In anticipation of federal regulators soon authorizing vaccines for children ages 5 to 11, state and local health officials in Maryland are preparing to launch school-based vaccination clinics and specialty sites for this age group in addition to offering shots at existing clinics.
A U.S. Food and Drug Administration advisory panel will meet next week to discuss the safety and effectiveness of administering the Pfizer/BioNTech vaccines to young children, then a U.S. Centers for Disease Control and Prevention committee will meet in November. State and local health departments and other vaccinators must wait for guidance before they can start vaccinating 5- to 11-year-olds.
But once authorization comes, officials said they expect some parents to rush to sign their kids up as quickly as possible while others look to trusted messengers and support systems for guidance.
Pfizer, the first company to submit kids’ clinical trial data to the federal government for authorization, evaluated three dosage levels — 10, 20 and 30 micrograms. The company selected the 30-microgram dose for adolescents and adults, but found that younger children could fend off severe illness effectively using the lowest amount.
There are about 515,000 Maryland children in the 5-to-11 age group, according to the latest U.S. census estimates. Each child will need two separate doses, three weeks apart, for full effectiveness, the same as adults. Pfizer would be the only vaccine producer authorized for this age group, and also is the only one authorized for 12- to 18-year-olds.
Maryland’s pediatric vaccine allocations from the federal government are expected to be sufficient to meet demand for all of these individuals, said Andy Owen, spokesman for the Maryland Department of Health.
Owen said the state is working with pediatricians, local school systems, local health departments and pharmacies to ensure that there will be multiple options for 5- to 11-year-old Marylanders to get COVID-19 vaccines.
State officials believe school-based vaccination clinics will be one of the best ways to equitably reach Maryland’s kids, he said.
School clinics helped reach teenagers and young adults when they became eligible for the shots in May. Some parents who attended those clinics with their kids said having their school communities present made them feel more at ease about vaccinating their children.
Family doctors, pediatricians and school administrators will be crucial to getting this population vaccinated, said Dr. Debbie Badawi, president of the Maryland chapter of the American Academy of Pediatrics.
Such “trusted messengers” can help tamp down any fears parents might have about vaccinating their kids, Badawi said. She anticipates families with older children will make use of pharmacies, while parents of younger kids will seek out their doctors and schools for more assurance.
Unfortunately, Badawi said, many doctors’ offices in the state have indicated that they won’t have the capacity to administer COVID-19 vaccines in young children, given the Pfizer vaccines’ ultracold storage requirements and relatively short shelf life. Physicians are concerned about wasting doses, she said, and aren’t always certain that they will have enough takers for shots on a given day.
“Smaller practices don’t find it feasible because they don’t have the staffing or the space to store the vaccines,” Badawi said. “The biggest challenge is anticipating who’s going to go where, so we can anticipate where to distribute the vaccine.”
Complicating matters even further, some pharmacies in the state aren’t planning to vaccinate children. Owen said in an email that private pharmacy operators may opt in or out at their own discretion.
Some major chains, such as CVS Pharmacy, said they expect to play a major role in vaccinating the 5- to 11-year-old age group, but it was not clear whether the policy would be uniform at every location. Matt Blanchette, CVS Pharmacy’s retail manager, said employees already were administering routine childhood vaccinations and were preparing to add youth COVID-19 vaccines into the mix once they were authorized.
Badawi said the state may set up storage “hubs” in each county where providers can go to pick up smaller amounts of vaccine should they encounter demand. She said some county governments are preparing to help transport and store the vaccines, too.
County officials said Tuesday that they were deliberating several options to best serve those 5 to 11, who have different needs and transportation abilities than adults.
Anne Arundel County is working with schools and plans to provide vaccines at 20 elementary schools and at regular county vaccination sites, said Dr. Nilesh Kalyanaraman, the county health officer. Anne Arundel, he said, also will partner with pediatricians already offering vaccines to 12- to 17-year-olds, federally qualified health centers and pharmacies.
The county has about 52,000 kids in that age group, Kalyanaraman said. He said he did not have “pre-positioned” doses and is working with state and federal health officials about how to best transfer supply.
“The goal is to start within days” after the CDC releases guidance, he said. “A lot will depend on if we can pre-position the vaccine. We have the personnel. We just need to have the vaccine in hand to do that. We’ll be ready to start within a day or two.”
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Elsewhere, such as in Baltimore County, health officials are considering reopening mass vaccination clinics to quickly administer the doses to young children, but don’t have any firm plans to do, said Elyn Garrett-Jones, spokeswoman for the health department. Several other options also are being considered, she said.
In Howard County, officials plan to use a new space at Howard Community College, which will be designated just for the vaccination of younger residents, said Lisa de Hernandez, spokeswoman for the county health department. They too have not been given guidance as to how the vaccine might be rolled out nationally or statewide, she added. They also plan to make use of pharmacies and private providers.
The Carroll County Health Department is working on clinics for young kids, spokeswoman Maggie Kunz said, but officials there don’t have anything to share yet. She said they would be similar to those it ran for the 12- to 17-year-old age group.
The same goes for the Baltimore City Health Department, which will lean on its existing school-based clinic model. More than 100 such COVID-19 clinics have been held for older students, spokesman Adam Abadir said, and the department is exploring larger-facility options for younger children in all four quadrants of the city.
Health officials in Harford County did not respond to requests for comment about the expected eligibility expansion.
Kalyanaraman said he hopes the state can get ahead of the colder months coming, as some Northern and Western states already are seeing upticks in cases, though he noted that those states have far lower vaccination rates than Maryland. He’s concerned about holiday travel and the spread of infection as kids visit lesser-vaccinated states.
“That’s a core concern and why we have to keep pushing on vaccinations,” he said. “The best thing we can do if people are not vaccinated is to get vaccinated, and if they are eligible, get a booster.”