by Carolyn Bick
There was nothing but good news at the Public Health – Seattle & King County COVID-19 briefing on Wednesday, May 12.
Public Health – Seattle & King County (PHSKC) Health Officer Dr. Jeff Duchin announced in the press conference that the data suggests that not only has the County started to “turn the corner” on its most recent surge of COVID-19 cases, but that the Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP) has officially approved the Food and Drug Administration’s (FDA) emergency use authorization (EUA) for the Pfizer vaccine to be administered to young people aged 12-15.
Previously, the CDC had only recommended the Pfizer vaccine for people ages 16 and older. The decision to expand the age pool is good news for young people, Duchin said. It means that, once vaccinated, adolescents will be able to safely return to doing things that are so crucial to their growth and well-being — things like gathering together with friends and family, playing sports, and returning safely to in-person learning.
“With ample vaccine supply now, we’ve got many vaccine providers across the county ready to serve these young people,” Duchin said, adding that “you can go ahead and check the usual sites,” such as one of the Seattle’s mass vaccination sites, the city’s walk-up, no-appointment sites at Lumen Field, Rainier Beach, and West Seattle Monday through Saturday, 8 a.m. to 5 pm., one of the County’s mass vaccination sites, or a community provider, such as International Community Health Services (ICHS) or Kaiser Permanente. Adolescents may get vaccinated without an appointment at any one of the County’s or City’s mass vaccination sites.
In an effort to reach younger people, Duchin said, adolescents will be also able to get vaccinated at their schools. He said that PHSKC has reached out to all the County’s school districts to match them with vaccine providers to provide vaccine clinics on-campus, before summer vacation.
“Starting next week, we know that nearly all districts have plans in place to hold clinics at the high schools and middle schools,” Duchin said.
Vaccine clinics at Seattle Public Schools (SPS) are open to all students ages 12 and older at all K-8 schools, middle schools, and high schools, according to the Seattle Public Schools’ vaccination webpage, which was updated today. No insurance is required, and vaccinations are free. Vaccine clinics at different SPS locations are listed on that page, and parent or guardian consent forms are available in multiple different languages on that webpage.
Duchin said that some sites have consent policies in place that may require a parent or guardian to be present, but that many sites will only require written permission. However, there are exemptions for youth who are emancipated.
But not all adolescents who may want the vaccine have a parent or guardian they can count on, and they may not be legally emancipated. These young people may live unhoused and alone, or, even if they are housed, face a dangerous or difficult home situation.
The Emerald asked how young people in these kinds of situations could get vaccinated without having to rely on an adult. Duchin said that if a young person who is eligible for the vaccine and wants it is “basically emancipated, for all practical purposes, from guardians or a parent, there are criteria that vaccinators can use to assess the situation” of that particular person.
These criteria are known as the Mature Minor Rule. The result of a 1967 court case, the Mature Minor Rule allows County health care providers to treat people under the age of 18 as they would adults “based upon an assessment and documentation of the youth’s maturity.”
This assessment is based on what are known as Mature Minor Factors. A young person seeking health care without the consent of a parent or guardian must meet just one of the factors, which are listed on the County’s webpage.
“We understand that there are some youth who do not have that option [of a parent or guardian’s permission], and so we do not want to systematically deny them the ability to be protected against this disease,” Duchin said.
Duchin said that even though young people are less susceptible to complications from COVID-19, this does not mean they are not susceptible at all. Both “adolescents and younger children are making up a growing share of new COVID-19 cases in the U.S., accounting for about 20% recently. Nine percent of recent cases are just due to adolescents in the ages of 12-17.”
Duchin also said that adolescents have been falling ill throughout the pandemic: to date, 1.5 million adolescents aged 12-17 have fallen ill, and 13,000 of them have been hospitalized. Among these young people who have gotten sick, 127 have died and 804 have developed the still-rare, but deadly multi-system inflammatory syndrome.
Duchin said that the County’s mass vaccination sites in Auburn and Kent and the City of Seattle’s mass vaccination site at Lumen Field will also be hosting family days this coming weekend for all ages who are eligible to get the vaccine. Walk-ins are welcome, vaccines are free, and no insurance is required.
Duchin also said that PHSKC will “continue to help motivate people who are on the fence and just need a little nudge to get vaccinated.”
“We are partnering with 4Culture [the County’s cultural funding agency] on a pilot program called ‘Vax to the Future,’ which will bring art and music to COVID vaccination sites throughout the County,” Duchin said. “This will make vaccination a community-focused event that will encourage people to get vaccinated and share their vaccination experience with others using social networks.”
Duchin added that he hoped this strategy would also motivate young people to get vaccinated, and that the first events start this weekend, with live music outside the Kent Showare vaccination site on Saturday, May 15, from 11 a.m. – 3 p.m. He also said local artists have created special buttons for people who have gotten vaccinated, and encouraged those who have been vaccinated to download the V-Safe app, which allows people to share any symptoms post-vaccination.
Earlier in the day, the State Department of Health held its regular weekly COVID-19 briefing, in which officials briefly discussed preparations schools should be making for a return to in-person learning both over the summer and in autumn.
Deputy Secretary for COVID-19 Response Lacy Fehrenbach said that the DOH is asking that schools should have the following health and safety measures in place: universal and correct masking; hand washing and respiratory etiquette; “ensuring healthy facilities with ventilation, cleaning, and infection control plans;” and having a plan to respond to COVID-19 cases when they happen, including reporting to public health agencies, utilizing contact tracing, and communicating with staff and parents.
Fehrenbach also said that “physical distancing is recommended,” and that schools should have two plans in place: “one that factors in the recommended physical distancing of three feet in classrooms and six feet elsewhere to the greatest extent possible and reasonable, while providing full-time, in-person instruction for those families that want it.
“Schools should also have a plan that does not have a physical distancing requirement,” Fehrenbach continued. “This is partly because we are pretty far away from the school year, in terms of pandemic time, so we are asking schools to have both of those plans, and we will keep them posted over the summer, as we monitor the science and course of disease and vaccine updates in our state.”
But though DOH officials also spoke in rosy terms about the efficacy of vaccines and encouraged everyone eligible to get vaccinated as soon as possible, DOH Sec. Dr. Umair Shah appeared to carefully skirt the issue of “herd immunity,” or the point at which most of a population becomes immune to a disease, thereby making its spread unlikely. Instead, he focused on “robust vaccine coverage” that would allow the state to “blunt” the effects of COVID-19. This is not the same thing as herd immunity.
Shah also did not answer a reporter’s direct question about whether COVID-19 is “a disease that we are going to be facing and coping and living with for quite some time — that it’s not going to be easily defeated?”
Instead of answering the question, Shah said that he is “going to feel a heck of a lot better with the answer to that question, if we had more people vaccinated.”
Many public health experts and scientists believe that we will never reach herd immunity, due to the combination of the sheer number of variants and the refusal of about 25% of Americans to get vaccinated. At this point, COVID-19 is likely endemic, which means it’s here to stay.
When the Emerald followed up with the DOH via email to explicitly ask whether Shah and the DOH believed this, too, and whether the DOH is preparing for the scenario in which herd immunity is never reached, the DOH did not directly answer the question. Instead, DOH public information officer Shelby Anderson said that “[t]he threshold for community immunity is tough to estimate due to variants and not knowing how long antibodies last.
“While we know it will be difficult to reach, we also know that we do not have to reach the population immunity threshold to see benefits of vaccination. In fact, we’re already seeing signs immunity is helping slow transmission and it’s reducing strain on our health care systems,” Anderson continued.
The Emerald followed up, asking whether the statement that “we also know that we do not have to reach the population immunity threshold to see benefits of vaccination” means that the DOH is prepared for the United States to never reach herd immunity, and whether those discussions are happening within the DOH and with other State officials. The DOH did not respond before publication of this article, but the Emerald will update this article, if it receives a response.
Featured image: COVID-19 vaccine vial at a Seattle pop-up vaccination clinic. Photo by Alex Garland.