Every Picture Tells a Story: Vaccinating 'The Children'

By Chuck Dinerstein, MD, MBA — Sep 23, 2022
With respect to COVID, children experience less severe disease but remain transmitters of the infection, especially within their immediate and extended households. Should we vaccinate or not? A new study looks at the demographics of NY City school children receiving the complete (2 shot) initial vaccination.
Image by Anil sharma from Pixabay

[I would mention the study, main author and journal as a little foreplay here.]

The researchers looked at the vaccination records of 1574 NYC public schools “not exclusively serving special education students.” Let’s begin with a few of the facts about the students. [1] 

  • 48% we're female
  • 23% had disabilities
  • 75% were economically disadvantaged, with 8.4% experiencing homelessness
  • 52% of all students were vaccinated - 51% of middle or high schoolers, and 36% of elementary school children. [AM I BEING STUPID OR DO THESE NUMBERS NOT ADD UP?]

There are any number of factors that could contribute to or detract from the vaccination rates. There can be issues of access, knowledge, and the preference (judgment) of the parents [MIGHT WANT TO ADD UNFOUNDED FEARS]. For context, here are some rough generalizations about the five boroughs of NY City. Manhattan is the wealthiest, best educated, and white. The Bronx is the poorest, least educated, and least white. Brooklyn lies somewhere in between. Queens is a veritable UN of nationalities, but Asians are predominant. Staten Island is PREDOMINANTLY the home of NYC middle-class workers, teachers, firefighters, and cops; it is also the only Republican borough in the city. [2]

What seemed to drive vaccinations?

The answer remains speculative, but what the heck [I SUGGEST FUCK, BUT THATS JUST ME], let’s speculate.

No surprise, Manhattan had the highest vaccination rate – educated, wealthy, with no access issues. Staten Island had the lowest – educated, financial issues TYPICAL of the middle class (which we might discount since all vaccinations are free), and no access issues. The most significant difference is the political affiliation of the parents. Let me hasten to say that being a Republican does not mean you are against vaccination; it is simply a social marker of some of your other thoughts, say, a distrust of the CDC or the COVID vaccine. [3]

Asians led the way on vaccination, again, no surprise. Anyone who has walked or worked in NYC knows that Asians have been wearing masks when ill or in “flu season” long before COVID reared its ugly head. Across the boroughs, more Hispanics were vaccinated than Blacks. Again, both groups had similar educational and financial demographics, and for some Hispanics, English was a second hurdle. Why the difference? It can’t be the desire to protect their children. Is there a difference in trust [I DONT KNOW IF YOU WANT TO GET INTO TUSKEGEE HERE BUT IT WAS PART OF THE STORY TO SOME EXTENT]? Finally, except in Manhattan and almost Brooklyn, Whites were the least likely to be vaccinated. ??WHY?

It is not about race, finances, education, or access. To me, the vaccination rates of children in NYC schools are about parents’ preference – it is about who parents trust, and that is entangled in education and their cultural and neighborhood ethnicity.

 

[1] A quick caveat, when doing a comparison to the numbers of individuals below the age of 18, at least based on the 2010 NYC census, about a third of White children are not enrolled in NYC public schools; they are presumably in private institutions and are not counted in this study.

[2] Please do not write or comment on the lack of nuance in my characterizations; I am painting with not just a broad brush but with a roller. I know that all of the boroughs contribute to the city of Oz.

[3] This raises a question that has never been asked or answered. President Trump should rightfully be given credit for the speedy development of the COVID vaccines; Operation Warp Speed is his baby. So why are so many of his supporters against what was probably his most significant public health contribution?

 

Source: Analysis of School-Level Vaccination Rates by Race, Ethnicity, and Geography in New York City JAMA Network Open DOI: 10.1001/jamanetworkopen.2022.31849

 

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Chuck Dinerstein, MD, MBA

Director of Medicine

Dr. Charles Dinerstein, M.D., MBA, FACS is Director of Medicine at the American Council on Science and Health. He has over 25 years of experience as a vascular surgeon.

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