A child receives a dose of the Pfizer-BioNTech pediatric coronavirus disease (COVID-19) vaccine.
Mayela Lopez | Reuters
On Saturday, independent vaccine experts from the Centers for Disease Control and Prevention backed Pfizer and Moderna’s Covid-19 vaccines for children as young as 6 months old.
The CDC committee voted unanimously to recommend the vaccines for use in infants through preschoolers after two days of open public meetings. CDC Director Dr. Rochelle Walensky is expected to approve the committee’s recommendation this weekend, which would allow pharmacies and doctor’s offices to begin administering the injections.
The White House expects vaccinations for children under 5 to begin on Tuesday, after the June 16 holiday. Appointment availability may be limited initially, but every parent who wants to have their child vaccinated should be able to do so in the coming weeks, according to Dr Ashish Jha, who is overseeing the Biden administration’s Covid response.
Almost everyone in the United States is now eligible for the Covid vaccination less than two years after the first vaccines were authorized for the elderly in December 2020.
“I fully believe that vaccines should be recommended,” said CDC committee chair Dr. Grace Lee. “We can clearly prevent hospitalizations and deaths. And I think we have the potential to prevent long-term complications from infections that we don’t yet understand.”
Covid risk for children
Although Covid is normally less severe in children than in adults, the virus can be life-threatening for some children. Covid is the fifth leading cause of death in children aged 1 to 4, according to CDC data. More than 200 children aged 6 months to 4 years have died from Covid since January 2020.
More than 2 million children in this age group have been infected with Covid during the pandemic, and more than 20,000 have been hospitalized, according to CDC data.
Hospitalizations of children under 5 with Covid increased during the winter wave of omicron, reaching the highest level of the pandemic for this age group. The overwhelming majority of them, 86%, were admitted primarily because of the impact of Covid on their health, CDC data shows. In other words, they were not included in the data because they tested positive for the virus after being admitted for another health reason.
According to CDC data, more than 50 percent of children under age 5 hospitalized had no underlying medical condition. Nearly a quarter of hospitalized children in this age group ended up in the intensive care unit.
Nearly 2,000 children under the age of 5 have developed multisystem inflammatory syndrome, or MIS-C, after a Covid infection. MIS-C is a condition in which multiple organ systems — the heart, lungs, kidneys, brain, skin, eyes, or digestive organs — become inflamed. Nine children under the age of 5 have died from MIS-C.
“These very clear data just destroy the myth that this infection is not life-threatening in this age group,” said Dr. Sarah Long, committee member and pediatrician at St. Christopher’s Hospital for Children in Philadelphia.
Pfizer, differences between Moderna vaccines
Pfizer’s vaccine is given in three doses for children 6 months to 4 years old. The shots are dosed at 3 micrograms, one-tenth the level of what adults get. Three injections were about 75% effective in preventing mild illness caused by omicron in children 6 months to 2 years old and 82% effective in children 2 to 4 years old.
However, data on vaccine efficacy are preliminary and imprecise as they are based on a small population of 10 children, with estimates ranging from 14% to 96% protection against omicron. Dr. Bill Gruber, head of vaccine research at Pfizer, said the antibody response seen in children after the third dose, which was greater than that of people aged 16 to 25 who received two injections, should reassurance about the effectiveness of the vaccine.
“In the interest of some sort of full transparency for parents, it seems appropriate to me to acknowledge the uncertainty surrounding this,” committee member Dr. Matthew Daley said of the estimate of the vaccine efficacy.
It is crucial that parents who opt for Pfizer ensure that their children receive the third vaccine to be protected against the virus. Two doses were only about 14% effective in preventing infection in children under 2 years old and 33% effective in children 2 to 4 years old.
“I don’t want parents to feel like two doses is enough,” said Daley, a pediatrician who studies vaccine safety.
Moderna’s vaccine is given in two doses for children 6 months to 5 years old. The shots are dosed at 25 micrograms, a quarter of the level that adults receive.
Moderna’s vaccine was about 51% effective in preventing mild omicron disease in children 6 months to 2 years old and about 37% effective in children 2 to 5 years old. However, the company expects the vaccine to provide strong protection against serious disease, as children had higher antibody levels than adults who received two doses.
Moderna is studying a booster dose that targets omicron for children in this age group with data on vaccine safety and immune response expected in the fall, according to Dr. Rituparna Das, who is leading the development of the Moderna’s Covid vaccine.
According to the FDA, the most common side effects of vaccines were pain at the injection site, irritability and crying, loss of appetite and drowsiness. Few children who received either vaccine developed a fever above 102 degrees Fahrenheit, and there were no cases of myocarditis, a type of heart inflammation, in Pfizer trials. or Moderna.