To reach the unvaccinated, follow the childhood immunization model

Let’s be realistic. No self-respecting five-year-old wants another needle stuck in her or his arm. Ever since childhood immunizations became routine, kids have had to be bribed with all sorts of rewards if they got their shots: Lollipops, brightly colored band-aids, even cotton candy and gummy bear-flavored ice cream.

There are a good number of parents who are holding their breath, however, waiting eagerly for the day when they can have this emotional confrontation with their elementary school-aged children. That day will come soon, as the federal government is now considering the data released by Pfizer and BioNTech on their COVID-19 mRNA vaccine in children 5 to 11 years of age. The results were promising  — side effects were similar to people 16 to 25 years of age and the levels of protective antibodies were just as high, even with a smaller vaccine dose.

But this came at the same time that the U.S. surpassed a tragic milestone, with more people having died from COVID-19 than were estimated to have died from the 1918 flu pandemic — more than 700,000 people killed in the U.S. alone. Even more tragically, 14.6 percent of all deaths from COVID-19 globally — so far — have occurred in the U.S. whereas only about 1.4 percent of all deaths globally from the 1918 flu pandemic took place here.

Back in 1918, we had little understanding of what caused influenza and what viruses were, no safe and effective vaccine, and no intensive care units or antiviral drugs. But, despite all the advances in medicine and public health over the past 100 years, we still could not prevent more than 700,000 deaths from COVID-19 in the U.S.

If I had a magic wand that could get rid of the pandemic, it would be a vaccine. But we have three vaccines, all of the vaccines are effective in preventing hospitalization and death, and the U.S. has a large enough vaccine supply on hand to immunize elementary school children and provide boosters to those who qualify.

These three amazing tools were just a dream during the 1918 flu pandemic, and they can almost magically prevent deaths from COVID-19 in the U.S. — as of today, averaging about 1,764 per day. And yet, nearly a quarter of the population has yet to receive even one vaccine dose. And fewer than half of children 12 to 15 years of age have been fully vaccinated against COVID-19, despite being eligible since May.

Childhood immunization is not just about brightly colored bandages: Almost all of the immunizations that every child and parent face are mandated by state governments to protect them and the children around them. Some of the strictest mandates with the best compliance are found in states where sentiment against COVID-19 vaccines runs high.

Public school students in Mississippi, for example, must receive five childhood vaccines and are not allowed exemptions for philosophical or religious reasons — only medical reasons are permitted. As a result, the state has one of the highest childhood immunization rates in the country, with measles immunization above 96 percent. Yet the state ranks third to last in the U.S. in COVID-19 immunization, with an estimated 44.6 percent of its population fully vaccinated.

Not all of these unvaccinated people — in Mississippi and everywhere else — are anti-science fanatics. Some are hesitant and have received too much conflicting information. As of August, approximately 44 percent of the remaining unvaccinated adults were willing to get the shots but had not yet done so. Many come from underserved communities that we have not yet reached with information and vaccines. While white Americans account for 60 percent of unvaccinated adults, Black and Hispanic Americans are less likely to be vaccinated than white Americans, although these differences are decreasing.

As we make plans to roll out COVID-19 vaccines for elementary school-aged children, we need to also dig deeper and reach those unvaccinated communities that can be reached. This is not about placing a band-aid on the political arguments that have torn apart our country. It’s about saving lives and putting an end to the havoc wrought by COVID-19. We have the tools — including three magic wands.

William J. Moss, MD, MPH, is the executive director of the International Vaccine Access Center at the Johns Hopkins Bloomberg School of Public Health.