The FDA has approved Covid-19 vaccines for children under the age of five. What should parents be aware of?
On Friday, the US Food and Drug Administration granted emergency use authorization for the Pfizer/BioNTech and Moderna vaccines for young children. Vaccine advisers to the US Centers for Disease Control and Prevention voted unanimously on Saturday in favor of giving Covid-19 vaccinations to babies and other children as young as 6 months.
Dr. Rochelle Walensky, Director of the Centers for Disease Control and Prevention, approved the plan, paving the way for the vaccinations to be administered this week.
According to an April survey, parents may be hesitant to purchase them when they become available. According to an April Kaiser Family Foundation Vaccine Monitor survey, only 18 percent of parents of children under the age of five said they would vaccinate their child against Covid-19 as soon as a vaccine became available.
Almost 40% of those polled said they would “wait and see” before vaccinating their young children, 11% said they would only get the vaccine if it was required, and 27% said they would “definitely not” get the Covid-19 vaccination for their child.
Even parents who are eager to vaccinate their children are likely to have questions. How certain should they be of the FDA’s decision? When will vaccines be available for young children, and how will families be able to obtain them? Pfizer or Moderna, which vaccine is superior? Should my child be vaccinated if they have already had Covid-19? And what if my child is about to turn five? Should I wait?
Dr. Leana Wen, an emergency physician and professor of health policy and management at the George Washington University Milken Institute School of Public Health, spoke with me. She is the mother of two children under the age of five and the author of “Lifelines: A Doctor’s Journey in the Fight for Public Health.”
Dr. Leana Wen: I’m thrilled and so relieved. It’s been a year and a half since adults first started getting the Covid-19 vaccine. There are about 17 million children not yet eligible for vaccination, and FDA’s authorization was a major hurdle to have crossed. Now that the CDC has also recommended both vaccines, I’m really looking forward to getting my young kids — ages 2 and almost 5 — the same exceptional protection that my husband and I have.
The FDA and its external advisers followed a rigorous process and conducted independent analyses of data submitted by Pfizer/BioNTech and Moderna. They discovered that three doses of the Pfizer vaccine and two doses of the Moderna vaccine were both safe and produced a strong immune response comparable to that seen in young adults. In addition, they discovered that both vaccines reduced symptomatic infection in this younger age group.
I’m relieved by the CDC’s thorough, careful, and deliberate process, and when they give the go-ahead, as I expect, I’ll be calling my pediatrician to get both of my kids vaccinated.
When do you think vaccines will be available to children under the age of five, and how should parents and caregivers get them?
States had already been able to order vaccines pending the CDC decision, which came Saturday, which means that some doctors’ offices, community health centers, health departments, and pharmacies may have them in stock and ready to go by next week.
The first place I’d recommend eager parents go is to their pediatrician’s office. Parents are accustomed to having their children vaccinated there, and the pediatrician will be aware of when and if the Covid-19 vaccine will be administered. If they do not intend to carry the vaccine, they can recommend other trustworthy locations in the community.
You could also contact your local pharmacies, though keep in mind that many pharmacies are not equipped to give shots to young children. Your local city or county health department, as well as the state health department, may have resources, as may local children’s hospitals.
How will parents select between Pfizer and Moderna vaccines for their children?
Wen: Both vaccines are both safe and effective. Both vaccines produce high levels of antibody, which correlate with protection against severe disease in the elderly. Although these are preliminary findings, the three-dose Pfizer vaccine appears to be more effective at preventing symptomatic infection, and both vaccines induce high antibody levels, which correlate with protection against severe disease in older age groups.
I believe there will be a wide range of parental preferences here. Some parents are eager to get their children vaccinated as soon as possible. In that case, the two-dose Moderna vaccine may be preferable, because the second dose is administered four weeks after the first, and their child will be considered fully vaccinated two weeks later. If a child begins the series next week, he or she could be fully vaccinated by mid-August, just in time for the start of the next school year.
Other parents may prefer to provide their children with the highest level of protection possible, even if it takes longer. Pfizer may also reassure them because it has been given to children aged 5 to 11 for months.
The first two doses are given three weeks apart, followed by the third two months later. Even if the first dose is given next week, a child will not be fully vaccinated with Pfizer until at least mid-September. The dosage of the Pfizer vaccine is also lower than that of Moderna, which some parents may prefer, though there does not appear to be a difference in the severity of potential side effects associated with the different doses, such as fever, fatigue, and irritability.
Other parents may simply want to give their children whatever they have access to first. All of these decisions, I believe, are reasonable, given that the CDC recommends both vaccines equally.
What about children who have already received Covid-19? Should they still be immunized?
Wen: Yes. Vaccination after infection recovery provides more durable and long-lasting protection than infection recovery alone. I hope the CDC addresses the question of how long children should wait to get vaccinated after recovering from the coronavirus at their meeting. The CDC has stated unequivocally that children who have had Covid-19 should still be vaccinated.
Should children who will turn 5 soon wait for the higher dose or get vaccinated now?
Wen: They should not wait. The CDC is following previous guidance for the 5- to 11-year-old age group, which means that the 11-year-old – and in this case, the 4-year-old – should not wait. Begin the vaccination process now, and when the child reaches the age of 5, they can receive the higher dose.
What if parents are skeptical of the vaccine and prefer to wait and see?
Wen: All parents, I believe, want the best for their children. My best advice is to consult with your pediatrician, whom you trust with other aspects of your children’s health care. Personally, I am very reassured by our federal regulatory agencies’ thorough and careful process, and I can’t wait to give my children a safe vaccine that will help protect them from the coronavirus.
