The Deeper Dig is a biweekly podcast from the VTDigger newsroom, hosted and produced by Sam Gale Rosen. Listen below, and subscribe on Apple Podcasts, Google Play, Spotify or anywhere you listen to podcasts.
With the pace of vaccinations increasing, Gov. Phil Scott has echoed President Joe Biden in saying life will be back to normal around the Fourth of July.
But there’s a sizable population that’s not going to be vaccinated anytime soon: Vermonters under 16. Only one Covid vaccine, from Pfizer/BioNTech, is authorized by the federal government for 16- and 17-year-olds, and none are authorized for younger children.
That excludes families from many new guidelines, such as Vermont’s lifting of quarantine requirements for vaccinated travelers and relaxed limits for multihousehold gatherings.
Officials have signaled that could change in the coming weeks if enough of Vermont’s adult population receives the vaccine. According to State Epidemiologist Patsy Kelso, high uptake among adults could still protect kids — and potentially allow the state to loosen restrictions further.
“We need to get as many Vermonters willing to be vaccinated with the safe and effective vaccines that are available, and that way, really decrease the spread within Vermont communities,” Kelso said. “That’s the best way to get ourselves out of this pandemic response that we’ve all been facing for a year now.”
On this week’s podcast, VTDigger’s Erin Petenko talks to Kelso about herd immunity, Vermont’s vaccination strategy and what the summer might look like for families with unvaccinated kids. Below is a partial transcript, edited for length and clarity.
Erin, why can’t kids get vaccines now?
Erin Petenko: Well, so far, the vaccine manufacturers that have gotten approval from the FDA have only tested and gotten approved for people over the age of 18, for Moderna and Johnson & Johnson; and for Pfizer, people over the age of 16. So children younger than 16 are completely excluded from the vaccine schedule right now. And people 16 and 17 can only take the Pfizer vaccine.
Why is there no authorization for younger populations?
Erin Petenko: I think it was just simpler for the vaccine manufacturers to start off by getting authorization for adults. It’s a little bit easier to experiment on adults than on children.
Right now, at least one manufacturer is testing the vaccine on kids aged 12 to 16. But the younger children haven’t really gotten started yet in terms of trials. There’s different estimates right now as to when kids will be able to get the vaccine. But even when they start to open that up, it’ll probably be older children first, and younger children will have to wait even longer.
With that in mind, where does that leave families of younger children, as it relates to state guidance around things like travel and gatherings?
Erin Petenko: They’re left in an awkward position. Because a lot of the new guidance coming out is based around whether someone has the vaccine. You can travel out of state without quarantining if you have the vaccine. You can be with anyone in any household — without a mask, inside, even — if you have the vaccine.
And eventually, almost all of us will have the vaccine. The estimate that the state gives is for mid-June for everyone who wants the vaccine to have it. But those families that have kids still have those restrictions in place. Even if there’s just one kid in that household that doesn’t have the vaccine yet, the rest of the family still has to figure out what to do with that one kid when it comes to multifamily gatherings or social gatherings, parties — whatever comes up during that time period in the summer.
We’ve been hearing over the past couple of weeks, it sounds like state officials are signaling that there might be some leeway in that. And there might be some changes soon. What do we know so far?
Erin Petenko: What we know so far is that state officials still feel pretty confident in keeping schools open and keeping summer programs running. They say that that is totally fine. Because schools and other programs for kids do have social distancing guidelines in place, and testing, and other measures designed to curb the spread of the virus. But they have said that in the next couple of weeks, they might give more information on kid-specific guidance for things like multihousehold gatherings.
It is a bit of a complicated situation too. Because we do know that kids are at less risk of severe disease, and there is some evidence that they are less likely to spread disease, particularly the very young kids. But we do know still that they get sick. And if absolutely none of them are vaccinated, there could still be a higher case rate in kids, even when the majority of the adult population is vaccinated.
You’ve been talking to some state officials about how they’re deciding how to deal with this fairly substantial unvaccinated population. What have you been hearing?
Erin Petenko: I talked with the Vermont state epidemiologist, Dr. Patsy Kelso. And we discussed the possibility of reaching herd immunity without vaccinating children.
Erin Petenko: Could you start off by just explaining what herd immunity means in a layperson’s terms?
Patsy Kelso: Sure. Herd immunity is when enough of a population is immune or protected from getting an infectious disease so that it can stop the spread of that infectious disease in a community.
There are two ways to achieve herd immunity. One is through people getting the infection naturally and developing an immune response. And the second way is through vaccination, when there’s a vaccine for whatever that disease is.
Erin Petenko: Herd immunity doesn’t mean that there are no cases in a population, right? There can still be cases?
Patsy Kelso: Right. Herd immunity means that enough people are protected to prevent further spread.
So if you think about, on any given day, if a person interacts with 20 other people, if 80% of those 20 other people are immune, either because they’ve already had the infection or because they’ve been vaccinated against it, then those people are not going to get the infection — even if they have contact with the infected person. It prevents them from getting it, and it prevents them from spreading it on to other people.
The proportion of our population that needs to be protected to prevent further spread of a disease depends on how infectious the disease is. With something like measles that’s very infectious — easily spread from one person to another — you need a really high majority of a group of people that might interact with a case to be protected in order to prevent further spread. But with diseases that aren’t spread that easily, you can get away with much less of the population, perhaps even only 50% of the population, being protected to prevent further spread.
Erin Petenko: We know that if a certain percentage of the total population of Vermont gets vaccinated, it’ll protect the rest of the population — even the unvaccinated population — from getting the virus. And according to Dr. Kelso, we don’t have a great understanding of what that will look like for Covid because it’s such a new disease. It could be anywhere from 50% to 70%. I’ve seen estimates as high as 85%.
Vermont’s adult population, if it has really great uptake of the vaccine, would be about 75% of the total population of Vermont. So it’s possible that we could achieve herd immunity without vaccinating children, but we’re kind of cutting it a bit close, I guess you could say.
Patsy Kelso: We know that the vaccination rates in Vermonters age 70 and older as of today are super high. They’re not 100%. But they’re over 80% or 85%, which is a great thing. And that means that if people in those age groups were only interacting with other people in that age group, then there would be very little spread. There still might be a case here or a case there, but those cases would be very unlikely to spread it to other people, because most of the people around them would be protected — because they’ve been vaccinated, or some of them have had Covid.
The challenge is that people don’t interact with only people in their same age group, or the same people all the time. And so we need to get herd immunity at the community level. When you think about all the people you might interact with, whether it’s through your children, or your parents or your friends, and then all the people they interact with — that’s why we need to get these vaccination levels high in every age group and every risk group across the state.
I guess then the question becomes, is herd immunity the ultimate goal here? Or does the state plan on loosening regulations even if we’re not quite at that exact threshold?
Erin Petenko: I asked Dr. Kelso about this. What she said was that they just want to get as many people vaccinated as they can. They understand that there may still be cases, and even potentially small instances of transmission, even after a high percentage of the population is vaccinated. But they believe that having more people vaccinated will reduce the risk of severe disease and have somewhat of an effect on the case rate, even if we don’t hit herd immunity level.
If 50% of the population is vaccinated, that’s 50% of the population that can’t get Covid-19. So it can still have an effect on the case rate.
Patsy Kelso: Our strategy is to get as many people vaccinated as are willing to be vaccinated. That’s the best approach.
There’s herd immunity threshold, and the absolute minimum proportion of a population that needs to be immune in order to prevent the spread. But then, there are always going to be susceptible people — either because they chose not to get the vaccine, or because no vaccine is 100% effective in every person who gets it.
So we need to get as many Vermonters willing to be vaccinated with the safe and effective vaccines that are available, and that way, really decrease the spread within Vermont communities. And that’s the best way to get ourselves out of this pandemic response that we’ve all been facing for a year now.
From what we know about how Covid works and what we expect about how herd immunity works — from someone like Dr. Kelso’s perspective, what is the expectation of what this summer might look like for people who have unvaccinated kids?
Erin Petenko: What Dr. Mark Levine said in a press conference recently was that we’re not going to just throw our masks away. We’re going to have the social distancing restrictions, and this mentality of trying to keep people safe, well into the spring and probably into the summer to a degree. It’s a return to normalcy, but it’s not completely normal yet. The families with children who are unvaccinated might have to be more conscious of those issues, but they probably will still benefit somewhat from the general population being safer.
Patsy Kelso: In the meantime, what that means is, we might still continue to see Covid spreading among kids — especially because they’re not able to be vaccinated. But again, because we know kids interact not just within their own age group — they interact with older people in their lives — if those older people, their older siblings, or parents, family, friends, grandparents, if all of those people are protected, then they won’t be spreading it to kids. And then kids won’t be able to spread it to someone else.
So it does take a population-level community level effort. And I think we will continue to see cases among kids. But those cases should decline as well, as more and more of the population around them gets protected.
Erin Petenko: We already know that people in unvaccinated households right now could gather with one other household at a time. And that’s not because the vaccine is protecting them. That’s because state officials just believe that the entire state of Vermont is safe enough to do that. So it’s possible that more restrictions and guidelines like that will get extended to children in the following months.
