes it just gets written off.

Maura Leahy:

Abby, I feel like you made so many brilliant points there and I just, I have to say, I agree with all of them. Kate and Ben, did you have anything you'd like to add?

Ben Hoffman:

The biggest place where I think we need to do work is in making sure that the messaging is done by the right people. Especially in black and brown communities because of the general mistrust in it and the impacts of generations of systemic racism. People don't necessarily trust the health system around COVID period and I totally understand. I bring some trustworthiness as a pediatrician. I think nurses have a tremendous capacity. I feel like this is a huge opportunity to really weave in a culturally representative community and traditional health workers. That's where I see the huge opportunity for public health in being the connector, the convener, and to facilitate this cross sector approach. It can't be one of us, it has to be all of us,

Maura Leahy:

Abby, I know you've been acting as one of these trusted messengers in your community and working with the North Carolina department of health. Could you talk a little bit about what you've been involved in and how you've been assisting their vaccination efforts?

Abby Melton:

Yeah, of course. With the youth health advisory I'm a part of with the division of public health, we've worked really closely with a social media team recently. Because that's a really great way to get information out to people my age is through social media, if only it can be delivered by reliable sources. Which we've hopefully been able to create content that is from a source with, a reliable distributor of information. T hey can also capture people's attention. We recently posted a picture that has been one of the most liked pictures on their Instagram in recent months, maybe even t he past year, which has been really great. I've also done a lot of outreach through my school in terms of starting up efforts to take polls and get more information about where our community kind of stands on the COVID vaccine. And it's been really important to work with school administration on that, because I know a lot of people, sometimes it can be really valuable to hear it from someone your age, not just the school administration. So being able to collaborate with them on their efforts has been really, really helpful.

Maura Leahy:

Thanks, Abby. There's been a lot of discussion in the news and on social media about the COVID vaccine for younger children, as well as a lot of misinformation and anti-science aggression about the safety and efficacy of the vaccine. I can only imagine how confusing this must be for parents who are hearing different conflicting and sometimes incorrect messages and fact. And we also know that trust is an important factor that affects parents and caregivers intent to vaccinate children that we've sort of started to touch on a little bit. Kate, what would you like public health and MCH professionals to do to increase your trust in the information that you're receiving from health professionals?

Kate Robinson:

I think being able to just have a little more transparency into the research. And again, I realize that it's tricky to do in sort of bite sized, digestible pieces of information, but I think there's a happy medium somewhere. I mean, frankly, I think more partnership. I know that the ad council is doing a whole campaign, but I mean, we have brilliant marketers in this country, like amazing. Like the Geico commercial people or whatever. I mean, if we just have like incredibly entertaining, thoughtful advertisements. And I just feel like being able to kind of partner, and I know some of this is being done, but I just keep thinking, sort of wishing for that sort of a flavor married with the science. And being able to just have a little more transparency into what we learned in the research.

Maura Leahy:

Ben, could you tell us about some strategies that you use in your work? For example, how do you communicate the safety of the vaccine to parents and why it's important that young children get vaccinated?

Ben Hoffman:

My experience is that the first most important thing is to make sure you're ready to listen, to just ask specifically what are your concerns and why. If it's something that I know I can address, I will address it and be as reassuring as I can. I have to be, we have to be, very careful to not overstep our bounds and make sure that we're honest about what we know and what we don't know. So I think listening to families, listening to their concerns, addressing what you can address there and then figuring out what you can do, is there additional information that might be out there that you can help them identify working with them? Because we both have the same goal, which is that their child thrive and achieve the best possible health. I also will very clearly state that there is nothing I would ever recommend for their kid or their family that I would not do for myself, would not do or have not done for my own children. And I feel like that often brings some credibility and helps bolster that trust. This is not something I'm imposing on you. This is something that I did myself or I would do. I feel like that that is often very helpful.

Maura Leahy:

Are there any other innovative strategies to promote vaccination either for the younger children or for adolescents and young adults that you've seen work well that we haven't talked about yet?

Abby Melton:

I wanted to state the importance of social media as a tool. It can be used not just as a means of propagating misinformation or aggression. It can be used, when in the hands of the right people, as a way to promote the facts, promote the science that we know to be true about the vaccine. And I believe it's one of the most important ways to get in touch with teenagers about it because teenagers, a lot of the times, aren't the ones watching the news or reading the science journals. We're the ones who see the Instagram infographic on the explore page and click and scroll. So using social media in a way that a lot of the times, using social media in a youth, guided way, that it can best reach teenagers who will be receiving it, I believe can be a very powerful tool.

Ben Hoffman:

So I would say, even before the vaccine was released for the kids five to 12, r ight, there was really good polling numbers that suggested a third of people w ere going to show up on day one, be super excited. A third of people were not just no, but hell no. And I think we need to spend our time in the middle, with the people who are willing to have a conversation. And not that we can't worry about the hell no's, but I think focusing on not picking arguments, not trying to move immovable objects. And getting the people who, you know may potentially actually do it. Because we are not g oing t o mask and hand sanitize our way out of this pandemic. We need as many people vaccinated as possible.

Maura Leahy:

All right. I just wanted to see real quick. Was there anything else that any of our panelists wanted to share with us today?

Kate Robinson:

I just have one thing that I really do want to say. I guess what I want to say is that the sort of desperation I had felt in this pandemic and that I felt as a mother of a kid with a complex disease is just something I would never wish on anyone. And when you've kind of been through that, the life or death moments, and you're lucky enough to get to a place of relative safety and stability, you do anything to not have to go back there, including extreme quarantine and whatever you need to do. And so now it feels we're at the mercy of our community to not go back there. And I loved that Dr. Hoffman said,"we're not going to hand sanitize and mask our way out of this pandemic. We need people to get vaccinated." Families like mine are relying on parents to vaccinate their children and get vaccinated so that we can be safe and we can move forward and survive. And so I just sort of feel like begging people to do that and to know that the science is very real, it is safe and effective. And if we do vaccinate, we can get out of this pandemic and yeah. Yeah.

Maura Leahy:

Thank you so much, Kate. It's hard to believe that we're still in this and we haven't been better humans to each other when we can. Well, I just want to thank all of our guests one last time for sharing their time, their thoughts and experiences. Being here and talking with you all and just listening to you all speak has me feeling, you know, we have a lot of work to do still, but I do feel optimistic that we can get through this and protect our children and our young people, which is protecting our futures. Thank you all for joining us for this episode of MCH Bridges. We kindly ask that you take a few minutes to fill out a quick feedback survey at bit.ly/MCHbridgespilot. Let us know what MCH related topics you're interested in and who you want to hear from on future episodes. A link to the podcast feedback survey, as well as a transcript of this episode can be found online at www.mchbridges.org. For those interested in learning more about strategies for increasing COVID vaccinations, among adolescents and young adults, and for communicating with parents about the COVID-19 vaccine, we've shared several additional resources in the description of this episode at our website. Be sure to follow AMCHPDC_AMCHP up on social media. We're on Twitter and Instagram at DC_AMCHP We hope this episode created some new connections for you. Stay well aBd I hope our paths cross on the next MCH Bridges.

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This project is supported by the Health Resources and Services Administration, or HRSA, of the US Department of Health and Human Services, or HHS, as part of an award totaling$1,963,039 with 0% f inanced with non-governmental sources. This information or content and conclusions are those of the author a nd should not be construed as the official position or policy of nor should any endorsements be inferred by HRSA,, HHS, or the US government.