As CDC Panel OKs Vaccine for Younger Children, Answers to Questions on Dosage Levels, Safety Monitoring

Children ages 5 to 11 could receive COVID-19 vaccines as early as Wednesday after the Centers for Disease Control and Prevention recommended approval of Pfizer’s child-sized shots. Photo from scimex.org.

Advisers to the Centers for Disease Control and Prevention have recommended giving Pfizer’s COVID-19 vaccine to all kids ages 5 to 11, a decision that means those children could be receiving shots as soon as Wednesday.

CDC Director Dr. Rochelle Walensky signed off on the panel’s endorsement Tuesday evening. Vials of the pediatric version of the vaccine have already been shipped to states, so they would be ready for use as soon as the CDC panel acted.

Making the 28 million American children in that age group eligible for a COVID-19 vaccine for the first time is projected to help accelerate the current decline in infections nationally, and reduce the ability of any new variants of the virus to take hold.

A CDC estimate shared ahead of Tuesday’s vote by the Advisory Committee on Immunization Practices said that vaccinating 5- to 11-year-olds could reduce infections by 8% between now and the end of March.

“I feel that I have a responsibility to make the vaccine available,” said Dr. Beth Bell, a clinical professor at the University of Washington’s School of Public Health and a member of the advisory panel. “If I had a grandchild, I would certainly get that grandchild vaccinated as soon as possible.”

Preventing outbreaks 

Federal health officials and the CDC’s panel of independent advisers said expanded eligibility for a COVID-19 shot would help prevent infections from spreading throughout families, minimize school disruptions, and allow kids to resume the social interactions that were severely curtailed by the pandemic.

The ultimate reach of the benefits, however, will depend on how many parents feel comfortable in having their child roll up their sleeve.

Several studies have found roughly one-third of parents with children 5 to 11 say they definitely plan to vaccinate their child. One study presented Tuesday found another 22% say they “probably” will do so.

A parent’s own vaccination status and the recommendation of a family physician are key factors in that decision, CDC’s Dr. Sara Oliver said Tuesday. Parents who remain hesitant typically have cited concerns about long- or short-term side effects, and uncertainty about whether the vaccine will work.

Fears about the vaccine causing infertility have also been cited frequently, likely in part due to misinformation that has spread on social media. Health experts have underscored that there is no reason to believe that the vaccine could negatively affect fertility.

Safety monitoring

During Tuesday’s day-long hearing, public health officials detailed the safety monitoring procedures in place, as well as the trial data indicating that the shot — like the one approved for adults — is safe and effective.

Dr. Rochelle Walensky, the CDC’s director, said at the beginning of that meeting that the risk to children should be framed in comparison to other vaccine-preventable diseases, like chicken pox, which caused fewer deaths than COVID-19 prior to a vaccine’s approval.

While the risks of severe outcomes from a COVID-19 infection are lower for children than for adults, “the risk is too high and too devastating to our children, and far higher than for many other diseases for which we vaccinate children,” Walensky said.

In Pfizer’s trial of more than 3,000 children, the pediatric formulation of the vaccine had a 90.7 percent efficacy rate in preventing symptomatic COVID-19 in children ages 5 to 11.

As with Pfizer’s shot for teens and adults, the version for children also requires two doses spaced three weeks apart. The dosage for the younger age group is much smaller: 10 micrograms for kids, compared to 30 micrograms for adults.

Does a child’s weight matter, or age?

Tuesday’s discussion delved into the nuances of expanding the vaccine to a younger age group, and the questions that some parents may have, such as whether a child’s weight is a consideration in getting the vaccine. (The answer: The vaccine dose is based on age, not on weight.)

Those who may turn 12 in between their first and second doses should receive the formula that’s correct for their age on the day they’re being inoculated. But if a child who recently turned 12 receives the pediatric formula for their second dose, they’ll still be considered fully vaccinated.

The panel also reviewed the risks of myocarditis, an inflammation of the heart muscle that has been linked to the Pfizer and Moderna vaccines in older boys and young men.

There were no cases of myocarditis during the clinical trials with 5–11-year-olds. Dr. Matthew Oster, a pediatric cardiologist from Atlanta, told the panel that the risk of vaccine-related myocarditis is lower than the risk of having COVID-19 for kids in the age group, who are believed to have a lower risk of the side effect than adolescents.

State and local health departments told the CDC that they expect pediatricians’ offices to be the most common place for doses to be administered, and parents have said they prefer seeking out a shot from their child’s doctor.

But a range of other providers also will be administering the vaccine, including pharmacies, children’s hospitals, rural health centers, and school districts.

Unlike the beginning of the adult rollout, it’s expected that there will be sufficient supply available. But the teen vaccination campaign has shown disparities in accessing shots in poorer and rural communities, even after supplies became more plentiful.

Maryland Gov. Lawrence J. Hogan Jr. (R) will provide a vaccine-related update at a State House press conference on Wednesday. More than 515,000 Maryland children are newly eligible for vaccines; the state had anticipated 180,000 doses in an initial shipment of shots to Maryland providers.

Danielle E. Gaines contributed to this report. 

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Laura Olson
Laura covers the nation's capital as a senior reporter for States Newsroom. Her areas of coverage include politics and policy, lobbying, elections, and campaign finance. Before joining States Newsroom, Laura was the Washington correspondent for the Allentown Morning Call, where she covered Pennsylvania's congressional delegation, public policies affecting the state, and federal elections. She also wrote about Pennsylvania state politics for the Pittsburgh Post-Gazette and Capitolwire.com, and covered the California state capital for The Associated Press and the Orange County Register. A Nebraska native, Laura has a bachelor's degree from Northwestern University, where she studied journalism and political science.