COVID-19 Vaccine Provider Access and Vaccination Coverage Among Children Aged 5-11 Years - United States, November 2021-January 2022.

On October 29, 2021, the Pfizer-BioNTech pediatric COVID-19 vaccine received Emergency Use Authorization for children aged 5-11 years in the United States.† For a successful immunization program, both access to and uptake of the vaccine are needed. Fifteen million doses were initially made available to pediatric providers to ensure the broadest possible access for the estimated 28 million eligible children aged 5-11 years, especially those in high social vulnerability index (SVI)§ communities. Initial supply was strategically distributed to maximize vaccination opportunities for U.S. children aged 5-11 years. COVID-19 vaccination coverage among persons aged 12-17 years has lagged (1), and vaccine confidence has been identified as a concern among parents and caregivers (2). Therefore, COVID-19 provider access and early vaccination coverage among children aged 5-11 years in high and low SVI communities were examined during November 1, 2021-January 18, 2022. As of November 29, 2021 (4 weeks after program launch), 38,732 providers were enrolled, and 92% of U.S. children aged 5-11 years lived within 5 miles of an active provider. As of January 18, 2022 (11 weeks after program launch), 39,786 providers had administered 13.3 million doses. First dose coverage at 4 weeks after launch was 15.0% (10.5% and 17.5% in high and low SVI areas, respectively; rate ratio [RR] = 0.68; 95% CI = 0.60-0.78), and at 11 weeks was 27.7% (21.2% and 29.0% in high and low SVI areas, respectively; RR = 0.76; 95% CI = 0.68-0.84). Overall series completion at 11 weeks after launch was 19.1% (13.7% and 21.7% in high and low SVI areas, respectively; RR = 0.67; 95% CI = 0.58-0.77). Pharmacies administered 46.4% of doses to this age group, including 48.7% of doses in high SVI areas and 44.4% in low SVI areas. Although COVID-19 vaccination coverage rates were low, particularly in high SVI areas, first dose coverage improved over time. Additional outreach is critical, especially in high SVI areas, to improve vaccine confidence and increase coverage rates among children aged 5-11 years.

Decision support architectures for the recovery of interdependent infrastructure with large-scale damage and socially vulnerable populations.

Infrastructure damage has household-level consequences after a major disaster. Losses are experienced due to factors such as unavailable services and impaired mobility. Socially vulnerable residents, in particular, have few resources with which to adapt. Decision support tools for making justifiable, transparent, repeatable decisions that center the needs of users during recovery are currently nonexistent. In part, this is because infrastructure recovery is a complex process, often involving the coordination of multiple entities. The recovery problem can be rendered more tractable by applying tools suitable for modeling complex systems and processes. System theoretic process analysis (STPA) can be used for goalsetting in a complex, dynamic system such as community civil infrastructure. STPA is used here to devise a decision support tool architecture suitable for coordinated multiagency recovery efforts. The example application is a long-term recovery process with widespread infrastructure damage, population displacement, and other disruptions in system use due to a major disaster. In the example, losses and hazards are defined to reflect recovery challenges commonly faced by vulnerable populations experiencing partial or total displacement. This extension of STPA then reverses these hazards, starting with the most hazardous system states and progressing sequentially to less hazardous states until recovery is complete.