Claudia Espinosa wanted to get her child a flu shot and a COVID booster during the same visit last week to her pediatrician. But when she arrived at the Tampa office, she learned the COVID shots hadn’t arrived. Her pediatrician was unable to tell her when the office would have them available.
The slow rollout of updated COVID boosters is challenging for Florida’s parents seeking to immunize their children for the fall respiratory season. It also has been difficult for pediatricians who carry a bigger burden now in making the shots available to patients.
The federal government is no longer buying and distributing COVID vaccines, which means pediatric groups, pharmacies and clinics must purchase the updated shots directly from the manufacturers. The vaccines for children between 6 months and 11 come in a different dose size and packaging than the version for people 12 and older. That has created a quandary for pediatric practices that want to make the shot available, but are unsure of the demand or how much insurers will pay them for the shots.
“Pediatricians have to shell out money ahead of time, and vaccines are expensive,” said Dr. Lisa Gwynn with University of Miami Miller School of Medicine. “Vaccines have narrow margins to begin with, and some doctors don’t want to stock it because of that.”
Two-thirds of parents with children under age 12, and six of 10 parents of teens, said they won’t get their child vaccinated against COVID-19 this fall. In Florida, only 25% of children ages 6 months to 11 years old are vaccinated.
Still, for Florida parents who do want to protect their children, frustrations are running high, with pharmacists and pediatricians unable to confirm when the shots will arrive.
“The pharmacists tell me they have not received any pediatric vaccines,” said Lori Glass of Weston, who has been scouring pharmacies in her neighborhood, trying to find a COVID booster for her 11-year-old. “It seems like they aren’t even planning to get them.”
On Wednesday, the Centers for Disease Control & Prevention and the American Academy of Pediatricians held a town hall on the child vaccine rollout. CDC director Mandy Cohen said children who previously received a primary series with one brand can switch to a different brand when getting an updated dose. She also assured pediatricians that availability of vaccines will increase in the coming weeks.
To encourage orders, Pfizer has agreed to 100% returns for the three-dose COVID-19 vaccine vials authorized for children 6 months through 4 years. Pediatricians now must decide how many doses to buy.
When are they arriving?
In a written statement, Pfizer told the Sun Sentinel it already has shipped more than 1 million pediatric doses. “We’re continuing to meet demand from wholesalers and customers and anticipate delivering millions of additional doses each week,” the statement said. “Additionally, we have been made aware of the need for more flexibility in ordering size from pediatric clinics, and we are adapting deliveries to meet these requests.”
Moderna began shipping pediatric doses two weeks ago, according to the Washington Post. Moderna did not respond to questions about distribution of its pediatric doses in South Florida, but its website says “additional supply is being shipped daily as we continue to see high demand.”
On Thursday, some of the new pediatric booster doses began to arrive in South Florida. Gwynn said UM has received some for the university’s mobile clinic and its nine school health clinics in Miami-Dade County.
“Its not an issue of supply,” she said. “The big issue is commercial insurance plans are not all covering it yet, but they will be.”
Who will have the boosters?
Pediatric Associates, with 36 offices in the tri-county area, has had to balance demand, storage and cost. The group has decided it will offer Pfizer updated pediatric COVID boosters at all its locations and sent back the unused former boosters. Although the group has ordered the new shots, they haven’t arrived yet.
When the boosters do arrive, Pediatric Associates will carry the formulation for the youngest children 6 months to 4 years old, those for children 5- to 11-year-olds, as well as boosters for 12 and older.
Pharmacies like Publix say they will carry the boosters only for children ages 12 and older — basically the shots for adults. At other retail pharmacies, only certain locations will have shots for the children. Vaccines.gov allows you to search by age group, vaccine brand, and ZIP code.
CVS Minute Clinic spokesman Brent Burkhardt said parents can make appointments for the pediatric COVID-19 vaccine for children ages 5 and older at CVS.com and through the CVS Pharmacy app. They can make appointments for children 18 months and older at MinuteClinic.com. Only certain CVS locations will have pediatric doses, and they are arriving on a rolling basis.
Novavax’s updated COVID-19 vaccine using a different platform than the mRNA only has been approved for anyone 12 and older. Many Walgreens locations in South Florida have them.
CDC director Cohen said children who previously received a primary series with one brand can switch to a different brand when getting an updated dose.
For the uninsured, Jay Williams, a spokesman for Florida’s Department of Health, said it is up to each Florida county to order the boosters for children from the CDC. Some county health departments may already have put their orders in.
“We were told as more doses become available they will be pushed out, but we have no idea when that will be,” he said.
Williams said only children 5 and older will be given a shot at a health department in Florida, as per the state’s COVID vaccine policy.
Why get the update COVID vaccines?
Although many parents are hesitant, federal health officials recommend the updated coronavirus vaccines for everyone 6 months and older. They cited data showing that infants, along with older adults, have the highest rates of COVID-associated hospitalizations.
Children are less likely to get seriously ill from COVID, but some do, said Dr. Mobeen Rathore, UF Health Jacksonville’s associate chair of the department of pediatrics. “You never know whether your child will be the one who gets sick enough from COVID to be hospitalized. It’s very unpredictable.”
Data shows most children younger than 5 who have been hospitalized for the disease had no underlying medical conditions. Hospitalization rates are relatively low for children comparable to flu, but once hospitalized, more kids went to the ICU for COVID-19 than for flu.
“The idea behind the vaccine is to prevent serious infections.” Rathore said.
Pediatricians like Dr. Mona Amin with Pediatric Associates in Fort Lauderdale suggests parents consult their doctors. “It’s a parental choice,” she said. “I am transparent in saying the booster won’t prevent your child from getting COVID or getting hospitalized, but it can reduce those things.”
While Florida is in a COVID lull, Dr. Espinosa, a mother and pediatric infectious disease specialist at University of South Florida, said parents with travel plans or who will participate in family gatherings should be patient, yet persistent.
“This is all pretty new. There are still things that need to be worked out,” she said. “Everybody is working for the kids. We don’t want them sick or hospitalized or to die. If vaccines are not on the shelves right now, wait a couple of weeks, call again, and know that everyone is working on it.”
Are children’s vaccines free?
There are many reports that people are being asked to pay for their COVID-19 vaccines. No one should be paying for a vaccine, including children, health officials say.
Private insurance companies are mandated to cover the updated vaccine with no co-pay. However, if you can’t find a pharmacy in-network with your insurance plan, you may need to get your child the vaccine at your pediatrician’s office.
For children without insurance, the government-funded Vaccines for Children program covers all kid’s vaccines.
Sun Sentinel health reporter Cindy Goodman can be reached at cgoodman@sunsentinel.com.
