As teenager Corey Ruth weighed getting the COVID-19 vaccine, rumors of computer chips and the legacy of the Tuskegee experiments were on his mind.
Even though his mom, a nurse in New Orleans, had already received her shot, he still wasn’t sure about it.
Ruth started to come around to the idea as he watched more of his high school football teammates get the vaccine.
“I wanted to protect my family and teammates,” said Ruth, who will be a junior at McDonogh 35 high school in New Orleans. But what clinched the decision for Ruth was talking over his concerns with his team’s athletic trainer, and getting reassurances that the vaccine was safe.
“Because I trust him with my body,” said Ruth. “He provides for me so I can be 100 percent on game day.”
As fixtures in their communities, schools have long been a source of public health information for families. For that reason, schools are perfectly positioned to play a vital role in helping students and their parents overcome uncertainty about the new COVID-19 vaccines, say public health experts.
The stakes are high: Strong vaccination rates are seen as key to middle and high schools returning to anything resembling pre-pandemic normalcy in many places this fall. The importance of vaccinating children extends well beyond the school walls, too. Many public health experts estimate around 80 percent of the country’s population needs to be vaccinated to truly stall the spread of the coronavirus, a task that is taking on additional urgency as the more infectious and deadly variant of the coronavirus, called the Delta variant, becomes the dominant strain in the U.S.
“We’re at the point where it’s an all-hands-on-deck situation,” said Wen-Ying Sylvia Chou, a program director at the National Institutes of Health who studies health communications and online discourse. “We all have a role to play, including schools. I think the question is how.”
But many parents, especially those of younger children, are reluctant to get their kids vaccinated with something so new. So far, only one COVID-19 vaccine, developed by drugmaker Pfizer, has been given emergency approval by the federal government for adolescents 12 and older, and that was only granted in May.
Approval for younger children could come as early as this fall. Forty-one percent of parents with kids 12 and older said in a recent Kaiser Family Foundation poll that they will get their child vaccinated immediately or already have. Only about a quarter of parents with children younger said they will get their kids a COVID-19 vaccine when one becomes available.
Parents’ vaccine hesitancy fueled by different factors
Whether it’s with the COVID-19 vaccine or routine childhood immunizations, parental reluctance to get their children vaccinated is something all schools will deal with at some point.
There are many different factors—fear, misinformation, and apathy—that can drive vaccine hesitancy, the public health term for the delay in accepting vaccines or refusing them altogether.
Fears of unknown, long-term side effects, especially with the COVID-19 vaccine, are stoked by fast-spreading misinformation on social media and exacerbated by a lack of trust in the government, science, and the media.
Among the de-bunked rumors circulating online: that the vaccine can cause infertility (there is no scientific backing for this and no evidence from the vaccine trials and ongoing monitoring of the vaccine in the general population that this is happening), that the COVID-19 vaccine changes your DNA (the messenger RNA in the vaccines developed by Pfizer and Moderna does not interact with a person’s DNA), and that the vaccine development was rushed (the “new” technology, or the mRNA used in the Pfizer vaccine approved for adolescents, has been in development for two decades).
Doctors from Johns Hopkins medicine give a detailed explanation for how these rumors are false, which you can find by following this link.
Parents’ gender, age, and race all factor into how resistant they are to vaccinating their children against COVID-19.
Mothers are more reluctant to vaccinate their children against COVID-19 than fathers, and younger mothers are significantly more resistant than older ones, according to polling by The COVID States Project, a research partnership between Northeastern, Harvard, Rutgers, and Northwestern universities. Black, Hispanic, and white parents are all about equally resistant to the vaccine, and much more hesitant than Asian American parents.
Some groups of parents are becoming more resistant to the vaccine over time, the research group found, in particular parents in households making less than $25,000, parents without a college degree, and parents who identify as Republican.
Hyper-divisive discourse is contributing to a reluctance to get the COVID-19 vaccine, something Chou has seen through her research.
“Not just anti-vax, but trying to make vaccines a fightable issue,” she said. “The information environment has enabled a more polarized society. That, in part, contributes to a tribal mentality around, are you anti- or pro-vaccine? … There are a lot of worries about identity and ideology that come into play.”
Another issue at play: People hesitate to get vaccinated if they don’t see it as doing them personally much good, said Glen Nowak, the director of the Center for Health and Risk and Communications at the University of Georgia’s journalism school.
“You can believe that the vaccine does have benefits, but that you yourself don’t really personally need those benefits,” Nowak said, an issue public health officials see every year with younger, healthier people not getting the flu vaccine.
So as parents weigh the unknowns and risks, real or imagined, they may feel it’s not worth taking a chance with their kids’ health, especially when most children do not fall as seriously ill with COVID-19 as older adults can.
Parents aren’t the only ones making that calculation. While there are many, many medical experts who believe vaccinating children against COVID-19 as soon as possible is important to protecting kids and society at large, those beliefs aren’t unanimous.
Some have raised doubts over whether the country should push to immunize younger, healthy children as aggressively as it did adults, especially as case numbers around the country are dropping and evidence is growing that in rare instances the vaccine has been linked to treatable heart inflammation in adolescents and young adults (COVID-19 can also cause heart inflammation).
A pass from parents on the COVID-19 vaccines now, however, doesn’t mean a pass forever, Chou and Nowak emphasize. Most people are somewhere on the spectrum between enrolling their child in a COVID-19 vaccine trial and being a staunch anti-vaxxer. They need good information, time for that information to marinate, and a sounding board for their concerns.
And this is where schools can play an important role in overcoming hesitancy, and not just for the COVID-19 vaccine.
“Whether it’s the school nurse, the school event, the PTA, the schools are embedded in the community, parents trust the schools,” said Dr. Rani Gereige, a pediatrician at Nicklaus Children’s hospital in Miami who also researches schools’ roles in children’s health. “I think their role is huge [in] spreading the correct information and guiding the parents to the right resources and giving them access to experts … and to other parents.”
Finding the right message and messenger
In New Orleans, school district officials see the vaccine as key to getting schools back to something resembling normal this fall. The district launched a pilot program this summer to encourage eligible students to get a COVID-19 vaccine and to figure out what messaging around vaccines resonates with families ahead of the school year.
COVID-19 hit Black communities across the country disproportionately hard. At one point during the pandemic, the New Orleans area had the highest death rate per capita in the country.
The district there partnered with major health systems in the area to host vaccination drives for students over 12 enrolled in its summer programs, similar to what it had done for teachers this past spring. The turnout, however, has been vastly different. Families have been far less enthusiastic than teachers were to get the vaccine, and district officials quickly realized they had to do more than make the vaccine easily accessible, said Tiffany Delcour, the chief operations officer at NOLA Public Schools.
“Week one showed us immediately that we have to do a lot more work with engagement, information sharing, before the start of the school year,” she said.
The district plans to hold town halls with local medical experts for families and is exploring the possibility of offering incentives, such as meet and greets with New Orleans Saints players or even doing away with schoolwide mask mandates if enough students in a given building get vaccinated.
Among the schools that had the most success vaccinating students in the first drive were those belonging to a local network of charter schools called InspireNola, which invested in a major outreach to families about the vaccine.
InspireNola did email blasts and social media campaigns. It sent information packets about the COVID-19 vaccine home to parents along with permission slips for students to get inoculated at school. It offered incentives to students to get vaccinated, such as free uniforms and special field trips. And the charter network encouraged school personnel, such as teachers, principals, and coaches, to talk about their personal experiences getting vaccinated.
InspireNola’s schools have also been leveraging students’ peer networks to share information about the vaccines.
At McDonogh 35, an InspireNola high school, Principal Lee Green and his staff identified influential students in their school—students involved in athletics or school clubs—and invited them to meet with school officials to discuss their concerns and questions about the vaccine.
“And then we did not answer those questions immediately, because we are not the experts,” said Green. “We made clear we were not the experts. We brought those questions to the medical experts in our area through our nurse. And then we let [the students] take that out to their peers.”
Green is hoping that by seeding this information among student leaders, it—along with personal anecdotes as students get vaccinated—will organically spread through the student body and home to families.
It worked for Ruth. Before he got vaccinated, Ruth talked to his teammates about their experiences. His teammates didn’t turn into zombies, Ruth said, which was one of many rumors floating around school. They just had sore arms.
Lee said there’s been a fine line to walk with messaging: Educators don’t want to push students to get vaccinated, but they also need to stay ahead of rumors and misinformation.
“We made sure we did not use the words, ‘You have to,’ or ‘This is mandatory to come to school,’” he said. “But we’re asking them to go out, research on it, find out some more information, talk to your parents about it, and then talk to your peers about it.”
‘Where schools need to play a bigger role is education’
Connecting families to experts who can answer their questions, incentivizing the vaccine through prizes, and normalizing the vaccine by sharing personal experiences are all tried and true ways to overcome hesitancy.
Some families, though, may need more personalized communication to get over the hump, said Keri Rodrigues, the president of the National Parents Union, an advocacy organization for parents in K-12 education. Her organization has been surveying parents on their feelings toward the COVID-19 vaccine.
“What we are seeing in our surveys is that parents and families are interested in knowing that schools care about their individual child. It’s not about just whipping out a flyer and saying, ‘Hey, vaccines are available, if you want it,’” Rodrigues said.
Schools must also be sensitive to the communities they serve, and be prepared to tailor their approach in encouraging the uptake of vaccines among their students.
For example, the nation’s history of performing medical experiments on Black Americans drives mistrust and hesitancy about the government and medical establishments to this day, as does issues with ongoing racial bias.
There are also religious communities and parents dedicated to natural wellness and alternative medicine who are resistant even to routine childhood vaccination.
And just because some public health experts think this is a natural role for schools to play doesn’t mean it’s a role every community will embrace.
There is the sticky issue of politics. Schools could face blowback for encouraging the COVID-19 vaccine—which polling shows wide swaths of Republicans are distrustful of. Former President Donald Trump’s recent advocacy on cable news against vaccines for children, as well as a dust-up in Tennessee where Republican lawmakers accused the state’s own health department of pushing the vaccine on children illustrate how politicized the issue is becoming.
Whatever approach schools decide to take, they need to handle messaging around the COVID-19 vaccines with care. It must be authentic and not overly aggressive, said Nowak, because pushing vaccines too hard can have the opposite effect.
“You can strengthen people’s hesitancy if they feel they are getting a sales pitch.”
A version of this article appeared in the July 14, 2021 edition of Education Week as Vaccinating Kids Against COVID-19: Why Families Are Afraid And How Schools Can Help