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What's missing in our debate over vaccinating kids

Students line up in the morning at Yung Wing School P.S. 124 on September 27, 2021 in New York City. (Michael Loccisano/Getty Images)
Students line up in the morning at Yung Wing School P.S. 124 on September 27, 2021 in New York City. (Michael Loccisano/Getty Images)

Recently, my 75-year-old aunt told me the story of walking from her elementary school to the VFW down the street to be among the first children to receive the polio vaccine in 1954. My grandmother and great aunt watched from the kitchen window of their shared three-family house in Providence as my aunt and her cousin made the short trek with their class to get a poke in the arm and a polio pioneer pin that my aunt still keeps in her jewelry box. She recalls later being told that my grandmother and great aunt feared they were sending their daughters to be guinea pigs in an experiment that could go terribly wrong. But the fear of polio was greater. And it seemed at the time to be the right and patriotic thing to do.

I’ve been thinking a lot about my grandmother standing anxiously at that window with the recent FDA approval of the COVID-19 vaccine for children ages 5 to 11. As with many things, I wish she was still here so I could ask her more about what she was thinking that day. How did she make the decision to let my aunt be a “pioneer”? How sure was she (or wasn’t she) that it would all turn out for the best? It did of course. The punchline to this family story is that my aunt got the shot and promptly passed out. She was sent home from the VFW in a taxi and missed the rest of the school day. Neither she nor any of her classmates ever got polio.

As a child psychologist, I know that the science of parenting is often more about the psychology of parents than of children. It may have been my aunt who fainted from anxiety that day, but it was my grandmother who had to overcome her fear to weigh the risks and make the decision that helped to effectively eradicate a disease that had devastated generations. She did this with arguably much less ensuring her own child’s safety than I have as I decide whether to have my 11-year-old vaccinated against COVID-19.

As a child psychologist, I know that the science of parenting is often more about the psychology of parents than of children.

I suspect that my grandmother’s decision was influenced by both facts and political propaganda, not unlike my parenting cohort. She would have weighed the risks of my aunt getting the vaccine versus the risks of her getting polio. She also would not have been immune to the confirmatory biases that affect all human decision-making. We have a powerfully reliable tendency to look for evidence that supports our already firmly held beliefs. In 1954, everyone knew someone who had been devastated by polio while evidence of negative vaccine side effects was scarcer.

Today, confirmatory bias is working against the pro-vaccine camp. Early messaging that COVID-19 was less dangerous to children than adults was comforting. Even as variants have emerged and proven otherwise, parents will continue to believe what they want to believe and to look for evidence to confirm rather than contradict those beliefs. Many will choose not to get their youngest children vaccinated because the risks of the virus don’t seem high enough.

Yet, I also suspect my grandmother’s decision was influenced by factors we have largely been ignoring in the current debate over vaccinating our youngest children; to our (and their) detriment. Perhaps what we have been missing in our risk analysis is a fuller accounting of the benefits of vaccination.

My grandparents believed that human beings have a moral responsibility to humankind that is at least equal to their responsibility to their immediate family. This family value was rooted in their faith and communicated to us in every decision they made. We knew they loved us unconditionally, that we were uniquely important to them. But we were never led to believe that we were somehow existentially more important than anyone else. To put it in their terms, God loves us all the same.

It’s this value that I see reflected in my grandmother’s pushing past her own fear to send my aunt for her shot that day. My grandmother believed that my aunt getting vaccinated would benefit others as much as it would benefit her.

The benefits to humankind of as many people getting vaccinated as possible have been a secondary byline in the discussions of vaccinating children against COVID-19. We talk about them protecting their grandparents from COVID. We don’t talk enough about how their being vaccinated protects us all. If we want to effectively eradicate COVID like the “Greatest Generation” did polio, parents need to push through their own anxiety and fear to have their children vaccinated.

It does not do any good to parent from a place of fear and anxiety. Anxiety makes parents more controlling, which is provenly bad for kids. Anxiety also triggers a fight, flight or freeze response. Put another way, parents’ fear of the slim chance that vaccines will harm their individual child triggers argument, avoidance, and indecision. None of these are the position from which to make as weighty a decision as vaccination. All contribute to unhealthy conflict, on display at school board meetings across the country.

There are of course exceptions to every rule. Some parents will have good reason to delay or defer vaccinating their children. But neither fear nor politics qualify as good reasons. If you want your children to live by the rule that others’ lives are of equal value to theirs, and the risks to them are no more than to the average child, you will get them vaccinated. If you believe that parents’ job is both to raise happy healthy kids and to raise contributory citizens of the world, then this is the “right” decision. Acknowledging your worry and living out your values will shape them. They will do as you do, not as you say.

We talk about them protecting their grandparents from COVID. We don’t talk enough about how their being vaccinated protects us all.

Of course, they are also listening. I see this in my practice where my patients are taking their cues from their parents. Many are anxious to get their chance to roll up their sleeves — and not because shots are scary.

Children under 12 aren’t cognitively equipped to do long-term thinking and weighing of risks and benefits on their own. Parents must make the ultimate decision for them and can still override their teens in medical decision making. But parents can use this as an opportunity to model and teach values and an approach to making tough choices that will serve their children in all kinds of decisions to come. This can happen in small ways (letting an anxious little choose which arm for the shot) and bigger ones (talking with a 12-year-old about why you are choosing to get them vaccinated). Children and teens who are involved and informed in family decision making will be more likely to internalize family values and to be less anxious both in the short and longer term.

I never had to weigh the decision of whether to get my 17-year-old vaccinated. He made himself an appointment as soon as he was eligible. He weighed the benefits to his own physical, social, and emotional health and to his peers of getting the shot versus the possible risks and side effects and had no doubt. I took him to the vaccination clinic with enough pride to easily outweigh my worry.

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Ellen H. O'Donnell Twitter Cognoscenti contributor
Ellen H. O’Donnell, Ph.D., is a pediatric psychologist at MassGeneral Hospital for Children and an assistant professor at Harvard Medical School.

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