Barriers to Equity In Childhood COVID-19 Vaccination

Expanding the COVID-19 vaccination recommendation to children ages 5 through 11 years paves the way for 28 million more children to receive the vaccine. However, we know many children have faced barriers to vaccination in the past.
Learn more about COVID-19 vaccination barriers, which children are at the greatest risk, and find out lessons learned from schools and families.
chart line icon As more children receive COVID-19 vaccines, CDC is tracking progress.
- chevron right icon CDC’s COVID Data Tracker
- chevron right icon Children and COVID-19 Vaccine Data Reportexternal icon from the American Academy of Pediatrics
There are some children at greater risk from COVID-19. Many of these same children may face additional barriers in getting vaccinated.
- Children who are unable to visit a pediatrician often ─ such as those who are experiencing homelessness or those who live in rural areas.
- Children who have historical disadvantages when it comes to health ─ such as those in racial and ethnic minority groups or households with lower incomes.
- Children with developmental disabilities ─ such as cerebral palsy, autism spectrum disorder, or an intellectual disability.
- Children who have special healthcare needs ─ such as lung, heart, or kidney disease, an immune system problem, malignancy, diabetes, some blood diseases, or conditions of the muscular or central nervous system.
- Children living in congregate settings ─ such as those who are incarcerated or detained or those who live in group homes.
- Children who are non-English speakers, immigrants, or with undocumented status.

Children from certain racial and ethnic minority groups are not only more likely to become sick or die from COVID-19, but they are also more likely to have lost a parent or caregiver to the disease.
chevron right icon The Hidden US COVID-19 Pandemic: Orphaned Children
Past research on influenza (flu) has shown racial and ethnic minority groups have had lower rates of flu vaccination. These disparities have been identified in both adults and children.
- During the past few flu seasons, some racial and ethnic groups were more likely than others to get a flu vaccine.
- Most children who received a flu vaccine last year got it in a doctor’s office.
- Language, insurance status, ability to take time off work and other factors can reduce a family’s ability to go to the doctor regularly.
Based on experience with flu vaccination challenges, alternative strategies are needed to reach all children ages 5 years and older with COVID-19 vaccines.

syringe solid icon Black children have had the lowest rates of flu vaccination for the past three years and were more likely than other children to become very sick from the flu.
- chevron right icon Influenza Vaccination Coverage, Children 6 Months Through 17 Years, United States
- chevron right icon Flu Disparities Among Racial and Ethnic Minority Groups
Qualitative data from schools and organizations serving K-12 students emphasize the importance of creating communication for the group meant to receive it.
- Use a health equity lens when framing information about health disparities.
- Consider key health communications principles, such as using person-first language (e.g., “a person with diabetes” instead of “a diabetic”) and avoiding unintentional blaming.
- Use preferred terms for select population groups and communities while recognizing that there isn’t always an agreement on these terms.
- Consider how communications, messages, and products are developed ─ looking for ways to improve health equity and inclusivity.

people icon CDC underlines the importance of addressing all people inclusively and respectfully.
- chevron right icon Health Equity Guiding Principles for Inclusive Communication