Earlier this month, the Centers for Disease Control and Prevention, the American Academy of Pediatrics, and the American Academy of Family Physicians issued recommendations that children ages 5 to 11 receive an age-approved Covid-19 vaccine.

This means that for the first time, about 28 million children in the United States in this age group are now eligible for vaccination. At the same time, it’s been well-documented that roughly one-third of parents — many of them vaccinated themselves — plan to take a wait-and-see approach regarding vaccinations for their younger children.

As parents who are also physicians, we understand and respect that the decision to vaccinate keiki is complicated. On the one hand, the science is clear: the same vaccines that have protected the lives of many millions of adults and teens now show a high efficacy of 90% protection against Covid-19 illness without severe side effects in trials of younger children. And while the Covid vaccines themselves are relatively new, the exacting standards and practices by which they were developed and approved for use are not.

On the other hand, whenever children are involved, we rightly subject our decisions and actions to even greater discernment and scrutiny. There is nothing more precious than the well-being of our children.

In Hawaiian culture, we have an ʻŌlelo Noʻeau: Ka lei hāʻuleʻole, he keiki. This Hawaiian saying translates to, “A lei that is never cast aside is one’s child,” because our keiki are our most precious treasure.

Unfortunately, this disease is so highly contagious that adopting a wait-and-see approach can be risky — especially with the holiday season upon us. This past summer, the spread of the delta variant led to a surge of Covid-19 cases in children, with hospitalizations of children and teenagers in the U.S. up fivefold compared with the number of cases in the spring.

Despite the seemingly low death rate among children, Covid-19 is now one of the top 10 causes of death of children in the United States. Even a death of a single child from this preventable illness is one too many. Furthermore, potential long-term effects of Covid-19 are serious with about 2% of infected children in Hawaii needing hospitalization — that’s already 2% too many children in the hospital who are not at home embraced by the aloha of their ohana.

Here in Hawaiʻi, the infection rate among Native Hawaiians has risen during the delta surge. This seems especially poignant considering our history, throughout which vaccine-preventable illnesses have been a major cause of death in Native Hawaiian children and adults for nearly 200 years.

In addition to serious physical illness, the Covid-19 pandemic has had other detrimental impacts on the mental health of our young people. The risk of another resurgence and a return to sheltering-in-place brings with it the possibility of prolonging conditions in which our kids are denied the chance to be together in school, out surfing or fishing, dancing hula or playing music and sports with their ohana cheering them on.

These are more than just pleasant childhood experiences — they’re vital for the social, physical, spiritual, academic and mental health of our keiki.

Healthy Ohana

After taking all this in, how can parents be expected to make this very personal decision quickly? It’s not by spending time in social media forums plagued with misinformation and pseudoscience on Facebook or Twitter.

Rather, the place to make the decision about vaccinating children is in personal kūkākūkā (consultations) with our families and the kauka (doctor) and other health care professionals we trust: our pediatricians, family physicians, and other primary care providers.

If — like many people right now — you find yourself unsure about what to do, we urge you to seek out the advice and perspective of your child’s pediatrician or primary care provider. We, as kauka, are eager to listen to your concerns, help dispel myths about vaccines, and help you make the best decision for the health of your ohana, your keiki, and our kaiāulu (community).

Even a death of a single child from this preventable illness is one too many.

As kauka, or Native Hawaiian physicians, it is our kuleana (responsibility) to provide accurate medical information and we encourage parents to get their keiki vaccinated. All three of us have keiki between the ages of 5-11 who have received their first dose of the Covid-19 vaccine. All of us have experienced caring for children who contracted Covid and it’s one of the most pressing reasons we want everyone’s child to be vaccinated.

We end with this ʻŌlelo Noʻeau: ‘O ka makua ke koʻo o ka hale meaning, “the parent is the support that holds the household together.”

To honor our kuleana to our children, we must weigh the facts and ultimately make decisions based upon what’s in our naʻau (heart and mind).

And the place to discover that is in quiet conversations with kauka and other professionals who we trust and are closest to us.