CS000000-A | 11/15/21

Rapid COVID-19 State of Vaccine 

Confidence Insights Report

November 1 – 3, 2021 | Announcement of COVID-19 Vaccines for 

Children ages 5 – 11 years old

Vaccine Confidence and Demand Team, Insights Unit

This is a special insights report following the Food and Drug Administration (FDA) Emergency Use 

Authorization (EUA) and the Centers for Disease Control and Prevention’s (CDC) endorsement of the 

Advisory Committee on Immunization Practices’ (ACIP) recommendation for the use of the PfizerBioNTech COVID-19 Vaccine in children ages 5 – 11 years old.1

This report employs the same methods and inputs from the COVID-19 State of Vaccine Confidence 

Insights Report, yet specifically seeks to better understand consumers’ perceptions and sentiments 

around the recommendation of COVID-19 vaccination for children ages 5 – 11 years old. The report 

details threats to COVID-19 vaccine confidence, content gaps and information voids, circulating misand disinformation, and action steps to take. 

The information in this report is a snapshot from November 1, 2021, through November 3, 2021.

Contents

2 Background

3 Perceptions, Concerns, and Threats to Vaccine 

Confidence

4 Misinformation Themes

4 Content Gaps and Information Voids

6 Ways to Take Action

8 Appendix

Centers for Disease Control & Prevention, 

COVID-19 Response, Vaccine Task Force

Vaccine Confidence & Demand Team, Insights Unit

The findings and conclusions in this report are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention (CDC).
Page: 2

Rapid COVID-19 State of Vaccine Confidence Insights Report

November 1 – 3, 2021 | Announcement of COVID-19 Vaccines for Children ages 5 – 11 years old

Background

Coverage on news media and social media conversations about childhood vaccination appears to have steadily increased 

since schools returned to in-person instruction in the fall of 2021. Following Pfizer and BioNTech’s September 20, 

2021, announcement that their COVID-19 vaccine trial showed encouraging results in children under 12 years of age,2

conversations about pediatric vaccinations increased on various media sources, such as digital media, social media, and 

CDC-INFO. On October 29, 2021, FDA expanded the EUA for the Pfizer-BioNTech COVID-19 vaccine to include children 5 –

11 years of age.3 This announcement and the CDC recommendation of the Pfizer BioNTech COVID-19 vaccine for children

ages 5 – 11 years old on November 2, 2021, likely drove a spike in mentions of pediatric vaccinations from news outlets

and consumers during the first week of November (See Figure 1).4

Figure 1.a

——

a

Meltwater

0

5000

10000

15000

20000

25000

30000

35000

40000

45000

50000

8/4/2021— 11/3/2021

Mentions of COVID-19 Vaccines or Authorization 

for Children Ages 5—11 Years

Source: Meltwater Report Date Range: November 1-3, 2021

Sept 20: Pfizer and 

BioNTech announce 

positive topline results 

from pivotal trial of covid19 vaccine in children 5 to 

11 years

Oct 7: Pfizer, BioNTech 

request COVID-19 vaccine 

emergency authorization 

for kids ages 5 to 11

Oct. 26: FDA 

advisers endorse 

Covid-19 vaccine 

for kids 5-11 Oct. 29: FDA Authorizes 

Pfizer-BioNTech COVID19 Vaccine for 

Emergency Use in 

Children 5 through 11 

years of age

Nov. 2: CDC 

Recommends 

Pediatric COVID-19 

Vaccine for Children 

5 to 11 years of age
Page: 3

Rapid COVID-19 State of Vaccine Confidence Insights Report

November 1 – 3, 2021 | Announcement of COVID-19 Vaccines for Children ages 5 – 11 years old

Perceptions, Concerns, and Threats to Vaccine Confidence

News stories of the EUA of the Pfizer-BioNTech COVID-19 

Vaccine for children 5 – 11 years old focused on the 

risk of COVID-19 in this age group and the timeline for 

vaccine availability. 5,6,7,8,9 Consumers demonstrated 

increased interest in the EUA, evidenced by an increase 

in online searches of keywords such as “CDC approval” 

and “5-11.”b Social media conversations following the 

October 29 FDA announcement were mixed. Some 

social media users posted support for the EUA and 

expressed excitement.10,11,12,13,14 On the other hand, some 

social media users expressed fears and concerns about 

giving children the COVID-19 vaccines. For example, some inquired about the vaccine’s possible side effects, including 

myocarditis, infertility, blood clots, delayed onset of menstruation, and unspecified long-term side effects.15,16,17,18,19,20 Some 

consumers believe the EUA for children 5 – 11 years old felt rushed, claiming the trials did not include studies of longterm effects or severe side effects. These claims coincided with a former government official’s statement that asserted 

the vaccinations for children were “a giant experiment.”21 Some social media users shared similar sentiments, claiming 

vaccination of children ages 5 – 11 years old is solely to investigate side effects of the COVID-19 vaccine in this age 

group.22,23,24,25,26,27

 Some social media users insisted that parents who 

plan to vaccinate their children are abusing28,29,30,31 or 

murdering their children.32,33,33

Some consumers expressed apprehension and 

anger that the EUA would lead to vaccine requirements for children under 12 years old.34,35,36,37 In fact, on November 

3rd, San Francisco became the first city in the United States to state that they will add children ages 5 – 11 years old to 

their vaccine requirement in the future.38A highly publicized story39,40,41,42,43 about two children, 6 and 7 years old, that 

accidently received adult versions of the COVID-19 vaccine led some social media users to spread misinformation and use 

this as an example of why the medical system and scientific experts cannot be trusted.44,45,46

b

Google Trends
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Rapid COVID-19 State of Vaccine Confidence Insights Report

November 1 – 3, 2021 | Announcement of COVID-19 Vaccines for Children ages 5 – 11 years old

Misinformation Themes

Below are the most common mis- and disinformation themes related to the authorization of COVID-19 vaccines in children ages 

5 – 11 years old: 

Reduced risk of COVID-19 among children

 Children do not need the vaccine because they are at decreased risk of severe COVID-19. Vocal vaccine deniers claim 

that children have a reduced risk of severe symptoms, hospitalization, and death from COVID-19, negating the need for 

vaccination.47,48 Although true, this is misinformation because these statements are misleading because they leave out 

additional context including the role children can have in spreading COVID-19 and that the benefits of vaccination are greater 

than the potential harms.

49

 Children do not need the COVID-19 vaccine because they do not contract COVID-19 at the same rate as adults. Some 

individuals are opposed to the COVID-19 vaccine in children because they believe that children are not at risk for COVID-19.50

Similarly, they think cases in children are too low to warrant vaccination. 

Vaccine safety concerns

 The Pfizer-BioNTech Vaccine contains tromethamine to reduce blood clots. Vocal vaccine deniers have been focusing on the 

addition of tromethamine (a buffer that is found in many medications and other vaccines) to the pediatric COVID-19 vaccine. 

They believe the ingredient was added to reduce instances of blood clotting and myocarditis in children, rather than its cited 

purpose to prolong storage of the vaccines.51

Distrust of government & health institutions

 The decision to recommend vaccination in children was made for the financial gain of pharmaceutical companies, not to 

address COVID-19 rates in children. Vocal vaccine deniers spread the belief that pediatric doses exist only for the financial 

benefit of pharmaceutical companies.52,53,54,55 To achieve this, some vaccine deniers also continued to promote the belief that 

pharmaceutical companies are lying to the government and the population about the safety of the ingredients in the vaccines 

and booster doses.56,57

 Pediatric vaccination is a means for government experimentation on children. Vocal vaccine deniers claim that there 

have not been enough long-term studies of the COVID-19 vaccine in children.58,59 Therefore, the EUA of the vaccines is to 

experiment on children ages 5 – 11 years old to determine the vaccines’ effects.60,61

Biological/immunity misinformation

 Infection-acquired immunity is superior to vaccine antibodies. Vaccine deniers claim vaccination in children ages 5 – 11 

years old is unnecessary because a more robust immune response can come from COVID-19 infection.62,63 There have been 

many accounts of parents not vaccinating children due to the belief that children will acquire stronger immunity from 

COVID-19 infection.64

Special Dissemination Theme: 

 Spreaders of misinformation focused on reaching children by posting videos on TikTok after the Pfizer-BioNTech pediatric 

vaccine approval. Adult users claiming to be health care providers65 and parents who do not support giving vaccines to 

children66 are creating video content with noted hashtags including ‘novaccinesforkids’, ‘notmykids’, and ‘wakeup’. Previously 

generated misinformation that mentions children is being reused in the context of the current announcement, including 

misinformation regarding vaccine safety and effectiveness, and messages about medical freedom and fighting tyranny.67
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Rapid COVID-19 State of Vaccine Confidence Insights Report

November 1 – 3, 2021 | Announcement of COVID-19 Vaccines for Children ages 5 – 11 years old

Content Gaps and Information Voids

Content gaps and information voids emerged following the CDC Director’s endorsement of ACIP’s recommendation to 

vaccinate children ages 5 – 11 years old against COVID-19 with the Pfizer-BioNTech Vaccine. Questions from consumers 

emerged organically on social media channels, websites, news articles, internet forums, and through inquiries to CDC-INFO in 

response to news coverage about the EUA. Below are the most frequently asked questions by theme:

Necessity of vaccines for children ages 5 - 11 years old

 Due to decreasing cases of COVID-19 and fewer severe COVID-19 symptoms for children ages 5 - 11 years old, why is a 

pediatric COVID-19 vaccine necessary for children?

 Do children who previously had COVID-19 need the Pfizer-BioNTech Pediatric COVID-19 Vaccine?

 Will administering the Pfizer-BioNTech COVID-19 Vaccine to children ages 5 – 11 years old help us reach herd immunity?

Safety of pediatric vaccines

 How do we know the Pfizer-BioNTech pediatric vaccine is safe?

 What are the safety risks of the Pfizer-BioNTech pediatric vaccine?

 Are the safety risks of the Pfizer-BioNTech pediatric vaccine comparable to the safety risks of the Pfizer-BioNTech COVID-19 

Vaccines for people ages 12 years and older?

How to get a pediatric vaccine

 Will the Pfizer-BioNTech pediatric vaccine be available at all places that offer COVID-19 vaccines for people ages 12 years 

and older?

 When will parents be able to schedule an appointment to get their children the Pfizer-BioNTech pediatric vaccine?

 When will vaccines.gov be updated with an option to search for COVID-19 vaccines for children ages 5 – 11 years old?

Other Questions

 Should providers use a child’s Body Mass Index (BMI) or age to determine the correct dose of the Pfizer-BioNTech COVID-19 

Vaccine? 

 How long do healthcare providers need to wait to administer the COVID-19 Pfizer-BioNTech pediatric vaccine after 

administering the influenza vaccine?

 Do vaccinated children need to follow previous quarantine guidelines after exposure to COVID-19?

 What is the difference between the Pfizer-BioNTech pediatric vaccine and the COVID-19 vaccines for people ages 12 years 

and older?

 Will the pediatric vaccines be free and, if not, what is the cost?
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Rapid COVID-19 State of Vaccine Confidence Insights Report

November 1 – 3, 2021 | Announcement of COVID-19 Vaccines for Children ages 5 – 11 years old

Ways to Take Action

Disseminate messages focused on the role of childhood vaccinations in managing the 

COVID-19 pandemic and how the U.S. vaccination program uses safety and effectiveness 

data to make recommendations

 Create and disseminate messages, especially on social media, about how the pediatric vaccine dose and formulation differs 

from that given to adults and that child height and weight do not affect vaccination.

 Continue to amplify messages that vaccination for children ages 5 years and older is the best way to protect them from 

illness, clarifying that the risk for severe COVID-19 or complication caused by infection is higher than the risk of an adverse 

event from vaccination.

 Develop and disseminate messages about the risk of COVID-19 for children. Highlight the case numbers among children 

and the number of children hospitalized with severe COVID-19. Remind consumers about the role that children play in 

spreading the virus.

 Provide schools and parents with educational materials highlighting the importance of COVID-19 vaccination given the 

increased risk of COVID-19 infection in children due to the Delta variant.

Partner with trusted messengers

 School administrators

 Encourage school administrators to partner with pharmacies, public health agencies, and other providers to hold inschool vaccination clinics.

 Partner with and support school administrators in promoting messages about the benefits of vaccination. Help them 

promote mitigation measures for children, parents, school staff, and the broader community. Remind them to connect 

unvaccinated staff and families to vaccination information and events.

 Amplify messages about where and how to vaccinate eligible children ages 5 – 11 years old and to promote the benefits 

of vaccination for students, staff, and the broader community. 

 Healthcare providers (especially pediatricians)

 Encourage pediatricians to proactively have conversations with parents of children under age 12 years old. 

 Expand talking points for healthcare providers to specifically address needs, concerns, and questions from parents of 

younger children.

 Engage trusted and new partners to disseminate and amplify these messages, particularly pediatricians and professional 

associations serving pediatricians.

 Create access points of vaccination in pediatricians’ offices while also proactively implementing school-located 

vaccination programs to address access concerns.

 Encourage pediatricians to discuss potential side effects of vaccination with parents and caregivers while explaining the 

relative risk of an adverse event compared to COVID-19 complications.

Address misinformation

 Amplify messages about the safety of vaccines for children ages 12 years and older, highlighting the low number of adverse 

events following a high number of administered vaccines. 

 Create and disseminate messaging that presents data on the safety and efficacy of other childhood vaccines for children 

ages 5 – 11 years and the COVID-19 vaccine in children ages 12 years and older alongside the mortality risks.

Support research efforts to better understand the impact COVID-19 has on children’s 

current and future vaccination intent and motivation

 Support research to better understand children and adolescents’ perceptions and opinions of COVID-19 vaccines and their 

motivation for getting vaccinated.

 Support longitudinal research investigating how parental, familial, community, or online vaccine hesitancy impacts 

children’s future vaccination intent and motivation into adulthood.
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Rapid COVID-19 State of Vaccine Confidence Insights Report

November 1 – 3, 2021 | Announcement of COVID-19 Vaccines for Children ages 5 – 11 years old

Appendix: Inputs and Sources

Type Input Cadence Sources Tactics for Utilization

Social Media 

Listening 

& Media 

Monitoring

Communication 

Surveillance Report

Daily on 

weekdays

Google news

 Meltwater

CrowdTangle

Native platform searches

 Share of voice topic analysis to identify themes

 Emerging topics 

Meltwater Daily  Facebook, Twitter, Instagram

 Blogs

News media

Online forums

 Share of voice topic analysis

 Emerging theme topics

Identify high reach/velocity topics

OADC Channel 

Comment Analysis

Daily on 

weekdays

Native platform searches  Sentiment analysis

Identify message gaps/voids

Direct 

Reports

CDC-INFO Metrics Weekly CDC-INFO inquiry line list  Sentiment analysis

Identify information gaps/voids

Web Metrics Weekly  Top pages

Google search queries

Identify information gaps/voids,

Identify keywords/search terms, changes in web 

traffic

Research

Poll Review Weekly Harris Poll, PEW research, 

Gallup Poll, KFF 

New data related to vaccine 

hesitancy

Identify socio-behavior indicators related to 

motivation and intention to vaccinate 

Literature Review Weekly  PubMed, LitCovid, ProQuest 

Central 

New data related to vaccine 

hesitancy

Identify current vaccination intention

Identify barriers to vaccination

Third Party 

Reports

Tanaq Social 

Listening +Media 

Monitoring Report

Weekly  Meltwater

 Sprout Social

 First Draft

Native platform searches

 Trending topics

Demographic and geographic conversation 

monitoring

CrowdTangle 

content insights 

report

Biweekly  Facebook  Top pages (voices), groups

General trends/sentiment analysis

News analysis through posts

First Draft 

News Vaccine 

Misinformation 

Insights Report

Monthly  Proprietary methods  Media trends analysis

 Emerging threats and data deficits

Online vaccine narratives

Project VCTR Weekly  Proprietary methods National and regional trends in negative 

attitudes toward vaccination

Conversations around Legislation

Virality Project Weekly  Proprietary methods  Mis- and disinformation trends related to COVID-19 

vaccine