‘There’s Almost No Incentive at All to Give Him the Vaccine.’

Before the Covid-19 pandemic, a mother I interviewed as part of my study on pandemic parenting said, she never had a problem with vaccines. Her 2-year-old son got all his recommended immunizations on schedule. When it comes to the Covid-19 vaccines, however, the mother, who is white and has a college degree, says she isn’t so sure.

“I just feel there’s almost no incentive at all to give him the vaccine,” she said. “Even if there was like no risk to it. It just seems why would we even get it for him? If he were to get it, he would be able to heal pretty quick. And it’s unlikely that he would spread it to others.” (All the mothers agreed to take part in this research on condition of anonymity.)

Vaccination for younger children could be available very soon, and while many parents have longed for it, there’s a substantial group of parents who are uncertain. A recent report from the Kaiser Family Foundation found that only a third of parents with children ages 5 to 11 say they will vaccinate their children right away. Less than a quarter of parents with children under the age of 5 say they plan to do the same when a vaccine is available for that age group.

Even among children who are currently eligible — ages 12 to 17 — vaccination rates are lower than would be expected. About 59 percent of kids in that age group have received at least one dose.

These numbers contrast with the uptake rates for most other vaccines for children. Data from the Centers for Disease Control and Prevention suggests that the portion of American children vaccinated by age 2 is more than 90 percent for polio, measles, mumps, rubella, hepatitis B and chickenpox, and more than 80 percent for diphtheria, tetanus and pertussis.

So, what’s different about the Covid-19 vaccines? Certainly they are more politicized than other vaccines, and there’s a great deal of misinformation and disinformation shared about them online. But, as I’ve covered in my research, those factors cannot entirely account for why so many parents — including politically liberal parents, highly educated parents and parents who previously followed vaccine protocols — are not planning to vaccinate their children against Covid-19.

What I’ve argued in my recent study — which draws on interviews with 80 mothers of young children whose vaccine decisions I’ve been following since 2018 — is that to explain why so many parents see little incentive to vaccinate their children against Covid-19, we need a theory of “moral calm.”

A moral calm is essentially the opposite of a moral panic — a term popularized in the 1970s by Stanley Cohen, who was a professor of sociology at the London School of Economics. If a moral panic is a situation in which exaggerated or misleading claims about the harm associated with some phenomenon leads to widespread fear of that phenomenon — such as the violence supposedly caused by video games — then I argue a moral calm is a situation in which we might expect widespread concern about some potentially harmful phenomenon but get the absence of fear instead.

Examining the moral calm around children and Covid-19 can help explain the hesitation around the vaccines and reveal what it may take to convince parents that their children should contribute to the public good.

Recent evidence has shown that Covid-19 can be a threat to children, even if the overall risk for severe illness remains low.Credit…Geber 86, via Getty Images

In the United States, children are often sentimentalized, and parents fret about wildly inflated threats to children’s health, leading them to check Halloween candy for razor blades or wring their hands over teenagers eating Tide Pods. It would not have been surprising to see widespread panic among American parents about the possibility of their kids getting seriously ill from or even dying of Covid-19.

And yet, in interviews, that’s not what I hear from most mothers in my study. An Asian American mother with a master’s degree in mental health counseling said she would “probably not” seek the vaccine for her children because “the data shows that they’re not very high risk at all.”

Recent evidence has shown that Covid-19 can be a threat to children, even if the overall risk for severe illness remains low. Children’s risk of getting infected, for example, appears similar to that of adults, children are much better at spreading the virus than early studies suggested, and they may experience symptoms that last for weeks or more if infected.

The risk of Covid-19 to children is higher than the risk of the vaccine. So why don’t parents feel more urgency around vaccination?

My research suggests it’s because public health messaging during much of the pandemic reassured parents that children, especially “healthy” children, were at low risk of contracting, transmitting and suffering serious consequences from Covid-19. An April 2020 report from the C.D.C. stated that “relatively few children with Covid-19 are hospitalized, and fewer children than adults experience fever, cough, or shortness of breath.” Mainstream media outlets amplified those early public health messages, with headlines that reinforced the idea that children, especially healthy white children, were safer.

Those public health and media messages assuaged mothers’ worries, leading them to view Covid-19 vaccines as unnecessary, even if they previously accepted all other recommended vaccines for their children.

In some cases, mothers I interviewed said they are not planning to vaccinate their children against Covid-19, even though they got the vaccine for themselves. One mother, who is white and has a master’s degree, said she and her husband both got a Covid-19 vaccine around July, but are not planning to vaccinate their three children under 12 — at least not right away.

“Part of me is almost not ready for it to be approved, because, at least at this point, you know, I don’t have the choice in my hands,” the mother said. “I’m not sure I believe the benefits of the vaccine for children outweigh the risks and unknowns,” she said, adding, “If it was something like smallpox, I would feel a much greater level of concern than I do in this situation.”

Confirmation bias — the tendency to stick with what we already believe despite new information to the contrary — may also lead some parents to overlook new messages about children and Covid-19 risks. Many mothers I’ve interviewed say they’ve stopped paying close attention to Covid news because they’re so overwhelmed by the conflicting information. “I’m listening to my husband and my mother a lot, but otherwise I’ve kind of put my head in the sand a little bit,” one said. That makes it harder for public health experts to share new information about the importance of vaccines or the risks of Covid-19 for children and have credibility.

Parents may also feel unmotivated by a lack of tangible incentives. If concern over Covid-19 risk to children is low, then suggestions that the vaccines may not change their child’s daily life right away may add to the lack of urgency. Why bother to vaccinate if vaccinated kids are still required to wear masks at school, for example, or if the school district has already eliminated mask requirements for unvaccinated students?

Prepandemic research suggests that once parents view vaccination as unnecessary for their children, they can also become more susceptible to misinformation about vaccine risks. Parents may be weighing the risks they hear about Covid-19 vaccines — even if inaccurate — more heavily than the vaccines’ potential benefits for that reason.

A pregnant mother of three I spoke to, who is Black and has some college education, said she would wait to get the vaccine both for herself and for her children. “They have told us, the C.D.C., that it’s safe,” she said, “but a lot of people are having bad reactions to it, which is leading people to believe that it’s not as safe as they claim. So I’m just really still iffy about it.”

“I wear my mask and the kids wear their masks,” she added, “and I feel a little bit safer doing those methods than the vaccine.”

American parents may also be particularly susceptible to misinformation about vaccines because of the pressure placed on parents, and especially mothers, to keep their children safe. Given America’s lack of public investment in families, parents know that if they don’t look out for their children, there’s a good chance no one else will. That pressure can leave mothers on alert for potential risks to their children’s health. In the absence of messages about the risks of Covid-19 for children, false and exaggerated claims about the vaccine risks can trigger that alert system, serving as fuel for fears and outlets for the pressure mothers face to keep their children safe.

The problem with that kind of individualistic thinking is that vaccines are most effective when everyone gets the shot. Public health experts have estimated that to reach herd immunity, more than 70 percent of the global population will need immunity to Covid-19. Vaccinating children may be important for ending the pandemic or at least making it safer for families to return to familiar routines.

Public health communicators face a difficult challenge. On the one hand, scaring parents unnecessarily is unproductive. On the other, the absence of fear around children and Covid-19 is discouraging parents from having their children do their part for the greater good.

If the short-term goal is to vaccinate as many children as quickly as possible, then media and public health experts have a key role to play in shaking parents’ sense of calm around children and Covid-19. Any information about vaccine risks, for example, should be presented in the context of information about the risks that Covid poses to children and also the risk that unvaccinated children pose to people around them, including vaccinated adults.

My hope is that when parents consider the “incentives” of vaccinating their children against Covid-19, they’ll look beyond the individual benefits and focus on how their children can help protect others. That’s why schools have long required vaccinations for children. And that’s why most parents have, historically, complied.

If we want to end the pandemic and avoid similar moral calms and moral panics in the long term, Americans need to rethink our insistence on individual responsibility as the key to public health.

Jessica Calarco (@JessicaCalarco) is a professor of sociology at Indiana University. She has been leading a research study involving surveys and interviews of 250 mothers of young children, whose vaccination decisions she has tracked since 2018.

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