Covid-19 vaccines were everywhere in the spring of 2021.
Nearly one year ago, Gov. Phil Scott lifted major Covid restrictions on businesses and gatherings as the state hit a 80% vaccination rate, the key benchmark of his “Vermont Forward” strategy.
To hit that goal and surpass it, the state hosted appointment-based vaccine clinics at health care centers, EMS headquarters and pharmacies. Businesses and community organizations held walk-in vaccine clinics at shopping centers and farmers markets — even on the beach.
The state has since navigated record-breaking Covid cases and several variants of the virus. In the midst of a receding Omicron surge in February, Health Commissioner Mark Levine announced a new Vermont strategy: treating Covid as an “endemic” disease.
To that end, Levine said in March that Vermont would roll back its state-run vaccination clinics. Instead, the vaccine would be available through pharmacies, health care providers and a smaller number of walk-in clinics run by the state.
At the same time, the state’s progress on the more recent waves of booster shots and vaccinations for the youngest eligible age group has not kept pace with the early days of the vaccine rollout. About 71,000 eligible Vermonters — those age 5 and older — have yet to receive their first dose of the vaccine. Only 59% of eligible Vermonters are up-to-date on all recommended booster doses, according to the health department.
Children 5 to 11 years old, who became eligible for vaccination in the fall of 2021, have the lowest vaccination rate of any age group, the health department reports. As of June 8, about 61% have started the vaccination process.
White House officials said last week that they believe vaccines for children 6 months to 5 years old could be available as soon as June 21, assuming that federal agencies approve the Pfizer or Moderna vaccines on schedule.
If that timeline holds, it would mark the first time a new age group becomes eligible without a state-run vaccination program in place. Instead, the health department plans to send vaccine doses through a patchwork system of pediatricians, health clinics and a few state-backed clinics, said Monica Ogelby, the immunization program chief for the department.
Dr. Leah Costello, a pediatrician in South Burlington, is one provider gearing up for the news.
“Vaccinations are what pediatricians do best,” she said. “This is our job. This is what we do all the time.”
Most parents, she said, prefer to have their children receive their vaccines through their central health care provider, what Costello referred to as their “medical home.”
“We just always knew that it was pretty unlikely a family was going to want to take their young toddler to the pharmacy, for example,” she said.
Pharmacies are also able to vaccinate children only if they’re 3 and older, Ogelby said, so there hasn’t been “a ton of excitement” around pharmacies signing up to get doses of the vaccine for young children.
But Costello cautioned that her office was relatively short-staffed, and the latest vaccination round is an “added demand” to an already busy schedule.
Some parents are already reporting difficulties in finding appointments for their children over 5 years old to get a booster, particularly in rural regions. Melissa Mikesell, a parent in East Burke with a 10-year-old child, told VTDigger she couldn’t find any open slots at local pharmacies or the closest pediatricians in Wells River.
“The only pediatrician’s office I found that had the booster would have required us to book a new patient appointment before she could get the shot, so it would be weeks,” she said via email.
After contemplating traveling all the way to traveling for a spot, she was ultimately able to find a walk-in clinic in Bradford, “but it was a process,” she wrote.
“Plenty of kids in schools near us are getting infected right now, so I feel an urgency to get her booster ASAP,” she wrote. “I just worry people who don’t have the resources to do the legwork and to drive more than an hour away won’t get boosted!”
Experts have previously raised concerns about the lack of Covid testing, vaccination and treatment in rural areas. When Vermont closed state-run testing sites in favor of provider-based testing, Anne Sosin, a health equity researcher at Dartmouth College, said that the state expected people to “jump through hoops” to find new testing providers.
Dr. Alex Bannach, a pediatrician in Newport, said her practice had pushed hard to provide additional access for local parents, holding vaccination drives and discussing the vaccine with parents during appointments. The office has set aside two afternoons each week for people to come to the practice for the vaccine.
When the vaccine was released, “parents were traveling up here to get their children vaccinated because they couldn’t find any clinics that were available to them in the greater Burlington area,” Bannach said.
At the same time, she can understand why parents may be having a hard time finding open appointments with some providers. “There’s still a shortage of physicians,” as well as nurses and other health care workers, she said.
Ogelby, from the health department, said the state’s plan to distribute vaccines through providers’ offices prioritized “populations disproportionately impacted by Covid,” such as people of color.
The state also plans to distribute doses based on each office’s history of vaccinating children and the number of children at the practice, she said. But at this point, the state “can’t really predict” how much demand there will be for the vaccine for young children.
National research indicates that only 20% of this age group might get vaccinated, but “Vermont tends to be culturally more vaccine-affirming, and excited” for the vaccine, she said.
Costello anticipated that demand might not be “quite as high” as for previous vaccines.
“Unfortunately, most families have had Covid this winter,” meaning that many think they have immunity to the disease, she said. “I think there is going to be an urgency, but I don’t see it quite to the level that it was when the vaccine for the 5- to 11-year-olds came out.”
The health department also plans to make the vaccine available at WIC offices and local health departments. Local organizations such as schools, libraries or community organizations can also sign up to host vaccine clinics, Ogelby said.
Families that don’t have a go-to health care provider for their child can call the health department office in their district for help finding the vaccine, she said.
“There are parts of the state where we know it’s at least a 30-minute drive to a pharmacy or a primary care provider,” she said. The state has tried to fill that gap with EMS teams, she said, but “that’s not to say that it’s not necessarily going to be happening on the day at the moment when that family might need access to vaccine.”
Responding to the lack of a centralized system for finding vaccine appointments, she said “the community is retaking control over the health care system” while the health department bridges the gap with walk-in clinics.
“I can completely see how it doesn’t feel like it’s necessarily the same type of one-stop shopping, where maybe it did feel when the state was managing soup to nuts,” she said.
A different type of barrier remains for raising the vaccination rate for children: Parents’ reluctance to get their kids vaccinated.
Costello said that educating parents on vaccines is something she does “day in and day out.”
“I meet the family where they’re at: Asking about what their questions are, what their hesitations are, because it can be so totally different for people,” she said.
Costello can also draw on personal experience as a parent to three.
“I just really tell parents I would never recommend anything that I wouldn’t do for my own children, and my 6- and 10-year-old got vaccinated the day it came out, and my 3-year-old will get vaccinated as well,” she said.
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