To vax or not?

Even among those who see COVID vaccines as safe and positive, the decision is often less than straightforward.

Katie Sherwin, of Oakland, said that even though she and her partner “have always been pro-vaccine” she felt hesitation about vaccinating her two children, ages 4 and 10 months.

“Maybe I shouldn’t admit this, but I do remember texting my friends [after the vaccine was approved.] ‘So we’re all still doing this vaccination thing, right?’” Sherwin said.

Sherwin is not alone in turning to friends to navigate these pressures. As the CDC guidelines and scientific consensus have shifted over the course of the pandemic, many parents have sought out their community, often consulting friends, family, neighbors and co-workers about their vaccine choices.

Marc McCoy, a parent and employee of the Oakland Unified School District, described his experience navigating the complex network of resources available to him.

“I try to listen to all the news channels, I try to watch as many news channels and talk to as many people as possible,” McCoy said. “I hear things that make me feel comfortable, and then maybe isolated incidents [where people] were healthy and then got vaccinated and died. As an individual, you have to make a choice about what’s accurate.”

Although Sherwin and McCoy did both eventually decide to vaccinate their respective children, the hesitation they expressed echoes that of people who have chosen against vaccination.

Claire Anderson, of Piedmont, for example, said that she and her partner “are not anti-vax, but we are with COVID.”

Because of this, her two kids are both unvaccinated against COVID, although they have had flu and TDAP vaccines. The choice for Anderson’s family came down to both the newness of the vaccine, and her perception that COVID was not serious for children. In speaking about the vaccine, Anderson said it’s “just too new. It’s only approved for emergency use right now, and I don’t want my kids to be guinea pigs.”

In fact, the FDA has approved the vaccine and boosters beyond “emergency use,” as it has passed all testing requirements, and it is expected to remain in use beyond the pandemic. But anxiety over the newness of the vaccine seems to be common, as parents grapple with the dramatically changing regulations and pandemic conditions of the last three years.

Concerns about testing despite rigorous procedures

Many Bay Area parents have echoed Anderson’s fears that her children would be made “guinea pigs.” Fears often center on the idea that both the original COVID vaccine and the subsequent boosters have not been properly researched, and that they were rushed through government approval due to the “unprecedented circumstances.”

The COVID vaccines have been tested according to the same standards as other FDA-approved vaccines, however, and although they are new, the science on which they are based has been long researched. The speed at which they were approved resulted from a combination of funding and administrative choices that supported pharmaceutical companies in researching and manufacturing the vaccine before approval. And the vaccines were still required to pass through the same testing process as vaccines like the TDAP and flu shot.

COVID-19 is just one of many diseases in the coronavirus family, and many of its relatives have been a focus of research for decades. The coronavirus family includes SARS and MERS, for example, two diseases that have long been of real concern for governments and the international health community.

COVID vaccines could not have been developed so quickly were it not for the years of research into coronaviruses that happened before the pandemic. In addition, the vaccine was approved and distributed much more quickly than normal due to a combination of increased funding, administrative prioritization, and pre-approval manufacturing.

Normally, many of the hurdles to vaccine approval and distribution are bureaucratic and financial, not scientific. The cost of funding testing and the financial risk involved in making vaccines can be prohibitive for pharmaceutical companies, especially relative to the profit on vaccines, as vaccines are not generally a lucrative commodity.

After designing them, pharmaceutical companies may have to wait for months for FDA attention, and normally only after they have been approved will they begin manufacturing.

The Trump administration’s subsidies and support, however, meant that billions of dollars went to supporting pharmaceutical companies in this process. The COVID vaccine was one of the top priorities for the FDA when testing was complete and received immediate administrative attention. Not only that, the subsidies allowed pharmaceutical companies to make large quantities of the vaccines before it was approved by the FDA.

What about the side effects?

It is worth noting that for the original COVID shot, this process included multiple phases of testing on both animal and human subjects. For some of the subsequent boosters, this process involved testing only on animals, which is in line with the normal, less rigorous process for updated vaccines.

This, too, has caused concern for some parents, however.

Rachel Concannon, of Oakland, for example, mentioned that the absence of human testing gave her pause in deciding to get her children boosted.

Many parents expressed concern about the impact of side effects on their children, as well as hesitation about subjecting their kids to those side effects when COVID seems to affect children less severely than adults.

Alameda’s Jackie Boyle, for example, described how vaccine side effects laid her low for a couple days.

“Even getting up to go to the bathroom was a mission,” she said.

Pointing to the 1-year-old child she nannies, she asked, “If the vax did that to me, I mean what’s it going to do to her, when she’s so little?”

Like other caregivers, Boyle is concerned that such an experience just might not be necessary. This is especially true as the so-called “tripledemic” has run through schools this season: parents of children who have recently had RSV or the flu were especially hesitant to subject their kids to another couple days of feeling ill.

Oakland’s Concannon, a mother and former school counselor, described how she weighed the decision: “There is part of me that’s like, you know, it is less serious in kids, do they really need to go through this?”

She did, however, ultimately both vaccinate and boost her two children, saying that the loss and mental health impact of missing school outweighed any potential side effects by a wide margin.

Unprecedented times

Ultimately, many Bay Area parents are struggling with the truly uncharted nature of decision-making in the pandemic era. Getting kids vaccinated requires trust in our social systems -- systems that are themselves grappling with new challenges.

However, while it is true that COVID is less likely to cause severe illness and hospitalization in children, the CDC and other health authorities have clearly stated that vaccinating children far outweighs any risks and provides important immunity. These health authorities highly recommend vaccinating and boosting children.

As Jackie Boyle put it, “If you have a heart attack, you’re going to go to a doctor, and all that research is coming from the same place.”

While the official advice is clear, there is a real heaviness to guiding kids through what has come to be tritely referred to as “unprecedented times.” Rachel Concannon described how her son asked her what she did during quarantine when she was a kid.

“Oh honey,” she remembers saying, “this has never happened before in my life.”