When can kids get the COVID-19 vaccine? A pediatrician answers 5 questions
Pfizer says its COVID-19 vaccine protects younger teens

In this Dec. 22, 2020, photo, provided by Richard Chung, his son Caleb Chung receives the first dose of Pfizer coronavirus vaccine or placebo as a trial participant for kids ages 12-15, at Duke University Health System in Durham, N.C. Pfizer says its COVID-19 vaccine is safe and strongly protective in kids as young as 12. The announcement Wednesday, March 31, 2021, marks a step toward possibly beginning shots in this age group before the next school year. (Richard Chung via AP)

In this Dec. 22, 2020, photo, provided by Richard Chung, his son Caleb Chung receives the first dose of Pfizer coronavirus vaccine or placebo as a trial participant for kids ages 12-15, at Duke University Health System in Durham, N.C. Pfizer says its COVID-19 vaccine is safe and strongly protective in kids as young as 12. The announcement Wednesday, March 31, 2021, marks a step toward possibly beginning shots in this age group before the next school year. (Richard Chung via AP)

Pfizer announced Wednesday that its COVID-19 vaccine is safe and strongly protective in kids as young as 12, a step toward possibly beginning shots in this age group before they head back to school in the fall.

Most COVID-19 vaccines being rolled out worldwide are for adults, who are at higher risk from the coronavirus. Pfizer’s vaccine is authorized for ages 16 and older. But vaccinating children of all ages will be critical to stopping the pandemic — and helping schools, at least the upper grades, start to look a little more normal after months of disruption.

In the vaccine study of 2,260 U.S. volunteers ages 12 to 15, preliminary data showed there were no cases of COVID-19 among fully vaccinated adolescents compared to 18 among those given dummy shots, Pfizer reported in a press release on March 31.

Kids had side effects similar to young adults, the company said. The main side effects are pain, fever, chills and fatigue, particularly after the second dose. The study will continue to track participants for two years for more information about long-term protection and safety.

However, the results of Pfizer’s vaccine trials in adolescents have not been fully released or reviewed by the Food and Drug Administration, and that will take several weeks.

According to a tally by the American Academy of Pediatrics, the COVID-19 death rate among children is higher than the mortality rate from the flu in an average year. Additionally, a small number have developed a serious inflammatory condition linked to the coronavirus.

5 QUESTIONS

The question of when children can get the COVID-19 vaccine remains a big one among parents and teachers, especially as more schools reopen. Some have wondered whether the vaccine is even necessary for children.

Dr. James Wood, a pediatrician and assistant professor of pediatric infectious diseases, explains what doctors know today about the risk children face of getting and spreading the coronavirus and when vaccines might be available.

Do kids really need to get the COVID-19 vaccine?

The short answer is yes. A lot of studies have shown that COVID-19 isn’t as severe in children, particularly younger kids — but that doesn’t mean kids aren’t at risk of getting infected and potentially spreading the virus.

Children under 12 who get COVID-19 do tend to have mild illnesses or no symptoms, while teenagers seem to have responses somewhere between what adults and younger kids have experienced. The Centers for Disease Control and Prevention (CDC) found that teens were about twice as likely to be diagnosed with COVID-19 as children ages 5 to 11. It’s important to remember that while most children get only mild symptoms, they still face risks. At least 226 U.S. children with COVID-19 have died, and thousands have been hospitalized.

Are kids spreading the virus?

In a setting like a school where mask-wearing and social distancing are enforced, young kids seem to not spread the virus very much when the rules and guidelines are being followed. One CDC review found little difference in community cases in counties with elementary schools open and those with remote learning. If precautions aren’t being taken, children infected with the coronavirus very well could spread it to adults. What isn’t clear yet is how great that risk is.

So, when can kids get vaccinated?

Right now, the Pfizer vaccine is the only one in the U.S. authorized for teenagers as young as 16. Before kids under 16 can be vaccinated, clinical trials need to be completed in thousands of young volunteers to assess the vaccines’ safety and efficacy, and the results must be fully reviewed and then authorized by the Food and Drug Administration.

Pfizer said it expects to submit results from its adolescent trials for review soon. Vaccine manufacturer Moderna also has trials underway with adolescents. If their vaccines are shown to be safe and effective and regulators authorize them, kids 12 and up could be vaccinated before school starts in the fall. Realistically, younger children probably won’t be eligible for the vaccine until late fall or winter at the earliest.

What’s different about the vaccines kids will get?

The composition of the COVID-19 vaccines for children is the same as used in adults — the difference is that children may require a different dose. The first step in vaccine trials is to figure out the right dose. The companies want to find the lowest possible dose that is both safe and produces a target level of antibodies. Once the company determines the optimal dose, it will launch a placebo-controlled trial to test its effectiveness, in which some children will get a placebo and some will get the vaccine. A rigorous system for pediatric vaccine trials is well established in the U.S. These trials are key to assessing the safety and efficacy of vaccines in children, which can differ from adults.

How can parents create safe playdates for kids?

When I talk to parents, I explain that it’s a risk-versus-benefit question. Each family has a different tolerance.

From a medical standpoint, the mental health of kids and having them play with other kids is an important part of childhood. I would say that unvaccinated kids playing indoors without masks on is still not a great idea. The risk is just too high at this point. As weather warms up, I would encourage kids to play outside. Ride bikes, play and socialize — just do it in a safe manner.

I am optimistic that a safe and effective vaccine will be available for children. Thus far, there have not been any safety signals from either the adult or adolescent studies that have been worrying to me as a pediatrician, but the studies still need to be done in children.

VACCINE SUPPLY

Another question is when the country would have enough supply of shots — and people to get them into adolescents’ arms — to let kids start getting in line.

Supplies are set to steadily increase over the spring and summer, at the same time states are opening vaccinations to younger, healthier adults who until now haven’t had a turn.


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