What a pediatrician says about the COVID vaccine for kids

Children ages 5 to 11 will soon be able to get a COVID-19 vaccine from their pediatrician, local pharmacy and possibly even their school, the White House announced Wednesday, as it detailed plans for the expected approval of the Pfizer injection for younger children in a matter of weeks. Federal regulators will meet in the next two weeks to weigh up the benefits of giving injections to children, following lengthy studies designed to ensure the safety of the vaccines.

So what does this mean for families and the fight against COVID-19? This is what Dr. Richard Besser, former acting CDC director and chairman of the Robert Wood Johnson Foundation, told “Face the Nation.”

The White House has announced plans to distribute vaccines to 5-11 year olds. How soon can parents as pediatricians expect their children to be vaccinated? If the Food and Drug Administration (FDA) approves the use of this vaccine in children and the Centers for Disease Control and Prevention (CDC) recommends it, the vaccines could be available in early November.

As a pediatrician and parent, I look forward to a safe and effective COVID-19 vaccine for young children. While we can all be thankful that they are at less risk of serious illness, the impact of the pandemic on children is huge. • More than 6 million children in the US have contracted COVID-19, more than 1.1 million in the past six weeks alone. • More than 600 children have died from COVID-19, 158 of them between the ages of 5 and 11. • More than 5,000 children have developed a serious multisystem inflammatory condition known as MIS-C after a COVID-19 diagnosis, which can have debilitating physical consequences.

Children who have not directly contracted COVID-19 have been hit hard by this virus. More than 140,000 children have lost a parent or guardian, while prolonged school closures and lockdowns have negatively impacted children’s social, emotional and mental health. Across the board, children of color and children from low-income families have suffered disproportionately from COVID-19. Fortunately, we are getting closer to a vaccine for younger children. Here’s how it works: On October 26, the FDA’s independent advisory committee on vaccines, known as VRBPAC, will meet to decide whether a vaccine is recommended for children in this age group. If the FDA eventually approves that vaccine, the CDC’s independent advisory committee, known as ACIP, will meet on Nov. 2 and 3 to make recommendations about who should get it; the CDC director, Dr. Rochelle Walensky, would then have to make its official recommendations before administering any vaccines to children. If that timeline holds, and both the FDA and the CDC give the go-ahead, we’d probably see the first shots fired in the arms of the kids within days of the CDC’s official recommendation being announced.

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It is critical from both a health and trust perspective that we allow this process to proceed rather than simply assume the vaccine will be approved. The FDA, the CDC and their respective independent agencies must conduct a thorough and independent review to determine whether the vaccine is safe and effective for children in this age group. The data released so far is promising, but independent scientific research should guide this process.

The Biden administration plans to release vaccines through many channels, including doctors’ offices, local pharmacies and schools. They’re not going to do mass vaccination clinics like we saw for adults. Will this be enough to ensure vaccines go to the most vulnerable or needy school-age children?

I am enthusiastic about the approach that is being followed. The Biden administration has announced that it has purchased enough vaccines for the US’s 28 million children, ages 5-11. They are working with states and localities to plan for vaccine distribution to all communities. It makes a lot of sense to shoot in environments where children are used to being vaccinated, such as their doctor’s offices where trust is high. As a pediatrician I am used to vaccinating children and answering questions from health care providers every time I am in the clinic. But we also know that many children do not have health insurance or their own health care provider: the latest figures show that 5.6% of children were uninsured in 2020, but the uninsured percentage is almost twice as high for children in poverty. Therefore, vaccination clinics in other places such as hospitals, pharmacies, health centers and schools are all essential to reach children in all neighborhoods. In addition, it is critical that public health officials collect data on race, ethnicity and neighborhood so that any differences in vaccine use can be documented and addressed.

We must also make it as easy as possible for parents to have their children vaccinated and to stay at home if some children cannot attend school for a day due to side effects. Unfortunately, people’s access to paid time off work in the United States largely depends on their job and income level. We are the only wealthy country that does not guarantee paid leave for new parents or to care for a sick relative. Black, Latino and Indigenous people are much more likely to work in minimum wage jobs without paid time off. Emergency legislation passed by Congress has pushed more employers to offer paid time off, including time off for vaccinations, but the temporary tax breaks for that purpose have expired and about 100 million workers are still without paid time off. The idea that every parent should have to choose between earning a salary and getting a potentially life-saving vaccine for their children is simply wrong. It is high time for the United States to establish a national paid leave program that covers all employees while taking meaningful steps to ensure that working families have quality and affordable childcare options.

What would you tell parents who are still unsure about the COVID-19 vaccine?

It is understandable that parents have questions and concerns about a new vaccine. Polls show parents are divided over COVID-19 vaccines for children: some plan to have their children vaccinated right away; some have no intention of doing this at all; and some prefer to take a wait-and-see attitude. We’ve seen these divergent views express themselves with vaccines for both adults and adolescents, so it’s no surprise to see it in younger children as well, especially since the clinical trials for children at this age were much smaller than those for adults.

As a pediatrician, I have spent many hours advising parents about vaccines for children. Just a few days ago, at the clinic where I still see patients, I spoke to a mother about vaccines for her teenage sons. She wants to see more data before making a decision. We had an open and respectful conversation. In my experience, it doesn’t work to pressure and scold people. The first step is listening; it’s important that we give people the time and space to ask questions and voice their concerns. Parents should raise these questions or concerns with a healthcare professional or others they trust to receive accurate information. Misinformation about vaccines is rife and its continued spread is ultimately disrespectful and endangers those who have legitimate questions to which they seek honest answers. The planned approach to administering COVID-19 vaccines to younger children will make it easier to have these conversations.

While children are at lower risk for COVID complications, how should parents of young children, infants and up to 5 years old approach the virus?

While it is cause for optimism that the number of cases has fallen significantly in recent weeks, it remains extremely high, and the US still has an average of about 1,500 deaths per day. I don’t believe we will really get this pandemic under control unless and until safe and effective vaccines are available for all age groups and until more adults decide to get vaccinated. It’s important to remember that even if vaccines are approved for children ages 5-11, children under age 5 will still be ineligible for the vaccine and will likely be ineligible by early 2022 at the earliest.

One of the most important steps we can take to protect children who are ineligible for vaccination is to ensure that the adults around them are fully vaccinated. There are currently approximately 66 million vaccine-eligible people in the United States who are unvaccinated. In places where vaccination rates are particularly low, those communities remain particularly prone to additional cases, hospitalizations and deaths. Achieving higher vaccination coverage across the board is the most important step we can take to save lives. There are other measures we can take to keep our youngest children safe. The CDC recommends that everyone ages 2 and older in schools and childcare facilities wear masks. That is an essential part of keeping children, teachers and staff safe and increasing the chances that these facilities can operate safely and remain open. The CDC also recommends that everyone six months and older get a flu shot. That’s incredibly important. In a typical flu season, thousands of young children are hospitalized because of the flu, and we are starting to see some respiratory viruses circulating earlier than usual this year with children back in schools and childcare facilities. Flu shots save lives and ease the strain on hospitals and other healthcare providers. Can you imagine a future where a COVID vaccine or booster will soon be part of routine childhood vaccinations, such as the polio vaccine? Vaccines have been part of my professional career for decades. There is nothing I do as a pediatrician that has more proven health value than making sure all my patients are fully vaccinated on time. Every state requires vaccinations for children to attend school. Vaccination rates for required immunizations, such as measles, mumps, and rubella, are usually extremely high. We’ve seen a growing number of vaccine mandates in the workplace across the country, which I think is the right move. We see this even in younger populations; some schools already require COVID-19 vaccines for certain older children, such as high school students.

While all three COVID-19 vaccines available in the US are highly effective in preventing serious illness, hospitalization, and death, only Pfizer’s COVID-19 vaccine has received full FDA approval to date. and only for those ages 16 and older. Over time, as the scientific basis for vaccine efficacy and safety continues to grow, we may see more full approvals granted by the FDA and for younger age groups. Additional full approvals could eventually lead to COVID-19 vaccines being recommended as part of the CDC’s routine childhood immunization schedule, and would likely lead to a greater number of states and localities adopting COVID-19 vaccine requirements.

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