In a Larkspur pediatrician’s office with an oceanscape on one wall and clear plastic chairs nearby, Ryan Youngberg turned his head to the right as a medical assistant stuck his left arm with the Pfizer coronavirus vaccine.
Ryan, 12, was nervous beforehand – “I don’t really like needles,” he said.
But afterwards, as he and his father, Kris Youngberg, waited 15 minutes in the parking lot to make sure he didn’t have an allergic reaction, Ryan said he felt “a lot better, less nervous.” Once fully vaccinated, Ryan will be able to see his grandparents safely for the first time since the start of the pandemic.
Ryan was one of six patients who received their first COVID shot on Wednesday, the first day the Larkspur office of Tamalpais Pediatrics began offering the vaccine. The private pediatric practice is one of the first in the Bay Area to administer the injections at its office, marking the start of what public health experts say will be a critical phase of vaccinations.
Until recently, most children received COVID injections in vaccine clinics run by major health systems, pharmacies or provincial health departments. But with many county-run mass vaccination sites being phased out and the age requirement for injections likely to drop next year, pediatricians’ offices are poised to become a primary place for children to get the coronavirus vaccine — especially now that the federal Centers for Disease Control and Prevention says children can get the shot at the same time they get other vaccinations.
More about the COVID vaccine
Pfizer’s coronavirus vaccine is now approved for use in children as young as 12, and Moderna’s may follow soon. The minimum age is expected to gradually drop to 5, then 2, and then possibly to babies as young as 6 months.
Some parents find it inconvenient to take their children to drive-in sites and pharmacies and prefer their pediatrician’s office — where needle-phobic children can be in a more familiar environment and medical staff are used to vaccinating children.
According to state data, only 27% of the approximately 3.2 million Californians ages 12 to 17 have received at least one injection. That is lower than in older age groups, but the backlog is partly due to the lack of vaccines for children under 16 until mid-May.
In the most vaccinated parts of the Bay Area, more than half of 12- to 15-year-olds have already received their first shot at community vaccination sites. The pediatric practices are preparing to catch the trickle of the remaining children in the summer and fall, including those who are now 11 and soon to be 12. Tamalpais Pediatrics is one of about 10 pediatric practices that Marin County recently began supplying with the Pfizer vaccine, said Dr. Matt Willis, the county public health officer.
The San Francisco Department of Health is supplying the vaccine to four pediatric practices and “would like to see that number grow,” a spokesperson for the San Francisco COVID Command Center said.
“We see pediatricians as one of many excellent avenues for pediatric vaccination, especially as studies have shown that people trust their personal doctor the most when it comes to providing factual information about the vaccine,” the center said in a statement.
Independent GPs and primary care physicians also play a more prominent role in vaccinating children and adults, especially in areas with low vaccination rates. Many people in such areas who fear the safety of the vaccines are more likely to get a shot if their own doctor, rather than a government health official or politician, says it’s a good idea.
Beginning this month, Alameda County will begin distributing the Pfizer vaccine to pediatric health care providers and small medical practices in low-vaccination areas, County spokesman Neetu Balram said.
“The rollout will begin in mid-June with a handful of pediatric practices that will receive small batches of vaccine,” Balram said. “From there, we will scale as we learn the resources and support needed to make this program a success.”
Obtaining and administering the Pfizer vaccine is tricky in smaller medical practices because it must be kept in freezers at a temperature of 70 degrees Celsius, which not all medical offices have. And once a vial of Pfizer is opened, all six doses have to be used quickly, meaning some can be wasted if only a few patients come for vaccines on any given day.
To sort this out, the Tamalpais Pediatrics nurse manager drove 15 minutes to the Marin County Public Health Department, which stores Pfizer vaccine in freezers, and returned vials in a small cooler. For the first day, the staff scheduled just enough patients to use up one vial.
That will be the practice in the coming months, before an expected influx of younger children when age authorizations expire, said Dr. Nelson Branco of Tamalpais Pediatrics.
“If that happens, I think the pediatrician’s office will become the primary place for vaccination,” Branco said, “and I’d like to be prepared for that and have the workflows worked out so we can do it smoothly.”
Catherine Ho is a writer of the San Francisco Chronicle. Email: firstname.lastname@example.org Twitter: @Cat_Ho