As more adults become vaccinated against COVID-19, the coronavirus has targeted more children not yet eligible for shots. But the first vaccine for those as young as 5 could be ready as soon as September.
A collection of experts laid out the benefits — and a few risks — of vaccinating kids during a symposium hosted by the Johns Hopkins University and the University of Washington.
“We should look at COVID-19 as a vaccine-preventable disease in children,” said Dr. Rochelle Walensky, director of the U.S. Centers for Disease Control and Prevention. “In terms of preventable disease and death, COVID should rank high.”
Children, she and others said, have borne heavy physical and mental burdens while under threat of infection. Vaccines will allow them and their families to return to more normal lives.
Federal data show children now make up about a quarter of new infections. And while cases are far less likely to be severe than in adults, deaths from COVID are still three times more than those from flu. Also, all of the long-term effects from the disease aren’t yet clear.
Pfizer/BioNTech’s vaccine is authorized already for use in adolescents as young as 12. The company plans to submit trial data for children as young as 5 in September. Moderna is on its heels, testing its vaccine in 16- and 17-year-olds as well as younger kids.
Johnson & Johnson and Novavax also are testing their vaccines in adolescents. The J&J vaccine is already authorized for adults, while Novavax has filed for emergency-use authorization for its vaccine from the U.S. Food and Drug Administration.
Officials with the companies said during Wednesday’s virtual symposium that doses for children are expected to be smaller than those for adults but should achieve the same high efficacy.
Other panelists spoke to the concerns parents are likely to have in vaccinating their children with new vaccines, particularly Black and Hispanic residents who suffered disproportionate health disparities both before and from the pandemic.
Misinformation has spread rapidly about vaccines, especially through social media, said Amy Pisani, executive director of Vaccinate Your Family, an educational organization cofounded by former first lady Rosalynn Carter.
She said there are three main issues. Parents want vaccines that are licensed and not authorized, which will come in time. They wanted trusted messengers, which will require commitment from doctors, as well as faith and community leaders. And, Pisani said, “they want to know about long-term effects from vaccines, and we counter that we don’t know long-term effects of COVID.”
She and other panelists said that much of what scientists do know about the vaccines is based on reactions from the millions of shots given to adults and now also adolescents.
The most concerning so far among adolescents has been rare cases of myocarditis, or inflammation of the heart muscle, as well as the inflammation of the tissue surrounding the heart. The FDA confirmed about 300 cases in young adults and adolescents and said this week that it would add a warning label about the rare, usually mild reactions.
Federal regulators will be looking at all the data before deciding to give emergency authorization for vaccines’ use in children and ultimately approvals, said Dr. José Romero, a member of the CDC’s Advisory Committee on Immunization Practices, which makes recommendations.
Romero, also the Arkansas health secretary, said there are various methods of collecting data, including from trials but also from reports from the public and the medical community, after they go into use. Trials, particularly in children, will be too small to pick up on rare side effects. That’s how the myocarditis was spotted, he said.
“We’ve been looking at the data as closely as possible at this point,” Romero said. “I think the risks from COVID will be greater than the risks from the vaccines. But we’ll continue to evaluate over time.”
That includes data from adolescents 12 and older, who already are getting the Pfizer vaccines and could soon get the Moderna vaccines, said Dr. Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research.
He said most side effects have been similar to those in adults, including pain at the injection site and flu-like symptoms lasting a day or two. There have been some allergic reactions. A very small number of adults getting the Johnson & Johnson vaccines have had blood clotting.
“The challenge for the FDA is to be transparent like we want to be, and maintain the kind of vaccine confidence we like to see,” he said.
Panelists noted that demand for vaccines has dropped. Federal figures show about 54.4% of the U.S. population has gotten at least one dose of vaccine, and among those age 12 or older 53.6% have had at least one dose. The vaccines most widely used, from Pfizer and Moderna, both require two doses.
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How many adults and children get vaccinated will be “super important” as the more transmissible Delta variant gains a stronger foothold, said Dr. Christopher Murray, director of the University of Washington’s Institute for Health Metrics and Evaluation.
Murray said he expects a surge in cases in late fall after kids go back to school, “nowhere near what we saw last year, but quite considerable.”
That means gaining parents’ trust will be crucial, said Dr. Joshua Sharfstein, vice dean for public health practice and community engagement at the Johns Hopkins Bloomberg School of Public Health.
He said some trials have had difficulty recruiting diverse volunteers, which could portend issues gaining some parents’ trust for vaccinations.
“It’ll be really important to invest in outreach and sustained engagement,” he said.
But one thing already is clear if vaccination rates don’t grow.
Said U.S. Rep. Kim Schrier, a Democrat from Washington state: “This virus is so contagious it will find you if you are not vaccinated.”