Vaccines for Young Children Are Coming, But Many Parents Have Tough Questions

Vaccines for Young Children Are Coming, But Many Parents Have Tough Questions

Vaccines for Young Children Are Coming, But Many Parents Have Tough Questions

It’s a moment many parents have been looking forward to for months: Children under the age of 5 are now eligible for coronavirus vaccinations, among the last Americans to qualify.

Without access to vaccines, parents of young children face almost impossible choices since the beginning of the pandemic. Many children have been turned away from schools, family gatherings and other activities, and deprived of normal childhood experiences. Now all that can change.

On Saturday, the Centers for Disease Control and Prevention recommended the Moderna and Pfizer-BioNTech vaccines for children 6 months and older. The decision means that the injections will be given to these children for the first time, perhaps as early as Tuesday.

Sunny Baker, 35, a mother of two in Oxford, Mississippi, said she vaccinated her oldest daughter, Hattie Ruth, 5, at the first chance, and is eagerly waiting for her 2-year-old daughter Alma Pearl to qualify.

“Yes Yes Yes! We’d love to be first in line,” she said.

But Baker may well be in the minority: a recent survey by Kaiser Health found that only one in five parents will vaccinate their young children right away. Many plan to delay for now.

As the pandemic stretches into its third year and Americans weigh the risks they are willing to live with, the CDC’s decision puts parents of young children on high alert.

Vaccines have lost some of their potency against infection with new variants, although they continue to offer protection against serious illness and death. And large numbers of Americans became infected during the Omicron outbreak, contributing to a misguided sense among many that the battle was over.

The exchange of advice also contributed to the lack of enthusiasm. Daryl Richardson, 37, of Baltimore, said he had no plans to vaccinate his three children, in part because of the constant changes in the number of recommended doses.

“First it was a shot, then it was a backup and another backup,” he said.

After navigating the dangers of the pandemic with their children for so long, parents are now faced with new questions, some so complex they’ve left even regulators and experts baffled. Which vaccine is better? How well and how long will they work? And why bother, if most young children have already been exposed to the virus?

Pfizer-BioNTech and Moderna injections are considered safe for young children, and both produce blood levels of protective antibodies similar to those seen in young adults. But none of them offer the miraculous protection provided by vaccines for adults in the early days of the pandemic.

Moderna’s vaccine appears to produce a strong immune response in young children and its protection is complete within 42 days of the first dose. But the vaccine causes fever in one in five children, and fewer vendors are likely to offer it as an option over the Pfizer vaccine.

The Pfizer-BioNTech vaccine is more familiar and produces fewer fevers, but children will need to take three doses to protect themselves from the virus. While it takes 90 days to reach peak protection, the effect can last longer compared to the Moderna regimen.

“Implementing these two launches will be incredibly challenging,” said Katelyn Jetelina, public health expert and author of the widely read newsletter “Your Local Epidemiologist.”

“There’s going to have to be a lot of proactive communication about the difference between the two and the implications of taking one over the other,” she said.

A direct comparison of the two vaccines may provide some answers for parents, but that is neither possible nor advisable, experts said in interviews. There are many differences in the way vaccines have been formulated and evaluated.

“It will really be impossible to say that one is better than the other,” said Dr. William Towner, who led vaccine trials for Moderna and Pfizer at Kaiser Permanente in Southern California.

The choice may depend more on whether parents are willing to take three doses instead of two, and which vaccine their providers have on hand, he said.

Many providers are not used to Moderna, having so far relied solely on the Pfizer-BioNTech vaccine. About 350 million doses of this vaccine were given to Americans at large, compared to 223 million doses of the Moderna vaccine and about 19 million of the Johnson & Johnson vaccine.

For young children, states have so far ordered 2.5 million doses of the Pfizer vaccine and 1.3 million doses of the Moderna vaccine. These numbers are below expectations, considering the 18 million children in this age group.

Absorption has been slow, even for older children. The Pfizer-BioNTech vaccine was authorized for children ages 5 to 11 in November, but less than 30% in that age group received two injections.

Vaccines in general have proven to be very safe, but many parents remain hesitant for a variety of reasons. Some are cautious because vaccines are relatively new or because they realize the risk of Covid-19 is negligible to their children.

Some parents may be uninterested because their children were among the 75% believed to have already been infected. But vaccination provides more powerful and consistent protection, even if a child has already been infected, CDC scientists noted Saturday.

Still other parents have weathered the pandemic.

In Middletown, Ohio, some parents were more concerned about keeping cool during the summer heat wave than they were about the risks of the coronavirus. Tori Johnson, 25, was not vaccinated and said she did not intend to immunize her two daughters, Liliana, 7, and Rosalina, 9 months.

Life had already returned to normal, she said.

Simone Williams, 32, said she was hesitant to vaccinate her 1-year-old twins Caidon and Arissa and 4-year-old Bryan. “I would buy for them if I had to, but other than that I’m in no rush,” Williams said.

Some pediatricians were preparing to explain to parents the merits of getting the vaccine. Even routine immunizations are a matter of concern in many parts of the country.

Pediatricians “have struggled with this for many, many years with the flu vaccine and standard dosage for measles, mumps, rubella and chickenpox,” said Dr. Lindsey Douglas, pediatrician and medical director of quality and safety at Mount Sinai. Kravis Children’s Hospital in Manhattan.

“Over the past two and a half years, there’s certainly been a lot more information out there,” added Dr. Douglas. “But there’s a lot more misinformation out there too.”

In a way, the odds were stacked against the use of vaccines in younger children.

The Moderna and Pfizer-BioNTech vaccines offered spectacular estimates of efficacy in adults, far beyond expectations, and raised hopes for a virus-free future.

But while vaccines were gradually being tested on younger children, the virus mutated rapidly, each new form more elusive and challenging than the ones before.

Newer versions of the Omicron variant have evolved to partially avoid not just the two-year vaccines, but even the immunity produced by an infection with the Omicron form that circulated just a few months ago.

The original estimates of efficacy in adults were on the order of 95%. That number has now dropped to 51% for two doses of Moderna’s vaccine in children aged 6 to 23 months, and just 37% for children aged 2 to 5 years.

As low as that may sound, two doses of Pfizer’s vaccine didn’t even meet the Food and Drug Administration’s requirements for an immune response, justifying the agency’s decision in February to delay the vaccine’s evaluation until the company had tested three doses. .

“As a mother, I find it unacceptable that it takes so long to vaccinate our little ones,” Jetelina said. But “as an epidemiologist, I also know the value of doing clinical trials rigorously and finding the right dosage.”

Based on the data, the FDA this week authorized two doses of the Moderna vaccine and three doses of Pfizer-BioNTech as the “primary series” for young children.

If authorities determine that even the youngest children need booster shots against future variants, the children will need to be given a third dose of Moderna and a quarter of Pfizer.

In press releases and in data reported to federal regulators, Pfizer estimated an 80% efficacy for three doses of its vaccine. But that calculation was based on just three children in the vaccine group and seven who received a placebo, making it an unreliable metric, CDC advisers noted at a meeting on Friday.

“We should just assume that we don’t have efficacy data,” said Dr. Sarah Long, an infectious disease specialist at Drexel University School of Medicine. But Dr. Long said she was “comfortable enough” with other data proving the vaccine’s potency.

Parents of younger children may be more willing to opt for a Covid vaccine if it can be offered alongside other routine immunizations. Dr. Towner said any vaccine would be better than none, but he predicted that more parents might opt ​​for Moderna.

“I’ll be honest, it might be a little difficult for some parents to get three shots instead of two,” he added. “If they have a choice, and if both are available, that could sway some parents toward Moderna.”

Some parents will not need to be convincing. In Alexandria, Va., Erin Schmidt, 37, said the news was “life-changing” because her family lives in “a sort of isolated alternate reality.” After vaccinating her 2-year-old daughter Sophia, she plans to open a bottle of champagne, take Sophia to a museum and “blow her mind on the world”.

Brendan Kennealy, 38, of Richfield, Minnesota, said that after his daughters, Hazel, 4, and Ivy, 1, were vaccinated, he and his wife Jocelyn, 35, would drive them to the lake town of Duluth. , where they plan to try new restaurants and attend an open-air concert by a local folk band called Trampled by Turtles.

The family had to avoid spending time indoors with their mother, who has lupus and is vulnerable to severe Covid. Her kids missed the state fair, dropped out of swimming lessons, and quit gymnastics.

“I’ve been really, really happy a few times in the past, and then they’ve pulled the rug back,” Kennealy said of the FDA’s halting progress on vaccines for children.

“Those shocks of hope were so needlessly defeating,” he added. “Until we’re at Walgreens or wherever we take them to get their pokes and band-aids, I’m trying to keep this under control.”

Adam Bednar contributed reporting from Baltimore, Cristina Capecchi from Richfield, Minnesota, Ellen B. Meacham of Oxford, Mississippi, and Kevin Williams from Middletown, Ohio.

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