For weeks, the school principal had been imploring Kemika Cosey: Would she please allow her children, ages 7 and 11, to get COVID shots?

Cosey remained firm. A hard no.

But “Mr. Kip” — Brigham Kiplinger, principal of Garrison Elementary School in Washington, D.C. — swatted away the “no.”

Since the federal government authorized the coronavirus vaccine for children ages 5-11 nearly three months ago, Kiplinger has been calling the school’s parents, texting, nagging and cajoling daily. Acting as a vaccine advocate — a job usually handled by medical professionals and public health officials — has become central to his role as an educator. “The vaccine is the most important thing happening this year to keep kids in school,” Kiplinger said.

Largely through Kiplinger’s skill as a parent vax whisperer, Garrison Elementary has turned into a public health anomaly: Of the 250 Garrison Wildcats in kindergarten through fifth grade, 80% have had at least one shot, he said.

But as the omicron variant has stormed through U.S. classrooms, sending students home and, in some cases, to the hospital, the rate of vaccination overall for America’s 28 million children ages 5-11 remains even lower than health experts had feared. According to a new analysis by the Kaiser Family Foundation based on federal data, only 18.8% are fully vaccinated and 28.1% have received one dose.

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The disparity of rates among states is stark. In Vermont, the share of children who are fully vaccinated is 52%; in Mississippi, it is 6%.

“It’s going to be a long slog at this point to get the kids vaccinated,” said Jennifer Kates, a senior vice president at Kaiser who specializes in global health policy. She says it will take unwavering persistence like that of Kiplinger, whom she knows firsthand because her child attends his school. “It’s hard, hard work to reach parents.”

After the Pfizer-BioNTech vaccine was authorized for younger children in late October, the out-of-the-gate surge in demand lasted a scant few weeks. It peaked just before Thanksgiving, then dropped precipitously and has since stalled. It hovers at 50,000 to 75,000 new doses a day.

“I was surprised at how quickly the interest in the vaccine for kids petered out,” Kates said. “Even parents who had been vaccinated themselves were more cautious about getting their kids vaccinated.”

Public health officials say that persuading parents to get their younger children vaccinated is crucial not only to sustaining in-person education but also to containing the pandemic overall. With adult vaccination hitting a ceiling — 74% of Americans ages 18 and older are fully vaccinated, and most of those who aren’t seem increasingly immovable — unvaccinated elementary school children remain a large, turbulent source of spread. Traveling to and from school on buses, traversing school hallways, bathrooms, classrooms and gyms, they can unknowingly act as viral vectors countless times a day. Parents give numerous reasons for their hesitation. And with their innate protective wariness on behalf of their children, they are susceptible to rampant misinformation. For many working parents, the obstacle is logistical rather than philosophical, as they struggle to find time to get their children to the clinic, doctor’s office or drugstore for a vaccine.

In some communities where adult opposition to vaccines is strong, local health departments and schools do not promote the shots for children vigorously for fear of backlash. Pharmacies may not even bother to stock the child-size doses.

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Despite the proliferation of COVID-crowded hospitals, sick children and the highly contagious aspect of omicron, many parents — still swayed by last year’s surges that were generally not as rough on children as adults — do not believe the virus is dangerous enough to warrant risking their child’s health on a novel vaccine.

Health communication experts additionally blame that view on the early muddled messaging around omicron, which was initially described as “mild” but also as a variant that could pierce a vaccine’s protection.

Many parents interpreted those messages to mean that the shots served little purpose. In fact, the vaccines have been shown to strongly protect against severe illness and death, although they are not as effective in preventing infections with omicron as with other variants.

And caseloads of children in whom COVID has been diagnosed only keep rising, as a report last week from the American Academy of Pediatrics underscores. Dr. Moira Szilagyi, the academy’s president, pressed for greater rates of vaccination, saying, “After nearly two years of this pandemic, we know that this disease has not always been mild in children, and we’ve seen some kids suffer severe illness, both in the short term and in the long term.”

Recognizing the urgency, proponents of COVID shots are redoubling their efforts to convince parents. The American Academy of Pediatrics has put together talking points for pediatricians and parents. Kaiser has its own parent-friendly vaccine-information site. Patsy Stinchfield, a nurse-practitioner who is the incoming president of the National Foundation for Infectious Diseases, keeps up an exhaustive speaking schedule, answering COVID vaccine questions from parents, teenagers, pediatricians and radio talk show hosts.

Johns Hopkins Bloomberg School of Public Health has posted a free, online training course to help give pro-vaccine parents language and ways to approach their resistant friends. It provides vaccine facts, resources and techniques to engage them.

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One tip is to share personal stories about COVID, to ground the purpose of the vaccine in real-world experience. Another is to normalize COVID vaccination by proudly telling friends and family when children get COVID shots.

Rupali Limaye, an associate scientist at Bloomberg who studies vaccine messaging and developed the course, said that giving parents tools to persuade others about COVID shots could improve uptake rates, particularly now that some hesitant parents are rejecting the advice of pediatricians. Peer “vaccine ambassadors,” as she calls them, have more time and exert less of a power dynamic than harried doctors. “This is a supersensitive topic for a lot of people,” Limaye added. Since November, Kiplinger, who has been Garrison’s principal for five years, has been working through a daily call list of parents. He says he understands their apprehension because he went through the same mental gymnastics before deciding to get his two young sons vaccinated.

He badgers in any way he can: At lunchtime he asks students to raise their hand if they have gotten a COVID shot, applauds them and urges the others to keep prodding their folks.

“I’m a real pain in the ass,” he admitted. “I lovingly harass them.”

COVID has been especially brutal on Black and Hispanic families, whose children comprise about 80% of the school’s population. Kiplinger understands that as a white man, he has limited standing to ask these parents to trust vaccines and so has been wrangling Black pediatricians to supply medical information as well as endorsements.

“Given the history of understandable medical mistrust in communities of color, hesitancy is natural and understandable,” he said. “But to keep our Wildcats safe and in school, we’ve got to push through the natural fear of the new and unknown and take every measure we can.”

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Many parents told him they couldn’t take off work to take their children to get shots. So Kiplinger coordinated with a city program to hold COVID vaccine clinics in the school’s cafeteria during the caregiver-friendly hours of 3:30 p.m. to 7 p.m. He attends each one, greeting families, holding and hugging children as they close their eyes and extend their arms.

Cosey, the Garrison parent who staunchly resisted Kiplinger’s entreaties for weeks, had worried that the vaccine could exacerbate her son’s many allergies. “It took me a little minute to do a lot more research,” she said.

Earlier this month, she took both children to a school clinic. Yes, her pediatrician had encouraged her, but she also gives credit to Kiplinger. She laughed. Her fifth grader has been at Garrison since kindergarten. “Mr. Kip is more like family, so when I say he was nagging, it’s a good nag,” she said.

At the school’s clinic, “Mr. Kip took a million pictures,” she added. “He was just superexcited that I decided to come in.”

Kiplinger is determined to convert the remaining vaccine holdouts at Garrison. At the most recent vaccine clinic, he stood by as a mother argued over the phone with her husband. “The mom and her four Wildcats wanted the shots, but for the dad it was a ‘no.’ It broke my heart,” he said.

“But we have another clinic coming up soon,” he added, “and I’m hoping that maybe he’ll come around.”

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