Two months after Pfizer’s covid vaccine was authorized for children ages 5 to 11 years, just 27 percent have received at least one shot, according to Jan. 12 data from the Centers for Disease Control and Prevention (CDC). Only 18 percent, or 5 million kids, have both doses.

The national effort to vaccinate children has stalled even as the omicron variant upends schooling for millions of children and their families amid staffing shortages, shutdowns and heated battles over how to safely operate. Vaccination rates vary substantially across the country, a Kaiser Health News analysis of the federal data shows.

Pediatricians say the slow pace and geographic disparities are alarming, especially against the backdrop of record numbers of cases and pediatric hospitalizations. School-based vaccine mandates for students, which some pediatricians say are needed to boost rates substantially, remain virtually nonexistent.

California and the District of Columbia require children 5 to 11 years old to be immunized. These places are said to be exceptions as  15 states have banned covid vaccine mandates in K-12 schools, according to the National Academy for State Health Policy.

Vaccine demand surged in November, with an initial wave of enthusiasm after the shot was approved for younger children. But parents have vaccinated younger kids at a slower pace than 12- to 15-year-olds, who became eligible in May. It took nearly six weeks for 1 in 5 younger kids to get their first shot, while adolescents reached that milestone in two weeks.

Experts cite several factors slowing the effort: Because kids are less likely than adults to be hospitalized or die from the virus, some parents are less inclined to vaccinate their children. Misinformation campaigns have fueled concerns about immediate and long-term health risks of the vaccine. And finding appointments at pharmacies or with pediatricians has been a bear.

“One of the problems we’ve had is this perception that kids aren’t at risk for serious illness from this virus,” said Dr. Yvonne Maldonado, chair of the American Academy of Pediatrics Committee on Infectious Diseases. “That’s obviously not true.”

Parents are left to weigh which is more of a threat to their children: the covid virus or the vaccine to prevent the virus. Overwhelmingly, research shows, the virus itself presents a greater danger.

Kids can develop debilitating long-covid symptoms or a potentially fatal post-covid inflammatory condition. And new research from the CDC found that children are at significantly higher risk of developing diabetes in the months after a covid infection. Other respiratory infections, like the flu, don’t carry similar risks.

The huge variations in where children are getting vaccinated reflect what has occurred with other age groups: Children have been much less likely to get shots in the Deep South, where hesitancy, political views and misinformation have blunted adult vaccination rates as well. Alabama has the lowest vaccination rate for 5- to 11-year-olds, with 5 percent fully vaccinated. States with high adult vaccine rates such as Vermont, Massachusetts, Connecticut and Maine have inoculated the greatest shares of their children.

Nationally, a November Kaiser Family Foundation poll found that 29 percent of parents of 5- to 11-year-olds definitely won’t vaccinate their children and that an additional 7 percent would do so only if required. Though rates were similar for Black, White and Hispanic parents, political differences and location divided families. Only 22 percent of urban parents wouldn’t vaccinate their kids, while 49 percent of rural parents were opposed. Half of Republican parents said they definitely wouldn’t vaccinate their kids, compared with just 7 percent of Democrats.

The White House said officials continue to work with trusted groups to build vaccine confidence and ensure access to shots. “As we’ve seen with adult vaccinations, we expect confidence to grow and more and more kids to be vaccinated across time,” spokesperson Kevin Munoz said in a statement.

The Biden administration has pointed parents to retail pharmacies and 122 children’s hospitals with vaccine clinics. Nationwide, more than 35,000 sites, including pediatricians, federally qualified health centers and children’s hospitals have been set up to vaccinate young kids, according to the administration. Yet administering the covid vaccine to children presents obstacles that haven’t been as prominent for other inoculations.

Enrolling pediatricians in the covid-19 vaccine program is a challenge because of the application process, reporting requirements for administered doses, and staffing, said Claire Hannan, executive director of the Association of Immunization Managers.

“Many of them are short-staffed right now and don’t necessarily have a huge capacity to serve,” she said. Plus, “it’s not as easy to engage the schools in school-based clinics in certain areas, just due to the political environment.” Health centers, government officials and other groups have set up more than 9,000 school vaccination sites for 5- to 11-year-olds nationwide.

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