Ten-year-old Joseph Percy gets his COVID-19 vaccine from nurse Kamiel Houston as his 5-year-old cousin Jacqueline watches at Cityview Community School in Minneapolis on Thursday. Credit: Evan Frost | MPR News

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Governor Tim Walz chose an appropriate enough spot last week to publicly announce the state’s COVID-19 vaccine rollout for kids ages 5-11: a school playground. 

Just two kids stood by Walz as a gaggle of adult reporters took note of his vaccination pledge. Three principles would drive the method behind the state’s vaccine rollout to children, Walz promised: speed, safety, and equity.

Equitable distribution of the vaccine proved elusive during the early days of the vaccine rollout among adults. When the state first released its COVID-19 vaccination data by race in March 2021, for example, people of color made up less than 10 percent of the vaccinated population but 21 percent of the state’s overall population. (Since then, the situation has improved, with vaccinated adults now generally evenly distributed across racial groups in Minnesota.)

On October 29, a panel from the U.S. Food and Drug Administration approved the two-shot Pfizer vaccine to children ages 5–11. Now, achieving vaccine equity will arguably grow even more important. Thirty-two percent of Minnesota’s population ages 19 and under are people of color, according to Minnesota Compass. That percentage is likely even higher among the 500,000 children ages 5–11 who are newly eligible for the shot. 

Children ages 5-11 are just as likely to be infected with COVID-19 as adults, according to the Centers for Disease Control and Prevention. Nationally, nearly 2 million kids in this age group have experienced confirmed infections since the start of the pandemic. Severe infections are rare but still possible: Roughly 8,300 kids between ages 5–11 have been hospitalized with COVID-19.

Minnesota will make a top priority out of distributing vaccines at schools. But the state’s 17 Federally Qualified Health Centers will also play a large role in bringing vaccines to diverse groups of younger kids. These clinics serve 200,000 patients across Minnesota. A majority fall below the federal poverty line, and 70 percent are people of color. 

After the FDA approval last week, the Minnesota Department of Health ordered 200,000 doses of the Pfizer vaccine for children ages 5–11. This week, Minnesota’s Federally Qualified Health Centers had 2,377 doses of the vaccine on hand and ordered 800 more, according to Minnesota Department of Health spokesperson Andrea Ahneman. The clinics are planning to continue ordering more doses each week, Ahneman added.

So far, local Federally Qualified Health Centers are at the very early stages of vaccinating this age group. 

Axis Medical Center and Community-University Health Care Center (CUHCC) both serve large immigrant populations in south Minneapolis. They report that they started administering the Pfizer vaccine last week to the newly eligible group of children. People’s Center Clinic & Services, another Federally Qualified Health Center, located in Minneapolis’s Cedar-Riverside neighborhood, expects its first shipment of 100 doses for kids will arrive on Friday. 

Jonathan James, an epidemiologist at Axis, estimates that the clinic administered three to six shots to children on Monday. 

Dr. Roli Dwivedi, CUHCC’s chief clinical officer, said that her clinic has so far administered fewer than 30 shots since last week. 

“The first day we launched, we did not get many patients, and earlier this week we did not get much,” Dwivedi told Sahan Journal on Wednesday. “But today, it’s starting to fill.”

Overcoming vaccine fears and building trust

CUHCC, located in Minneapolis’s Ventura Village neighborhood, serves a large patient base from the local East African, Latino, and Southeast Asian communities. Dwivedi said the clinic’s staffers are approaching the vaccine rollout carefully, knowing that many parents may be reluctant to get their children vaccinated. 

Fear and trust are issues, Dwivedi said, and misinformation about the vaccine is still circulating widely in all communities. There have been rumors about the link between myocarditis and the COVID-19 vaccines in teens. Myocarditis is a rare and generally treatable side effect of the vaccine. (Among males ages 12–29, it’s estimated to occur in 39 to 47 cases per 1 million second doses of COVID-19 mRNA vaccines.) Getting sick with COVID-19 is far more dangerous: The American Academy of Pediatrics estimates that the risk of myocarditis is 37 times higher for children under age 16 who contract COVID.

A history of hesitancy pre-dates the arrival of COVID-19. In 2017, for example, a measles outbreak affected the local Somali community, as vaccine hesitancy got in the way of kids receiving the measles, mumps, and rubella (or MMR) vaccine. So far, Dwivedi said COVID-19 vaccine misinformation about younger kids mostly amounts to myths that the vaccine will cause serious side effects. In truth, side effects to the Pfizer vaccine are typically mild side in children, and include short-term fatigue and headaches. 

Bringing vaccine drives to charter schools 

For outreach, CUHCC staffers are planning to team up with local Imam Sharif Mohamed to visit Somali charter schools and answer questions from parents and children about the vaccine. Imam Sharif helped organize a similar effort last spring to get 17 imams publicly vaccinated as a way to boost public confidence in the vaccine. CUHCC plans to send a small group of people to these events, including a nurse who can administer vaccines, should anyone decide to get a shot on the spot.

The idea is to avoid intimidating families by showing up with a big care team. “We want to be as gentle as we can in extending hands to the community,” Dwivedi said. 

The clinic also has plans to hold a vaccine event in Brooklyn Center at the CAPI food shelf. That event will target the Southeast Asian community. 

CUHCC says it also plans to start calling existing patients with children in the 5–11 age group to let them know the vaccine is available.

Axis is doing general outreach about the vaccine and plans to begin focused outreach to parents of newly eligible children. James said that, in general, the toughest thing to overcome is the misinformation spreading in all communities, including the Somali, Oromo, and Eritrean communities that Axis serves. 

Data can muddle clear messaging about vaccines 

Sometimes, the evidence that vaccines are safe and effective can seem complicated.

For example, James cited a recent study from Kaiser Permanente that found deaths from COVID-19 in the vaccinated population averaged 3.4, 3.5, and 8.4 per 1,000 people who received the Moderna, Pfizer, and Johnson & Johnson vaccine, respectively. The study found the unvaccinated COVID-19 death rate in comparison groups for each vaccine at 11.1, 11.1, and 14.7 per 1,000 people, respectively. 

Bottom line, the study shows vaccinated people are less likely to die from COVID-19—but it does so in a somewhat technical and complicated way.

“By the time you’re talking nuance like that, people aren’t listening,” James said. 

Instead, Axis is trying to drill down on straightforward messages, like that the vaccine is safe to take.

Getting the message out requires time and persistence. James compared it to the Axis clinic’s colon cancer-screening outreach program. In that case, medical professionals talked to patients about getting screened for cancer as many as eight times before the patient decided to do so.

“This is the same or similar,” James said. “We have to have multiple engagements, address questions, and incrementally move it forward. We don’t presume that we’re 100 percent right. Science is good, but imprecise still. We have to respect people’s autonomy, we have to respect their decisions, we have to respect that they may have very legitimate concerns.”

Ellis Fualefeh, who works in clinical support at Axis, takes part in weekly mobile vaccine clinics held by Axis and Minnesota Department of Health. These usually take place in churches, schools, and job fairs, and last around two hours. 

The most common question Fualefeh hears at these community meetings is whether the vaccine is safe. After answering yes, he often explains the potential mild side effects, and how they are a sign that the immune system is revving up to fight COVID-19.

“They usually end up getting the vaccine once we explain how they work,” Fualefeh said of the patients. 

A recent interaction with a middle-aged patient gave Dwivedi hope that the status change for  children could prompt vaccine-hesitant adults to finally get the shot. 

“She hadn’t had the vaccine yet,” Dwivedi said. “But she said, ‘I am ready now. If the vaccine is safe for kids, it’s definitely safe for me.’”

The takeaway point for Dwivedi? When you’re talking about vaccines, everybody thinks differently.

Joey Peters

Joey Peters is a reporter for Sahan Journal. His work has appeared in Reuters, Public Radio International, Columbia Journalism Review, KFAI Radio, the Pioneer Press, City Pages, MinnPost and more. He previously...