Some district leaders say offering vaccine clinics on campus, with the involvement of trusted school staff, is key to improving access and helping overcome hesitancy — particularly in communities with low overall vaccination rates. Still, many school systems are choosing not to offer elementary schools as hosts for vaccination sites after some middle and high schools that offered shots received pushback. More than 250 families signed up for vaccinations that began Thursday at elementary schools in Duluth, Minnesota, which organised clinics immediately after the Centers for Disease Control and Prevention gave the final signoff to Pfizer's kid-size COVID-19 shot for children ages 5 to 11.

Superintendent John Magas called the vaccines a "game changer." "This brings us one step closer to moving from pandemic to endemic," Magas said. "It allows us to reconsider things like social distancing and masking and things like that as safety permits." The Biden administration plans to send a letter to U.S. elementary schools in the next week asking them to host clinics. The Education Department is also urging schools to host town halls and webinars at which parents can talk to doctors about the vaccine.

Districts that have held or are planning clinics for younger children span Alaska to Vermont, said Hayley Meadvin, an Education Department senior adviser. Where schools choose not to host clinics, families can turn to doctor's offices, hospitals and other sites.

"There are many points of access, and there's no wrong door, honestly," Meadvin said.

In Ohio, some school districts offered on-site clinics for older students, but Rick Lewis, director of the Ohio School Boards Association, said they haven't heard from any districts planning them for younger students. He noted the CDC encourages districts to consider factors like local needs for school clinics and adequate community support. School vaccine drives have faced pushback and protests in Ohio and elsewhere, and some opponents say they plan to keep up pressure as the focus of the vaccination effort shifts to younger students. Sarah Kenney, who represents the group Mainers for Health and Parental Rights, argues that schools should not be getting involved or even talking to young children about the vaccine. She worries about its newness and potential for long-term side effects. A Pfizer study of 2,268 children found the vaccine was almost 91% effective at preventing symptomatic COVID-19 infections. The FDA examined 3,100 vaccinated kids in concluding the shots are safe. Kenney also expressed concern about stigma against children who do not get vaccinated. "These conversations and personal decisions have been difficult enough to navigate for adults, we shouldn't be putting this on our kids,'' she said.

Parents are required to give authorization for their children's shots. The vaccines are typically administered before or after school in partnerships with local hospitals and government health officials. Chicago Public Schools, the country's third-largest district, canceled school Nov. 12 to give parents an opportunity to get their children vaccinated by a healthcare provider or at a school-based site. In Portland, Oregon, vaccines will be offered in eight elementary schools starting next week in high poverty districts, where families are more likely to face barriers such as access to health care or transportation, Superintendent Guadalupe Guerrero said.

On the heels of California's decision to make vaccines for children mandatory, Portland is among districts considering the same. A recent board of education meeting to discuss that possibility was disrupted by a group of protesters.

For that reason, security will be present at the vaccine clinics, and their times and dates won't be publicized outside the local community, said Courtney Westling, the district's director of government relations.

"Schools are a trusted community hub," she said. "Families, in general, feel very safe at these school sites. We're also not asking for identification or insurance cards. We don't want people to fear ICE showing up or something. We are just trying to get people vaccinated so we can get some of this behind us and get back to some semblance of normalcy." In Hartford, Connecticut, schools superintendent Leslie Torres-Rodriguez said the vaccination clinics it is planning along with local hospitals will include school nurses, trusted by families. Only a third of the district's students 12 and older are vaccinated. "We take an equity stance here and think about the access and removing any barriers that our families might have," she said.

In nearby Tolland, Connecticut, school superintendent Walter Willett said his district also is teaming with health providers, including UConn Health, to offer vaccines at school sites to younger students. He said vaccines are important, not just for keeping kids in school, but for teachers, janitors and other staff who tend to be more at risk.

"They can more effectively do their job when kids aren't bouncing in and out of the classroom in quarantine," he said.

Liz Hamel, the vice president of opinion and survey research at KFF, a nonprofit that studies health care issues, said their recent surveys show parents are more likely to accept vaccine information from their pediatrician than from government or educational sources.

"And one thing we found with teens is that most parents didn't want their school to require the vaccine, but if their school provided information or encouraged students to get vaccinated, those parents were more likely to say that their child was getting the vaccine," she said. Sam Valle, a 9-year-old in Old Saybrook, Connecticut, said he's been bugging his parents for months, asking when he can get the vaccine. "Right now, I can't go into a restaurant without it," he said. "I can't go into a store without wearing a mask. I can't do a lot of things." Sam's quest will soon be over. His mother says his shot is now scheduled for Wednesday.