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Racial Disparities in COVID-19 Impacts and Vaccinations for Children




Although children have not borne the most severe brunt of COVID-19 relative to adults, some do become hospitalized, suffer long-term consequences, and even death from the disease. There is growing attention to how children are being affected by the pandemic, particularly as in-person school returns, and those younger than age 12 are not yet eligible for vaccination. While data remain limited, available research and data to date suggest that children of color have been disproportionately affected by COVID-19 and may be less likely to have been vaccinated, mirroring racial disparities observed among the broader population. These disparities may leave children of color at increased risk, particularly as they return to in-person school. Together the findings point to the importance of increasing data available to understand racial disparities in COVID-19 impacts and vaccinations among children and efforts to mitigate disproportionate impacts of COVID-19 for children of color going forward.


Disparities in COVID-19 Impacts among Children

Research suggests COVID-19 has disproportionately affected the health of children of color in ways that mirror patterns observed among adults. Studies find that, compared to their White counterparts, Black, Hispanic, and Asian children had lower rates of testing but were significantly more likely to be infected; Black and Hispanic children were more likely to be hospitalized and more likely to have multisystem inflammatory syndrome (MIS-C (a serious and sometimes deadly condition where different body parts become inflamed, including the heart, lungs, kidneys, and brain); Black children were more likely to be admitted to intensive care units due to MIS-C; and Hispanic, Black, and American Indian and Alaska Native (AIAN) children had higher rates of death. Recent data from CDC also show racial disparities in COVID-19 health impacts. As of August 31, 2021, there were almost 4.9 million infections, over 39,000 hospitalizations, and 725 deaths due to COVID-19 among children 19 and younger, which showed:

  • Infection rates were highest among AIAN, Native Hawaiian and Other Pacific Islander (NHOPI), and Hispanic children at over 500 cases per 10,000 people (Figure 1). White and Black children had over 300 cases per 10,000 people, while Asian children had the lowest infection rate at just over 200 cases per 10,000 people.
  • AIAN and Hispanic children had the highest rates of hospitalization, followed by NHOPI and Black children, who are two to three times as likely to be hospitalized than White children. Asian children had the lowest hospitalization rate.
  • There were large disparities in deaths for AIAN and Black children, whose death rates were over 3.5 and 2.7 times higher than the rate for White children, respectively. Hispanic children also were more likely to die than their White counterparts, while Asian children had a lower death rate. Deaths among NHOPI children were not reported due to insufficient data.

The pandemic has also adversely impacted children’s mental, social and academic growth, with Hispanic and Black children bearing the brunt of these impacts. A recent KFF Vaccine Monitor report shows that half of Hispanic parents say one of their children fell behind academically as a result of the pandemic compared to about a third (35%) of White parents who say the same. Additionally, half of Hispanic parents (52%) say one of their children experienced difficulty concentrating on school work, issues with sleeping and eating, or frequent headaches or stomachaches since the pandemic began, compared to less than four in ten (40%) White parents. Black and Hispanic parents also are more likely to say their household suffered a job disruption due to childcare needs in the past year and to say that the disruption has had a major impact on their family’s finances and stress level. These findings are consistent with a 2020 McKinsey analysis finding that Black and Latino students would disproportionately experience learning loss during the pandemic due to a variety of reasons, including a lack of access to high-quality remote learning, and high-speed internet. These disproportionate impacts of the pandemic may further widen existing gaps in academic performance for children of color.

Disparities COVID-19 Vaccinations among Children

Children ages 12 and older became eligible for COVID-19 vaccination on May 10, 2021, while children under age 12 are not yet eligible for vaccination at this time. Ensuring equity in COVID-19 vaccinations among children is important for mitigating the disproportionate impacts of COVID-19 and preventing widening disparities going forward. Moreover, because children make up a significant share of the population and are more racially diverse than the rest of the population, equitable vaccination among this group is key for achieving an overall high rate of vaccine coverage among the population and may help to reduce disparities in vaccination rates more broadly.

There is a dearth of data to examine vaccination rates by race/ethnicity among children, but the available data point to potential racial disparities in vaccinations among children. As of September 7, 2021, federal data were not available on vaccinations among children by race/ethnicity and just seven states were reporting these data. White children had higher vaccination rates than Black children in all seven reporting states, although the size of these differences varied widely across states (Figure 2). The vaccination rate for White children was higher than the rate for Hispanic children in two states (Connecticut, and Wisconsin), although the differences between rates were generally smaller than the differences in rates between White and Black children. Hispanic children had a similar or higher vaccination rate than White children in the remaining five states. In the five states for which we were able to calculate vaccination rates for Asian children, the rate for Asian children was higher compared to that of White children.

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Figure 2: Percent of Children Who Have Received a COVID-19 Vaccine Dose by Race/Ethnicity, September 7, 2021

KFF COVID Vaccine Monitor data show that Hispanic and Black parents are more likely than White parents to report potential access barriers to vaccination. Across racial/ethnic groups, the top concerns about the COVID-19 vaccine for parents of unvaccinated teens center around the potential for long-term or serious side effects in children. However, consistent with surveys of adults, Hispanic and Black parents are more likely than White parents to cite concerns that reflect access barriers to vaccination, including not being able to get the vaccine from a trusted place, believing they may have to pay an out-of-pocket cost, or having difficulty traveling to a vaccination site. A larger share of Hispanic parents than White parents also reports being concerned about needing to take time off work to get their child vaccinated.

Ensuring equity in vaccinations when children under the age of 12 become eligible for vaccination will be particularly important given the size and racial diversity of this group. There are 48 million children under the age of 12 in the United States, almost three times the number of adolescents, aged 12-15, who became eligible in May 2021. About half (50.5%) of children under the age of 12 are children of color, including more than a quarter (25.8%) who are Hispanic. An additional 13.3% are Black, 4.7% are Asian, and the remaining 6.7% are American Indian or Alaska Native, Native Hawaiian or Other Pacific Islander, or multiracial Some states have even larger shares of children of color.

Looking Ahead

Together these data suggest that COVID-19 has disproportionately negatively affected the physical and mental health, academic growth, and economic security of children of color. At the same time, the limited data available to date suggest some children of color may be less likely to receive a COVID-19 vaccine, leaving them at elevated risk as the virus continues to spread and as many return to in-person school.

Exposure risk associated with returning to in-person school may be mitigated by policies such as requiring face masks or vaccination among staff and eligible students in schools or by providing options for virtual learning. Because many of these decisions are being made at the local level, there will be wide variation in implementation of these protections across the country. However, some decisions are being made at the state level. For example, as of September 13, 2021, 18 states were requiring face masks in schools, 28 states did not have a face mask requirement in schools, and 5 states prohibited a face mask requirement in schools. Nine states had a vaccine mandate for school employees. While most states (29) are leaving decisions about school instruction mode to the local level, 19 states have a requirement for in-person learning and 3 have a requirement for hybrid learning. This varied implementation of mitigation policies also will have important implication for disparities in COVID-19 impacts among children going forward.

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FDA says the Pfizer COVID vaccine looks effective for young kids



FDA scientists concluded that in almost every scenario the Pfizer vaccine’s benefit for preventing hospitalizations and death from COVID-19 would outweigh any serious potential side effects in children. Pfizer via AP hide caption

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Pfizer via AP

Federal health regulators said late Friday that kid-size doses of Pfizer’s COVID-19 vaccine appear highly effective at preventing symptomatic infections in elementary school children and caused no unexpected safety issues, as the U.S. weighs beginning vaccinations in youngsters.

The Food and Drug Administration posted its analysis of Pfizer’s data ahead of a public meeting next week to debate whether the shots are ready for the nation’s roughly 28 million children ages 5 to 11. The agency will ask a panel of outside vaccine experts to vote on that question.

In their analysis, FDA scientists concluded that in almost every scenario the vaccine’s benefit for preventing hospitalizations and death from COVID-19 would outweigh any serious potential side effects in children. But agency reviewers stopped short of calling for Pfizer’s shot to be authorized.

The agency will put that question to its panel of independent advisers next Tuesday and weigh their advice before making its own decision.

If the FDA authorizes the shots, the Centers for Disease Control and Prevention will make additional recommendations on who should receive them the first week of November. Children could begin vaccinations early next month — with the first youngsters in line fully protected by Christmas.

Full-strength Pfizer shots already are recommended for anyone 12 or older, but pediatricians and many parents are anxiously awaiting protection for younger children to stem infections from the extra-contagious delta variant and help keep kids in school.

The FDA review affirmed results from Pfizer posted earlier in the day showing the two-dose shot was nearly 91% effective at preventing symptomatic infection in young children. Researchers calculated the figure based on 16 COVID-19 cases in youngsters given dummy shots versus three cases among vaccinated children. There were no severe illnesses reported among any of the youngsters, but the vaccinated ones had much milder symptoms than their unvaccinated counterparts.

Most of the study data was collected in the U.S. during August and September, when the delta variant had become the dominant COVID-19 strain.

The FDA review found no new or unexpected side effects. Those that did occur mostly consisted of sore arms, fever or achiness.

However, FDA scientists noted that the study wasn’t large enough to detect extremely rare side effects, including myocarditis, a type of heart inflammation that occasionally occurs after the second dose.

The agency used statistical modeling to try to predict how many hospitalizations and deaths from COVID-19 the vaccine would prevent versus the number of potential heart side effects it might cause. In four scenarios of the pandemic, the vaccine clearly prevented more hospitalizations than would be expected from the heart side effect. Only when virus cases were extremely low could the vaccine cause more hospitalizations than it would prevent. But overall, regulators concluded that the vaccine’s protective benefits “would clearly outweigh” its risks.

While children run a lower risk of severe illness or death than older people, COVID-19 has killed more than 630 Americans 18 and under, according to the CDC. Nearly 6.2 million children have been infected with the coronavirus, more than 1.1 million in the last six weeks as the delta variant surged, the American Academy of Pediatrics says.

The Biden administration has purchased enough kid-size doses — in special orange-capped vials to distinguish them from adult vaccine — for the nation’s 5- to 11-year-olds. If the vaccine is cleared, millions of doses will be promptly shipped around the country, along with kid-size needles.

More than 25,000 pediatricians and primary care providers already have signed up to get the shots into little arms.

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Tracking Social Determinants of Health During the COVID-19 Pandemic



The public health and economic effects of the pandemic continue to affect the well-being of many Americans. The American Rescue Plan included funding not only to address the public health crisis of the pandemic, but also to provide economic support to many low-income people struggling to make ends meet. Millions have lost jobs or income since the start of the pandemic, making it difficult to pay expenses including basic needs like food and housing. These challenges will ultimately affect people’s health and well-being, as they influence social determinants of health. This brief provides an overview of social determinants of health and a look at how adults are faring across an array of measures as of September 2021 when a portion of the population remained unvaccinated, and hospitalizations and deaths due to the delta variant are surging in some areas even as they wane in others.

What are social determinants of health?

Social determinants of health are the conditions in which people are born, grow, live, work, and age. They include factors like socioeconomic status, education, neighborhood and physical environment, employment, and social support networks, as well as access to health care (Figure 1).

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Figure 1: Social Determinants of Health

Though health care is essential to health, research shows that health outcomes are driven by an array of factors, including underlying genetics, health behaviors, social and environmental factors, and financial distress and all of its implications. While there is currently no consensus in the research on the magnitude of the relative contributions of each of these factors to health, studies suggest that health behaviors and social and economic factors are the primary drivers of health outcomes, and social and economic factors can shape individuals’ health behaviors. There is extensive research that concludes that addressing social determinants of health is important for improving health outcomes and reducing health disparities. Prior to the pandemic there were a variety of initiatives to address social determinants of health both in health and non-health sectors. The COVID-19 pandemic exacerbated already existing health disparities for a broad range of populations, but specifically for people of color.

How are adults faring across a range of social determinants of health during the pandemic?

Across a wide range of metrics, large shares of people are experiencing hardship. The Census Bureau’s Household Pulse Survey was designed to quickly and efficiently collect and compile data about how people’s lives have been impacted by the coronavirus pandemic. For this analysis we looked at a range of measures over the course of the pandemic. Unfortunately, the Household Pulse Survey does not provide pre-pandemic measures for comparison. While we have tracked data over time and there have been fluctuations at various points since March 2020, patterns of hardship remain largely consistent, and changes in measures do not necessarily follow economic indicators or pandemic trends. Data for the most recent period, September 1 – September 13, show that (Figure 2):

  • More than one in six adults (17.4%) reported that they or someone in their household had experienced a loss of employment income in the past four weeks;
  • More than half (50.9%) of adults reported difficulty paying for usual household expenses in the past 7 days, and 30.5% used credit cards or loans to meet household spending needs;
  • 5% of adults had no confidence in their ability to make next month’s housing payment (across renters and owners), and 8.8% reported food insufficiency in their household;
  • Nearly one in three (32.1%) adults reported symptoms of depression or anxiety.

Black and Hispanic adults fare worse than White adults across nearly all measures, with large differences in some measures. In September 2021, nearly seven in ten of Black and Hispanic adults (66.4% and 69.2%, respectively) reported difficulty paying household expenditures compared to 43.6% of White adults; 12.9% of Black adults and 10.6% of Hispanic adults reported no confidence in their ability to make next month’s housing payment compared to 4.1% of White adults; and 14.9% of Black adults and 14.2% of Hispanic adults reported food insufficiency in the household compared to 6.3% of White adults. Furthermore, around a quarter of Black and Hispanic adults reported living in a household that experienced a loss of employment income in the last four weeks (24.9% and 27.2%, respectively) compared to 13.1% of White adults.

While variation across age and gender was not as stark, younger adults (ages 18 to 44) fared worse on many measures compared to older adults. For example, higher shares of younger adults reported symptoms of anxiety and depression as well as difficulty paying for usual household expenses. In addition, higher shares of women reported symptoms of depression or anxiety and difficulty paying usual household expenses in the past seven days compared to men.

Across most measures, adults with children in their household fared worse compared to overall adults. For example, 22.0% of adults with children in the household experienced loss of employment income in the household in the last four weeks compared to 17.4% of adults overall, and six in ten (59.7%) adults with children in the household reported difficulty paying for household expenses in the past week compared to the overall population of 50.9%. Adults in households with children were also more likely to report food insufficiency, symptoms of depression or anxiety, and no confidence in ability to make next month’s housing payment than the general population.

Patterns of hardship over time indicate both effects of the pandemic and related policies as well as longstanding disparities in social determinants of health. Data indicate the shares of people experiencing hardships peaked in December 2020 but have otherwise remained largely stable (Figure 2). Trends across all measures have improved since December 2020, reaching lows during the pandemic in March and April 2021, likely reflecting the roll-out of the COVID-19 vaccines and new federal funding available during that period. However, differences in rates of hardship among certain populations has remained largely stable throughout the pandemic and to some extent reflect longstanding disparities that existed even before the pandemic. Still, understanding these disparities in the context of heightened levels of need over the past year highlights these differences and who may benefit most from government assistance.

What to watch going forward

The American Rescue Plan provides $1.9 trillion in funding to address the ongoing health and economic effects of the pandemic. Some of the provisions that provide key economic support for individuals include direct stimulus payments to individuals, an extension of federal unemployment insurance payments, a child tax credit of up to $300 per child per month from July through the end of the year, additional funding to address food insecurity, emergency rental assistance, and emergency housing vouchers. This federal support may have contributed to some improvements in metrics, but hardship is also affected by the trajectory of the pandemic (including a surge in cases and deaths due to the delta variant and any changes in vaccination rates). Looking ahead, the effects of some temporary federal support and the pandemic are likely to continue to be factors in future data releases; however, additional and extended federal support being debated in Congress that may seek to address underlying economic issues beyond the pandemic has the potential to change long-standing patterns of hardship across different demographic groups.

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Memes about COVID-19 helped us cope with life in a pandemic, a new study finds



Artist Jonas Never (@never1959) applies finishing touches to his mural of Sen. Bernie Sanders in Culver City, Calif., on Jan. 24. Standing out in a crowd of glamorously dressed guests, Sanders showed up for the presidential inauguration in a heavy winter jacket and patterned mittens — with an AFP photo of the veteran leftist spawning the first viral meme of the Biden era. Chris Delmas/AFP via Getty Images hide caption

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Chris Delmas/AFP via Getty Images

Does a meme a day keep the doctor away? Not quite, but it looks like it might help, according to one recent study.

Researchers with Pennsylvania State University and the University of California Santa Barbara found that memes helped people cope with life during the COVID-19 pandemic, according to a study published this week in the Psychology of Popular Media journal. Researchers found that those who viewed memes — a type of humor they described as funny or cute pictures that reference pop culture — reported “higher levels of humor” and more positive feelings, according to a news release from the American Psychological Association, which publishes the journal.

They surveyed 748 people online last December: 72% of those who responded were white, 54% identified as women, 63% didn’t hold a college degree, and their ages ranged from 18 to 88, the release states. They were shown a variety of meme types, with different kinds of photos and captions, and asked to rate the cuteness, humor and emotional responses prompted by the materials, as well as how much the memes in question made them think about COVID-19.

Those who viewed memes that specifically referenced the pandemic felt less stress than those who viewed non-pandemic-related memes. They also felt more capable of coping with the COVID-19 crisis and were better at processing information, according to the study. And they were also less likely to be stressed about the pandemic than those who didn’t view memes related to COVID-19 at all, researchers concluded.

The type of meme matters, too: People who viewed memes featuring cute babies or baby animals were overall less likely to think about the pandemic or the effects it has had on them, regardless of the type of caption, according to this week’s release. (And researchers also found that those who were surveyed found that memes with animals in them were cuter than those featuring humans, the APA said.)

The results of the study show that memes about stressful situations can potentially help the public deal with and process those situations, researchers said.

“While the World Health Organization recommended that people avoid too much COVID-related media for the benefit of their mental health, our research reveals that memes about COVID-19 could help people feel more confident in their ability to deal with the pandemic,” Jessica Gall Myrick, a lead author of the study and a professor at Pennsylvania State University, said in the APA release. “This suggests that not all media are uniformly bad for mental health and people should stop and take stock of what type of media they are consuming. If we are all more conscious of how our behaviors, including time spent scrolling, affect our emotional states, then we will better be able to use social media to help us when we need it and to take a break from it when we need that instead.”

So the next time you worry that you’re wasting time scrolling through memes, just think: It could be good for your health.

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The U.S. is ready to roll out the COVID vaccine once it’s approved for kids age 5-11



Safeway pharmacist Ashley McGee fills a syringe with the Pfizer COVID-19 booster vaccination at a vaccination booster shot clinic on Oct. 1, in San Rafael, Calif. Justin Sullivan/Getty Images hide caption

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Justin Sullivan/Getty Images

The White House said on Wednesday that it is ready to quickly roll out COVID-19 vaccines for kids ages 5 to 11, if the Pfizer-BioNTech vaccine for that age group is authorized by the Food and Drug Administration and recommended by the Centers for Disease Control and Prevention.

The administration has bought enough doses for all 28 million children in that age group and will provide it in smaller packages with essential supplies like smaller needles to make it easier to get to physicians, pediatricians and community health centers, Biden administration officials said.

“Should the FDA and CDC authorize the vaccine, we will be ready to get shots in arms,” said White House coronavirus response coordinator Jeff Zients during a news briefing Wednesday morning.

The vaccine could be cleared for use in children ages 5 to 11 within a couple of weeks, officials said. The FDA’s independent advisory committee meeting is scheduled for Oct. 26, and the CDC’s independent advisory committee meeting is set for Nov. 2 and 3.

The Pfizer vaccine currently has full approval for use in adults, and the federal government has authorized it for emergency use in children ages 12 to 17.

White House officials said they were announcing the plan to inoculate children ages 5 to 11 before the vaccine was approved for that age group so they could be “operationally ready” to deploy the doses as soon as the approval came.

Under the plan, the administration will work with state and local leaders to make the vaccine available at more than 25,000 pediatricians’ offices and primary care sites and 100 children’s hospital systems as well as pharmacies, schools and community health centers.

The administration also will roll out a national public education campaign to inform parents and guardians about the vaccine and solicit questions.

U.S. Surgeon General Vivek Murthy said the campaign would help head off one of the barriers to vaccinating both children and adults — misinformation about the drug.

“That’s why we’re making sure that it’s trusted messengers with scientific credibility who go out there and talk about these vaccines,” Murthy said. “But it is our collective responsibility — whether we’re in government, in the media, whether we’re individuals — to help prevent the flow and spread of misinformation online.”

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