Current Covid vaccinations for kids 11 and under aren’t available in early October. (Photo: Sgt. Kimberly Browne via DVIDS)

The Cambridge Public Health Department is still waiting for a supply of updated Covid-19 vaccine for children, delaying availability of kids’ appointments for the city’s five large Covid and flu vaccine clinics this month. There is a nationwide shortage of pediatric Covid vaccine, Lisa Dobberteen, department medical director, told members of the Cambridge Health Alliance public health committee on Thursday.

“We hope we will get a good supply. We don’t know how much we will get,” Dobberteen said.

Update on Oct. 16, 2023: The health department announced that it now has pediatric Covid vaccine. The department said people can make appointments for children from 6 months to 11 years old at its four remaining Covid and flu shot clinics on Saturday at the King Open School and the next week at the Reservoir Church, Pisani Center and Cambridge Community Center. Appointments are available here.

The health department originally intended to delay offering appointments for Covid shots – for everyone, children and adults –  until it got pediatric vaccine. But over the holiday weekend it began allowing people to register for adult shots on its website, while announcing that Covid vaccinations for kids 11 and under were not available because it did not have vaccine. (The department does have flu vaccine for anyone six months and older).

The shortage is also affecting private pharmacies. CVS and Walgreens have statements on their websites saying updated Covid vaccine for kids 11 and under is not available.

It’s not clear what has caused the shortage. The head of the Centers for Disease Control and Prevention, Mandy Cohen, told a news conference that manufacturers shipped adult vaccines first and that shipments of pediatric vaccine are increasing, according to news reports.

It’s one of the effects of “commercializing” the nation’s Covid-19 vaccine. Until this fall, the federal government, which paid part of the cost of developing Covid vaccines, also bought and distributed all doses nationwide. With the end of the pandemic emergency, doctors, hospitals, health departments and other vaccination providers must now buy vaccine directly from manufacturers. They will be reimbursed for most of the cost because public and private health insurers cover vaccinations. A federal program pays pharmacies temporarily for vaccinating people without health insurance.

The situation is somewhat different for pediatric Covid vaccine because another federal program, Vaccines For Children, supports childhood vaccination, and Massachusetts gets vaccine from that program and guarantees free doses for children. Cambridge is waiting for vaccine from the state program.

A spokesperson for the Massachusetts Department of Public Health said Tuesday that the state at first received “limited allocations” of pediatric Covid vaccine from the federal government and had to limit distribution in order to ensure that it was equitable across the state. Now the state agency has enough vaccine to “largely” fulfill requests and expects availability to increase “in the coming weeks,” the spokesperson said.

The health department’s flu and Covid vaccine clinics are scheduled for Oct. 18, 21, 25, 26 and 27. The Cambridge Health Alliance, which operates the city health department, arranged to provide the vaccine supply for the department, a spokesperson said previously. That apparently applied only to adult doses of the Covid vaccine, though.

CHA doctors have already begun vaccinating their own patients, and updated Covid vaccine is available to non-patients at pharmacies at Cambridge Hospital and an East Cambridge clinic – but for people 18 and older only. Spokesperson David Cecere said Tuesday that doctors can vaccinate kids who are patients. “While vaccine supplies have come in a little slower than in past years, we are administering the updated Covid vaccine to children 11 and under,” he said.

The Covid vaccination rate for children 5 and under is relatively low, but Massachusetts children in that age group have the second-highest rate of infections per 100,000 population, after people 80 and older, according to the most recent figures from the state Department of Public Health. The case rate for children under 5 is higher than the rate for people between 65 and 79 years old.

The city health department is pushing people to make appointments for the vaccine clinics because it needs to collect health insurance information for reimbursement. “We can’t turn anyone away,” but “that’s a cost we would have to absorb” if health insurance can’t be billed, chief public health officer Derrick Neal said.

The department has already started offering vaccinations to “vulnerable populations” at public housing projects for seniors and at homeless shelters and free-meal sites. Some people asked why they had to provide insurance information, but most agreed to do so after getting an explanation, spokesperson Dawn Baxter said.