COVID-19 vaccinations for Maryland children ages 5 to 11 may start by Friday

With federal signoff on the Pfizer/BioNTech COVID-19 doses for kids ages 5 to 11, local health departments, doctor offices, pharmacies and schools in Maryland may begin getting shots into kids’ arms as soon as Friday.

Vaccine has begun arriving in provider offices already. A total of 181,000 doses will be distributed throughout the state in the coming weeks — enough for more than a third of the 515,000 children in that age range, but perhaps not sufficient to meet the earliest demand from parents. Additional doses are being shipped directly to pharmacies in the state by the federal government and aren’t included in that figure.

All 24 public school systems in Maryland have agreed to host vaccination clinics, Gov. Larry Hogan said at a news conference Wednesday, and the state will also launch mobile vaccination clinics to help reach families in the state. Hogan said the state authorized healthcare providers to immediately begin scheduling appointments and to administer shots as soon as doses arrive.

Dr. Jinlene Chan, Maryland’s deputy secretary of health, said children have accounted for a growing proportion of coronavirus cases in Maryland and, although children are at lower risk of severe outcomes than the elderly, Chan said about 700 children under 12 years old have been hospitalized in the state with the disease. Clinical trials made clear that vaccines are safe and effective for children, Chan added.

“For all the parents out there, please look for a vaccine,” said Chan.

Anne Arundel County Health Officer Nilesh Kalayanaraman said on Tuesday that he anticipated it taking about three or four weeks for the supply of vaccine doses designed for children to match demand from parents. Anne Arundel anticipates initial doses will cover about a quarter of the 51,000 county children in that age group, and officials plan to spread vaccine around to ensure wider access.

“There will be a wait for the first few weeks,” Kalayanaraman said, “but rest assured, we will vaccinate your children.”

That reflects the strategy of most local jurisdictions, with parents signing up online or on the phone through health department portals or directly with doctors or pharmacies. Recognizing the inequitable distribution in the early days of the adult vaccination effort, state and local officials said they want some doses directed to children most at-risk or with the most obstacles to getting a shot.

On Wednesday, officials said they would be deploying the state’s Vaccine Equity Task Force to help identify and bring clinics into communities in need of easier access to vaccines. The state also will lend staffing support to school systems and counties, Hogan said.

State health officials are reaching out directly to parents to urge vaccinations and the state will also roll out a new round of public service announcements featuring pediatricians encouraging shots, Hogan said. But the governor said the decision “is up to, and should be up to, Maryland families and parents.”

The Pfizer vaccine is the same as the one given to adults and adolescents, though it’ll be a third of the dose. That was the optimal amount found through trials in recent months, with results showing the vaccine is safe and more than 90% effective in preventing COVID-19.

The vaccine is being specially packaged to ensure providers don’t mistakenly give kids the larger dose. Children, like adults, will need a second dose in three weeks.

President Joe Biden has said the federal government has bought enough doses to eventually vaccinate all children in the age range, and the shots will be free to consumers.

As the pandemic drags on, national surveys suggest there could be a burst of interest from parents. But some, even though vaccinated themselves, may not want a shot right away for their kids.

In adolescents, there was a rare chance of a condition called myocarditis, or inflammation of the heart. But most cases were not serious or lasting, and experts say the long-term risks from a coronavirus infection are far greater. Most other reactions were brief and included sore arms or fever.

Surveys in Maryland by the Johns Hopkins Center for Communication Programs found that 83% of Maryland parents would definitely or probably get their children vaccinated compared with 70% nationally.

More specifically on timing, a survey by the Kaiser Family Foundation found about a third of parents nationally said they planned to get the vaccine for their children right away, a third wanted to wait and a third were not planning to get their kids inoculated.

State and local health officials and health systems say they still are formalizing vaccination plans. For example, the University of Maryland Medical System and Johns Hopkins Medicine, which have affiliated doctors’ offices, plan to offer some vaccine for children in some locations but say appointments will depend on the supply they receive.

Retail pharmacies are receiving separate allocations directly from the federal government, but some such as CVS already have said they plan to offer vaccine to younger children. Maryland pharmacists are permitted to give the shots to 5- to 11-year-olds, but some corporate chains only vaccinate older kids.

Andy Owen, a spokesman for the Maryland Department of Health, said vaccines ultimately will be available at hundreds of health care providers, including family practices, pediatricians’ offices, local health departments, pharmacies and school-based clinics.

Some providers already have initial doses in hand, as they began shipping last week in anticipation of the approval from the U.S. Centers for Disease Control and Prevention, which came late Tuesday. The U.S. Food and Drug Administration authorized the Pfizer vaccine for younger kids last week.

The state maintains an online vaccine locator that will be updated with sites offering children’s vaccinations. More than 300 additional providers will be added in the coming weeks, according to the state.

Owen said doses are expected to be sent from federal stocks, directly to the providers, on a weekly basis.

“We expect to have ample supply to meet demand,” he said.

Parents who don’t want to go searching will likely be able to get their children vaccinated at a local school, and Owen said those clinics will be “one of the best ways to provide an efficient, equitable means for most 5- to 11-year-old Marylanders to receive their COVID vaccines.”

And the state plans to offer support to family doctor and pediatrician offices, which the department found was a top place parents’ wanted to take their kids. Owen said providers will be required to have proper storage capability for the vaccine, which initially is kept in deep freeze but can be refrigerated for a month.

Health officials also expect Pfizer to make further changes to make it easier for providers to use the vaccine, such as shipping fewer vials at once and seeking longer refrigeration time, Owen said.

The logistics of providing vaccine remains a sticking point for many pediatricians. About 40% in Maryland said they wouldn’t offer vaccinations, according to surveys by the Maryland chapter of the American Academy of Pediatrics.

The barriers are a national issue, said Dr. Sterling Ransone, president of the American Academy of Family Physicians and a doctor in the rural Chesapeake Bay community of Deltaville, Virginia.

He said storage and handling of vaccine was a challenge for a lot of doctor offices, but staffing was a bigger problem. The offices can’t spare nurses to exclusively vaccinate children, especially during a national shortage of nurses.

His office began offering telemedicine visits for some services and that helped free up staff to vaccinate adolescents. Staff even called people they believed were especially at risk for complications from COVID-19 and offered to schedule appointments.

Ransone said many family doctors want to vaccinate younger children because they know parents are likely to have questions. But even if they have a system and staff, there may be another issue: It’s now respiratory disease season and they also may be flooded with kids suffering from the flu or RSV. The coming weeks probably will be even worse.

“We’ll all be very busy tending to sick people,” he said. “Still, I encourage all parents to discuss vaccine with their physicians if they have concerns about it or the timing or anything.”

For others ready to get the vaccine, health departments in Maryland are beginning to schedule appointments.

Anne Arundel plans to use existing vaccination sites and schedule appointments possibly beginning Friday.

Howard County’s health department also plans to start scheduling appointments Friday and offer 400 appointments a day. Officials there said previously they would designate Howard Community College as a vaccination site for younger kids.

Harford’s health department has two clinics planned so far in November.

Baltimore City has said it will lean on its school-based clinic model, as it did for older students, and also likely host other sites around the city. Officials did not update their plans Tuesday.

Baltimore County’s health department said it also plans its first clinic Friday, and like other counties, the slots will go by appointment only. Sign-up links will be available Thursday once initial doses arrive.

The county has received 8,700 doses of the kids’ vaccine, according to the county, and will use the former Sears building at the White Marsh Mall for at least the first two clinics Friday and Saturday.

“Baltimore County Department of Health is looking forward to getting the vaccine into the arms of 5- to 11-year-olds,” said Dr. Gregory Wm. Branch, Baltimore County health officer. “We will make the vaccine available to this age group and to residents eligible for first, second or third doses at each of our vaccination clinics.”