The California coast welcomes children’s COVID shots. Inland areas not

Early demand for the COVID-19 vaccine for young children has been surprisingly uneven in California, with some areas embracing the shots and others much slower to accept them, a Times data analysis shows.

It’s a pattern that worries experts and could seriously affect how a winter wave of coronavirus could spread through different regions of the state.

In San Francisco, 30% of 5 to 11 year olds have received one shot since the age group vaccination was approved three weeks ago. In Santa Clara County, home to Silicon Valley, the figure is 28%, and in Marin County, once a hotbed of anti-vaccine sentiment, it’s an astonishing 46%, according to an analysis of state data by the Times.

These rates are well above the national rate of 12% and the national rate of 13%. Los Angeles and Orange counties report that 12% of children in the age group are partially vaccinated; San Diego County reports 13% and Ventura County, 10%.

Still, childhood vaccine uptake lags in inland California, with rates of 5% in San Bernardino and Kern counties, 6% in Riverside County, and 7% in Fresno County.

“In a sense, the higher vaccination coverage of 5 to 11-year-olds is kind of a surrogate measure of vaccine acceptance at all ages,” said UCLA epidemiologist Dr. Robert Kim Farley.

In general, the areas of California with the lowest rates of vaccine delivery — rural Northern California and the Central Valley — are where COVID-19 hospitalizations are the highest.

“There will be a winter wave,” said epidemiologist Dr. George Rutherford of UC San Francisco. “What I’m most concerned about is the Central Valley, in more rural California, where vaccination rates are lower than other parts of the state and currently have a high rate of transmission.”

The outlook is most optimistic for the San Francisco Bay Area, with the state’s highest vaccination rate and lowest hospitalization rate from COVID-19.

“In parts of California with higher vaccination rates, I think we can fully expect the winter wave to be more toned down. We can avoid it; we may not. I suspect it will just be at a lower level,” Rutherford said.

The future for Southern California’s coastal counties is less clear. It’s possible that the level of vaccination, plus naturally acquired immunity from last winter’s gulf, will leave Southern California’s largest metropolitan areas “fairly protected,” Rutherford said.

In a diverse area like LA County, there will likely be areas with varying rates of COVID-19 vaccinations, said Dr. Kirsten Bibbins-Domingo, chair of the Department of Epidemiology and Biostatistics at UC San Francisco.

“Ultimately, the experience with vaccination coverage is very local. And so how it will turn out – it could be an average of the two extremes in the Bay Area and the San Joaquin Valley, but probably more [likely], it will be that some communities will be really much more protected, and some will have the potential to have noticeably faster transmission speeds, especially as we go to the holidays,” Bibbins-Domingo said.

The Inland Empire already suffers from significantly worse COVID-19 hospitalization rates than the Southern California coastal counties. Riverside County has double LA County’s COVID-19 hospitalization rate, while San Bernardino County has triple. In San Bernardino, the daily number of patients has increased by about 34% since mid-October.

In San Bernardino and Riverside counties, less than 55% of residents of all ages are fully vaccinated, compared to about 65% in LA and Orange counties and over 75% in several Bay Area counties.

“They are much worse positioned to enter the winter and holiday seasons because of their relatively lower vaccination coverage — not just in 5- to 11-year-olds, but in all age groups,” Kim-Farley said.

Infected children can be important players in the spread of the Delta variant of the coronavirus. Recently, 5- to 11-year-olds sometimes had the highest cases of coronavirus among all pediatric groups in Los Angeles and Orange counties. Young children are not only at risk of getting sick themselves, but can also pass the virus on to older relatives, who – even if they are fully vaccinated – are at greater risk of becoming seriously ill if they get a breakthrough infection.

Nationally, new weekly coronavirus cases among children of all ages are up about 32% since the beginning of the month, resulting in more than 140,000 children with confirmed infections for the seven-day period ending Thursday, according to from an analysis by the American Academy of Pediatrics and Children’s Hospital Assn. Children now represent 25% of new cases reported by the country.

While some people have noted that children are less likely to become seriously ill from COVID-19 than adults, it remains crucial that they are vaccinated, epidemiologists say. The number of 5- to 11-year-olds who died of COVID-19 in a one-year period — 66 — makes COVID-19 the eighth leading cause of death for that age group.

Some doctors are also concerned about possible long-term consequences of COVID in children, such as higher rates of depression or anxiety, difficulty concentrating at school or prolonged headaches. Children are also at rare risk of developing a multisystem inflammatory syndrome related to COVID-19 that can lead to serious illness and death.

“Getting children vaccinated is an important part of increasing overall vaccination coverage and limiting transmission,” Rutherford said. “High vaccination equals low transmission. Low vaccination leads to high transmission.”

Officials should recognize that it may be more difficult for people in low-income communities to access COVID-19 vaccines for children, Bibbins-Domingo said.

“If you look into the Central Valley, I’m concerned about both active hesitation and, do we have the resources to reach all the communities in those areas? … How effective are we in getting vaccines in all communities where it is needed?” she said.

LA County officials are concerned that black and Latino 5- to 11-year-olds and those from lower-income households are less likely to be vaccinated.

The LA County Department of Public Health said on Tuesday that white children were three times more likely to be vaccinated than black and Latino children. While 13% of White, 14% of Asian-American and 12% of Native American children in this age group had received an injection, only 4% of Black and 3% of Latino children had received it by Nov. 14.

Children in this age group who live in the most deprived neighborhoods are vaccinated against a third of those in wealthier communities: 3.9% versus 12.5%.

“If we continue to see disparities in pediatric vaccination that put Black and Latinx children at greater risk as transmission increases, we could once again see a situation where these communities suffer the most during a wave,” said Barbara Ferrer, LA County executive director. Public Health. a statement on Tuesday.

Last week, Ferrer said the differences in vaccinations demonstrate the need to “build confidence in the safety and efficacy of the pediatric vaccine by ensuring that parents have good information, have their questions answered and know where to go to get their vaccines.” vaccinate a child”. said Ferrer.

Ferrer said LA County is working to improve access to vaccines for children in areas where it has been difficult. As of last week, there were more than 700 sites across the country administering doses to 5- to 11-year-olds; Hundreds more are expected to start in the coming weeks.

There’s a good reason many experts expect California to hit a winter wave.

Nationally, new daily cases of coronavirus are up 30% in the past month, from about 72,000 to 94,000; The number of hospitalizations due to COVID-19 has increased by 15% in the past two weeks.

The US Centers for Disease Control and Prevention considering California as having “substantial” community transfer, the second-worst category in its four-step scale.

California saw both weekly cases and hospitalizations rise in late October; however, both numbers have declined in the past two weeks.

Yet the state has leveled off at a relatively rapid pace. The number of daily reported cases is more than four times higher than in mid-June, when the state reopened its economy and lifted most pandemic-related restrictions on public spaces. The number of hospitalizations from COVID-19 is now three times higher than what the state was experiencing at the time.

Warning signs are also visible in other states, where the coronavirus is rampant again. The overall vaccination rate in California is about the same as that of Colorado, Minnesota and New Mexico, all of which deal with peaks and crowds in hospitals.

“Our 63%, while it’s great, isn’t enough,” Rutherford said of California’s vaccination rate.

In Fresno County, hospitals consistently operate above capacity, and ambulances are forced to idle outside hospitals before they can take patients to overcrowded emergency rooms.

“We don’t have enough hospitals to serve the population and needs,” says Dr. Rais Vohra, the Fresno County interim health officer.

Times staff writers Sean Greene and Thomas Suh Lauder contributed to this report.

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