Area doctors, community members grapple with the covid-19 vaccine mandate for children

Children 5 to 11 years old are a step closer to receiving the Pfizer-BioNTech Covid-19 vaccine after the U.S. Food and Drug Administration authorization for emergency use earlier this week. Other regulatory go aheads are expected in the coming days, and shots could go in young arms in a matter of weeks.

Meanwhile, even before all of the hurdles are cleared, a dustup around vaccine mandates for children is unfolding.

Gov. Gavin Newsom endorsed vaccine mandates for all students and staff in California schools earlier this fall once full approval is granted by regulatory agencies – which is unlikely to come before school opens next year. Others, however, see inequity in insisting on mandates for children while excusing groups like prison guards. 

“I cannot support a mandate that puts more restrictions on children than adults when the former [are] much lower risk,” wrote Dr. Monica Gandhi, a University of California San Francisco professor, infectious disease physician and researcher, on Twitter on Tuesday.

Further, under new Bay Area masking guidance, officials would keep masking mandates in place until eight weeks after the vaccine is available. “How odd if adults can unmask …. [and] kids can’t??” Gandhi wrote on the platform. That combination made her withdraw her support for Newsom’s vaccine mandate.

Later, she added that the situation was emblematic of California’s “unfortunate politics with children” that restricts children to keep adults safe. To her, the restrictions were counter-intuitive.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID), told CBS earlier this month that he agreed with Gov. Newsom’s vaccine mandate, but he declined to go “into the local issues.”

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Newsom’s mandate was yet another example of how guidance provided for adults more responsible for covid spread was denied to less culpable yet more restricted children, Gandhi told Mission Local. 

“I think it’s important to get kids vaccinated in order to protect us all,” said Gandhi, who plans to vaccinate her 11-year-old. Children are “certainly not zero risk” and can transmit and become ill with covid, but they have been restricted the most during the pandemic, she said.

They also aren’t represented by powerful and resourced unions, she added, referring to contributions made to Gov. Newsom’s campaign by the unions backing prison workers and teachers.

Her comments drew mixed reactions from parents, community members, and other health professionals. Some criticized Gandhi for inadvertently decreasing confidence in vaccines by withdrawing her support for the mandate. Don’t blame me, she indicated, it’s the California Department of Public Health’s doing.

Liz Highleyman, a medical journalist, wrote, “Vaccine mandates, if they exist, should be based on the risk-benefit balance of vaccines for kids, not whether or not they have to wear masks afterwards. I agree they shouldn’t have to, but that should be a separate issue.”

“Cautious public officials could just say, OK then, let’s restrict bars too, instead of loosening restrictions for kids,” she added. 

Courtney Giraudo, a San Francisco pediatric nurse practitioner, agreed with Gandhi. “I really don’t understand [California]. The best way to ensure kids 5-11 age group get vax’d is to ensure that it will be safe & appropriate to unmask,” she wrote in reply to Gandhi’s Tweet on Thursday. “We gotta get kids out of masks when transmission/cases are low.” 

Gandhi questioned whether state officials understood the power of “positive motivation.”  

“Many more parents will vaccinate their children if [California] says to them “okay, we also realized our approach was hard on kids here; we understand”,” replied Gandhi.

It’s unclear how hard and firm the masking mandate is. The California Department of Public Health indicates on its website that conditions for masking will be continually assessed with any updates to the requirements and recommendations determined by Nov. 1. 

The more immediate problem will be getting parents to vaccinate their younger children. Parental support is currently at around 30 percent at present, according to Kaiser Family Foundation. Local researchers, doctors and advocates for the vaccine appear to be using the present pre-approval time to build support for the roll out. 

For Dr. Charles Edwards, lead pediatrician for Mission Neighborhood Health Center’s Shotwell clinic, the vaccine’s pending authorization for 5 to 11 year olds “is very good news.” He plans to vaccinate his 5-year-old when it’s time, and he sees a lot of patients whose parents are planning to vaccinate them, too.

He was reluctant to comment on the mandate’s political dimensions, but he did add “police” to the list of mandate-free or mandate-shy groups. “There have been vaccination mandates in schools, so this isn’t new,” he said. He thinks many parents will approach the decision pragmatically.

“We have people here in the clinic, parents who have been vaccinated for example, who continue to wear their mask,” he said. “I think people who choose to get vaccinated are going to be ok with wearing masks anyway. Unfortunately [the vaccine] has become very politicized, it’s a shame.”

“It’s about keeping people safe — like the immunocompromised or people who don’t respond to the vaccine,” Edwards said of the mask guidance. 

Of the “very safe” vaccine, he said, “it’s a miracle medicine.”