Seattle Times Education Lab by reporter Hannah Furfaro

A majority of Washington’s eligible schoolchildren still aren’t vaccinated against COVID-19, state data shows, and experts warn that we’ve reached a critical moment: in most corners of the state, school starts in about five weeks.

It takes about five weeks — from the first shot to the end of the waiting period after the second — for vaccine to be most effective.

Pediatricians, researchers and Department of Health officials are now mounting a desperate call. The clock is ticking, they say, so hurry up and get your kids their shots.

“The time to start moving on this? That time is now,” said Dr. Frank Bell, a pediatric infectious-disease physician at Swedish Medical Center and board member of the Washington Chapter of the American Academy of Pediatrics.

The number of coronavirus cases in Washington has steadily increased over the past few weeks as the delta variant takes hold — mostly as a result of rising counts in places where a majority of people aren’t vaccinated, Roberts said.

And while Washington schools still plan to require both unvaccinated and vaccinated children and adults to wear masks in school buildings, many of last school year’s stringent requirements such as masking outdoors and 6 feet between desks have been relaxed or gone away entirely. The Centers for Disease Control and Prevention eased masking guidance earlier this summer, but in a reversal on Tuesday, the agency recommended that everyone in schools, regardless of vaccination status, wear masks inside.

Kids ages 12 and older have been eligible to receive the Pfizer vaccine for nearly three months; those 11 and younger still aren’t eligible. The Pfizer vaccine, which is delivered in two doses, is the only one authorized for those under age 18. The vaccine is not required to attend school.

But as of July 7, fewer than a third of children in 26 of Washington’s 39 counties had started their vaccine rounds, a Seattle Times analysis of DOH data shows. Rates are wildly different depending on where you live. San Juan County, where 68% of youth ages 12-17 have received at least one shot, boasts the highest vaccine initiation rate among young people; King County comes in second, at nearly 62%. Garfield County, in Eastern Washington, has the lowest: only 8.6% of kids had started their vaccine cycle.

In all, about 41% of Washington’s 12- to 15-year-olds and 49% of those 16-17 had initiated vaccination by late July — slightly higher than nationwide figures. But in an ideal world, at least two-thirds of children and teens will get inoculated, said Dr. Helen Chu, an infectious-disease expert who is an associate professor of medicine and public health at the University of Washington School of Medicine.

“I do worry about what’s going to happen in the fall,” she said.

Herd immunity — a “magical threshold,” as King County’s top health official, Dr. Jeffrey Duchin, calls it — is unlikely. But vaccinating as many people as possible as quickly as possible is still the state’s goal.

Similar to vaccine trends among Washington adults, the state’s pediatric data illustrates a stark east-west divide in who wants their children to be vaccinated, or who has easy access.

In all but two of Washington’s 19 eastern counties, fewer than a third of eligible children and teens have started their vaccine rounds. But in more than half — 11 of Western Washington’s 20 counties — at least a third of children have started vaccination.

Parents’ vaccine status, their education level, their income and how easily they can access health care might explain these differences, said Judith Malmgren, a Seattle epidemiologist who reviewed The Times’ analysis and conducted her own data review by region and population size.

Malmgren also found that counties with fewer children, in general, had lower vaccination rates than counties with more children. San Juan and Jefferson counties were the exceptions in places with fewer than 4,000 eligible children; about 68% of San Juan’s 890 kids have initiated vaccination, as have 42% of Jefferson’s 1,444 kids.

Although larger counties tend to have higher rates, several are still slow to get shots in arms. Just 28% of Spokane County’s eligible kids, for instance, have received at least one shot. Only 24% have initiated vaccination in Yakima County.

How serious parents consider the threat of COVID-19 — and their political preferences — may also influence their decision to get their kids a vaccine appointment.

In Asotin County, where just 11.8% of eligible kids have at least one shot, Clarkston schools Superintendent Thaynan Knowlton said Clarkston hasn’t held a vaccine clinic for children, and it doesn’t plan to. A number of Western Washington school districts had vaccine clinics on school campuses, but Knowlton didn’t push for one, he said, because he was concerned it wouldn’t have the community’s support.

Coronavirus vaccines are a political flashpoint in Asotin County, which sits across the border from Lewiston, Idaho, in a solidly conservative corner of Washington. Only 55% of Asotin residents ages 65 and up are fully vaccinated, and vaccine rates are between 18-33% for younger adults.

Clarkston was among Washington’s earliest to open for in-person learning last school year. Though the district was forced to close schools a handful of times when outbreaks occurred, case counts tied to school stayed relatively low, Knowlton said, because the district strictly enforced a long list of safety requirements.

Now, the ground is shifting: Several of those requirements are now recommendations. And unlike King County and other places with relatively high vaccination rates, most kids in Clarkston won’t be vaccinated in time for the start of school.

“I’m wondering, what’s next?” Knowlton said, regarding whether the state might head back toward stricter mask and distancing requirements. “This delta variant has made things a little more complex. It does feel a little like we’re starting all over again.”

Bell and others say they’re worried that early pandemic messaging that children are less susceptible to infection (they’re not) and less likely to get severely ill (generally true) is setting back the vaccine drive.

“The fact that [COVID-19 in kids is] less terrible than in adults and less terrible than in grandparents and the elderly population should in no way detract from the importance of COVID as a cause for illness and severe disease and sometimes death in children,” he said.

The difference between early in the pandemic and now, he added, is that the vaccine would almost entirely erase children’s risk.