With school districts in Alameda County headed back to school this month, efforts to get youth vaccinated have ramped up over the past few weeks. Vaccination rates for 12 to 17-year-olds lag behind other age groups, and racial disparities among this demographic are even more stark. 

When confronting vaccine hesitancy among this age group, health officials often face similar sentiments as they do in adults: distrust of government and healthcare institutions as well as belief in misinformation spreading on social media. But some attitudes, like a teenage sense of invincibility or rebellion, require a different approach.

Currently, only the Pfizer vaccine is approved for children 12 and older, and schools are unlikely to require it for students while it still has the emergency use approval from the U.S. Food and Drug Administration. But full approval could happen sooner than later—the FDA could give full authorization to the Pfizer vaccine by early September, the New York Times reported earlier this month. Gov. Gavin Newsom, when asked about a vaccine mandate for students last week, left the option on the table: “We’ll consider that if necessary.”

But until then, school and public health officials can only strongly encourage students to get vaccinated, and work to make it as convenient and accessible as possible. Oakland Unified School District has been hosting pop-up clinics at school campuses, sharing details about other vaccine opportunities with students, and holding information sessions for students and families. 

Genevieve Saechow, a senior at Oakland High School, got the shot last month at a vaccine clinic hosted by Kaiser Permanente and Beebe Memorial Cathedral in Temescal. The event was aimed at families and offered backpacks full of school supplies to any youth who got vaccinated. Saechow got an email from her school about the event, and the impending start of school was what motivated Saechow to get the shot, she said. 

She still has some friends who are on the fence about getting it. Her advice to them? 

“We’re going back to school, and you never know what’s going to happen,” she said. “Honestly, just get it. So this can all be over with.” 

Saechow received the vaccine after her mom gave her the choice. But that’s not the case in all families, said Dr. Kim Rhoads, the director of Umoja Health, a partnership between public health agencies, UCSF, and community organizations to provide COVID testing and vaccinations in Oakland, particularly for Black communities in Oakland.

“It’s going to take time and willing parents,” she said about the efforts to raise youth vaccine rates. “It’s very upsetting when we see kids who want to get vaccinated who can’t.”

Twelve to 17-year-olds must have a parent or guardian’s permission to get the COVID vaccine, unless they’ve been legally emancipated. Near the end of July, roughly 69% of 12 to 17-year-olds in Alameda County had received at least one dose of the two-shot Pfizer vaccine, and nearly 56% were fully vaccinated, according to county data. For Black youth in Alameda County, only about 31% had received one dose, and less than 25% were fully vaccinated, among the lowest rates in that age group.

In Oakland specifically, about 30%, or 2,089, of Black 12 to 17-year-olds have received at least one dose. That leaves nearly 5,000 estimated to be unvaccinated, according to a presentation by Umoja Health last week. Overall, about 60% of Oakland’s 12 to 17-year-olds have had at least one dose. Across all age and racial groups, 84% of Oakland residents have had at least one dose. 

The vaccine disparities are notable because of the disproportionate impact of the virus, said Dr. Nailah Thompson, who worked at the pop-up clinic hosted by Kaiser Permanente and Beebe Memorial Cathedral last month.

“Black and Brown communities are the communities that are being impacted by this virus that are dying,” she said. “And it’s not just about being sick, it’s about the disability that can occur after. This is not just about protecting yourself, but it’s about protecting your children, your loved ones, your communities.”

About 200 people registered for the Kaiser Permanente event, which not only allowed community members to get vaccinated, but also to have an opportunity to talk to doctors about any questions or concerns they had. Michelle Gaskill-Hames, senior vice president of hospital operations for Kaiser Permanente, and whose husband is the senior pastor of the church that hosted the event, said she’s heard a few common concerns. First, people had asked about whether the vaccines contain the actual coronavirus (they don’t), and they shared concerns about how quickly the vaccine was developed (the mRNA method in the Pfizer and Moderna shots had been studied and employed for decades, allowing vaccine manufacturers to work quickly). All of the vaccine manufacturers also went through standard, rigorous clinical trials, research, and data evaluations). 

“For each of the various concerns that are out there, we want to hear them. And we want to be able to provide information,” she said. “And I think the most important information I can provide is the fact that we’re seeing hospitalizations increase, we’re seeing a surge, and we’re seeing continued death and illness.”

Another barrier to getting young people vaccinated, particularly Black youth, is addressing similar attitudes found in Black adults of skepticism towards the healthcare industry and the government, Rhoads said. In both cases, the strategy is to have a conversation, but for youth, that conversation should be led by other young people to be most effective, she said.

In another effort to ramp up vaccinations, Umoja Health and the Alameda County Public Health Department launched the youth mobilizers crew this month to reach teens and young adults. One of their approaches will be to take to social media to provide accurate information about the vaccine and dispel misinformation that can go viral. It represents a relatively new frontier for healthcare experts.

“Public health and healthcare systems are so reliant on the fact that we’re experts and people will listen to us. We’re playing by the old rules. That’s not how social media works,” Rhoads said.

Traditionally, infants and young kids get vaccinated when their parents take them into the doctor’s office, but teenagers are at an age where they’re testing their independence and are trying to make their own decisions, Rhoads added, which is why it’s crucial for young people to have a role in helping their peers make those decisions.  

Dr. Emily Frank, a UCSF pediatrician and teacher at Life Academy in Oakland, said that allowing youth to read and evaluate information about the vaccines themselves can help ease some of their concerns. In May, Dr. Frank held a vaccine “teach-in” where students looked at Alameda County data on vaccines and COVID disparities, asked questions about the healthcare industry’s history of mistreatment of Black and Latino patients, examined data from the vaccine trials, and learned how the vaccines work. The training also gave students the opportunity to earn a vaccine educator badge to help persuade others to make vaccine appointments.

Within 10 days of the teach-in, 44% of the students had gotten their first shot or made an appointment for one, Frank said. 

As students head back into the classroom while the Delta variant surges, increased youth vaccination rates are just one piece of the puzzle to help schools stay open safely. “It’s more than just students. It’s students and staff and students’ families and staff’s families,” she said. 

That’s why the public health department has been partnering with other organizations to reach more communities, said Lisa Erickson, associate director for community health services who helps coordinate the COVID response for schools, childcare organizations and other youth settings. 

“This whole vaccine effort is a huge undertaking, and the partnership aspect of it is so important. The public health department can’t do it alone. We need faith-based organizations, community-based organizations, schools, the Alameda County office of education,” she said. 

At a Fremont High School vaccine event earlier this summer, junior Siurave Quintanilla said the most compelling reason for getting vaccinated is to help other people. She had some concerns about the side effects of the vaccine, and experienced arm pain for a few days after her shots. 

“I kept telling myself, having that arm pain for three to four days can help thousands of people live,” she said, adding that she has family in Central America who have lost their jobs or gotten sick because of COVID. “I heard all their problems and how they suffered so much. And that's what I don't want. I am so privileged to be here, because I know a lot of my family members cannot get the vaccine.”