Inquiring Minds: Children and the Covid Vaccine: Updated again!

The rollout of vaccines has started, if ever so slowly. My parents (both over 70 in age) received the vaccine last week — and a tension, a weight, I didn’t even know I was carrying, lifted. My heart goes out to all of those who have lost loved ones and I am so grateful for the health my family has been able to maintain.

But what’s up with the vaccine and children? When will the pediatric population be immunized? The short answer is: not soon. There is a chance that children over 12 might start to get vaccinated in the next six months; children under 12 are unlikely to have that opportunity before 2022. ***** This is a brief overview of why…

There are two vaccines currently approved in the United States, The Pfizer vaccine and the Moderna vaccine. The Johnson and Johnson (J&J) vaccine was submitted for FDA approval this week.

The Pfizer vaccine is a two dose vaccine, with each dose given three weeks apart. It is approved for ages 16 and up. It needs to be kept in a super cold freezer. At the time of FDA approval, trials showed that it was > 94% effective at preventing COVID infection, and reduced the degree of illness in those who did catch it.

The Moderna vaccine is also a two dose vaccine, with each dose given four weeks apart. It is approved for ages 18 and up. It needs to be kept in a normal pharmaceutical grade freezer. At the time of FDA approval, it was also shown to be greater than 95% effective at preventing COVID infection, and reduced the degree of illness in those who did catch it.

The J&J vaccine is a single dose. It is approved for ages 18 and up. It can be stored in any pharmaceutical grade refrigerator. Clinical trials have shown that it is 66% effective at preventing infection. Of note, the vaccine was tested against the new virus variants in South Africa and South America — the other two vaccines were tested before the new strains emerged.

There are no vaccines currently approved for children less than 16. Pfizer currently has a vaccine trial for children 12 - 16 in process. Those results might be available in the next four to six months.

Moderna**** just started a vaccine trial for children 12 - 16, and are still working on enrolling children. Those results are unlikely to be available until the late summer/fall. Of note, Moderna just started a vaccine trial in early March for children 6 months through 12 years. They plan on enrolling 6,750 children — and anticipate that the trial will be completed within 14 months, if not sooner!*******

On February 13, the Oxford-Astrazeneca started a trial of its’ vaccine for children between the age of 6 - 17. 300 children in three cities are being enrolled and the results should be back sometime in the late summer. The Oxford-Astrazeneca vaccine is not yet approved by the FDA — but hopefully will be in the next few months. It is possible that the vaccine might be available for some children by the fall.

There are two intertwining reasons for the delay in approving vaccines for children. One reason is ethics — a child can not give “informed” consent to participate in a clinical trial and a parent should not be allowed to give consent until vaccine safety is established. Children, in essence, should not be experimented upon.

The second reason, which overlays ethics, is safety — children have such an active immune systems that the side effects from the vaccine will likely be greater than that of adults. A safe “dose” of any vaccine will need to be established, and that takes time.

For now, social distancing, masking, and good hand washing are essential. But, I personally look forward to the next few months, when my immediate family can see their grandparents in person without my worrying that we might infect them. We’ll still all be masked. We’ll still be outside. We’ll still all try to keep our distance. But we can be more together than we have been in months.

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