Making COVID-19 vaccinations a family affair can protect against omicron: Analysis

President Joe Biden on Thursday released a new strategy on how to combat the spread of coronavirus into the winter season, an announcement that comes at a critical juncture as the omicron variant spreads throughout the world and the first case has been confirmed in the U.S.

In response to unknowns of the new SARS-CoV-2 variant, the Centers for Disease Control and Prevention has announced that all adults should receive a COVID-19 booster if it's been at least six months since receiving a two-dose mRNA vaccine or more than two months since getting the Johnson & Johnson one-shot vaccine. No matter how transmissible or evasive the omicron variant turns out to be, our best defense right now is a fully vaccinated public.

All Americans should be concerned about the unvaccinated in this country and throughout the globe. Among the eligible age groups with the lowest vaccination rates are kids 5 to 17, with logistical issues slowing rollouts. Biden's strategy includes a new effort to launch family vaccination clinics around the country, and swift implementation of this will be essential.

Following authorization in early November for children 5 to 11, a massive national mobilization ramped up, the largest since expanding eligibility to ages 12 to 15 in May. Special orange-capped pediatric vials were shipped to hospitals, pharmacies and pediatricians' offices nationwide, and vaccines for children are now available at over 22,000 sites. Over 4 million kids -- nearly 14.2% of this age group -- have received their first dose, according to CDC data.

Despite an ample supply of vaccines, only a small portion of the younger group was vaccinated in the first few weeks of the rollout and at a slower pace than the 12-to-15-year-olds. Vaccine confidence remains low among parents: According to a recent Kaiser Family Foundation poll, only 27% said they'll get a child age 5 to 11 vaccinated right away, with 30% saying they will "definitely not." While some schools are requiring vaccines for kids over 12, many have not put in place similar policies for those age 5 to 11, which affects overall vaccination rates. Many underestimate the risk to kids and cite concerns over vaccines' purported long-term effects or that they cause infertility, both myths long debunked.

We can also draw clues on uptake by looking at the other age band of kids -- adolescents 12 to 17. Nationally, 62% of this group has received at least one dose, with 52% fully vaccinated. When looking at the data, we see that one of the biggest predictors of vaccination in adolescents is vaccination rates among parents and guardians, drawing attention to the divisions among American families. With news of the omicron variant, it's vital to protect as many eligible Americans as possible. We must do this by making vaccination a family affair.

First, we must increase vaccine access for kids and adolescents. Our Vaccine Equity Planner shows that the number of sites offering the vaccine for kids 5 to 11 is around 40% of all sites nationwide. For comparison, nearly 69% of all sites offer the adult dose of the Pfizer vaccine. Vaccine deserts, always present throughout the rollout, have been exacerbated for younger populations, with fewer vaccinators prepared to support children and their parents or guardians throughout the process.

In some rural Tennessee counties, for example, child vaccination rates remain in the single digits, as parents may need to drive longer distances because of a lack of nearby providers. Research shows a stark rural-urban divide: 54% of urban kids 12 to 17 are vaccinated compared with 35% of rural kids. Increasing partnerships with community organizations and accelerating reimbursements for pediatricians promoting vaccine education and confidence can help us close this gap.

Second, we must streamline the appointment process, making it easy for all generations to book an appointment. Many sites offer a host of vaccine types, boosters and pediatric doses, as well as flu vaccines. Families should be able to easily book multiple appointments and get themselves and their children vaccinated in one visit. Biden's plan includes ​​a call on federal pharmacy partners to implement family-based scheduling in the coming months. This should happen immediately. Offering vaccines for adults in pediatricians' offices helps the whole family.

Third, as families gather this holiday season, we must promote vaccination. The data is clear: Messaging around vaccinations protects loved ones. In addition, we support the ongoing efforts by families to decrease transmission by deploying rapid tests, evidence-based masking and improving ventilation when possible. We know that the most trusted messengers are within our own communities -- friends or family talking about the benefits of vaccines may push some reluctant people into opting for vaccination.

Fourth, we must do all we can to lessen the barriers to vaccination for adults and kids. While the enforcement of OSHA's emergency temporary standard is currently paused due to litigation, we join the president's call on employers to continue providing paid time off for employees' boosters and consider making accommodations for parents and guardians needing time off. We believe employers should roll out family vaccine days. In addition, resources and staffing should be directed to community-based organizations with proven records of serving underserved communities. This December, vaccine should be offered at community block parties, schools, construction manufacturing sites and agricultural fields.

Cases in children rose 16% over the last week and 32% over the last two weeks, according to the American Academy of Pediatrics. With 95% of the American population now eligible to be vaccinated, now is the time for a renewed focus on vaccinating all generations. The omicron variant has arrived in the U.S. ahead of the holidays, and to protect the public from it -- and future variants -- our shield is population immunity.

The vaccination of all families is our fastest route.

Rebecca Weintraub, M.D., is an assistant professor at Harvard Medical School and associate physician at Brigham and Women's Hospital, and leads Better Evidence at Ariadne Labs. Benjy Renton is an analyst at Ariadne Labs. John Brownstein, Ph.D., is the chief innovation officer at Boston Children's Hospital and a professor at Harvard Medical School.