2 Nov. 2021 – Younger children may soon receive their first dose of Pfizer’s COVID vaccine after a panel advising the CDC on vaccination strongly endorsed the injection for this age group.
The 14 members of the CDC’s Advisory Committee on Immunization Practices (ACIP) voted unanimously on Tuesday to recommend 2 doses of Pfizer’s lower dose of mRNA vaccine for children from 5 to 11 years old.
There are an estimated 28 million children in the U.S. in this age group.
“I feel I have a responsibility to make this vaccine available to children and their parents,” said committee member Beth Bell, MD, a clinical professor at the University of Washington in Seattle. Bell noted that all evidence reviewed by the committee points to a vaccine that is safe and effective for younger children.
“If I had a grandchild, I would definitely get that grandchild vaccinated as soon as possible,” she said.
Their recommendations follow the FDA’s emergency authorization of Pfizer-BioNTech’s vaccine for the same age group last week.
If CDC director Rochelle Walensky, managing director, signs the recommendation, which she is expected to make, Pfizer’s vaccine will be available to children soon.
“I am voting for this because I think it can have a big positive impact [kids’] health and their social and emotional well-being, ”said Grace Lee, MD, a pediatrician at Stanford University who chairs the CDC’s Advisory Committee on Immunization Practices.
Although masks are available to reduce the risk of the virus for children, they are not perfect and transmission is still taking place, Lee noted.
“Vaccines are really the only consistent and reliable way to provide that protection,” Lee said.
The Pfizer vaccine for children is 2 doses given 3 weeks apart. Each dose is 10 micrograms, which is one third of the dose used in adults and teenagers.
To avoid confusion, the smaller dose for children will come in bottles with orange labels and orange tops. The adult vaccine is packaged in purple.
The CDC also addressed the question of children who are close to the age of 12 when they receive their first dose.
Generally, pediatricians allow a 4-day grace period around birthdays to determine what dose is needed. The same method will be used for the COVID-19 vaccine, experts said.
For children who are 11 when they start the series, they should receive another dose of 10 micrograms after turning 12 a few weeks later.
The news comes as COVID-19 cases in this age group climbed sharply over the summer and fall as the school reopened fully, sometimes without the use of masks.
In the first week of October, approximately 10% of all COVID-19 cases recorded in the US were among children aged 5 to 11. Since the beginning of pandemic, about 1.9 million children in this age group are infected, although this is almost certainly a count. More than 8,300 were admitted to hospital and 94 children died.
Colored children had an exorbitant impact. More than two-thirds of children admitted to the hospital were black or Hispanic.
Benefits vs. Risks
In clinical trials which included more than 4,600 children, the most common adverse events were pain and swelling at the injection site. Side effects such as fever, fatigue, headache, cold shivers, and sometimes swollen lymph nodes also occurred in some cases. These types of side effects appear to be less common in children between the ages of 5 and 11 than they were in teens and adults, and they were temporary.
Yet doctors say they are looking for it. In general, the greatest risk for myocarditis after vaccination was seen in younger men, between the ages of 12 and 30.
Even without COVID-19 or vaccines in the mix, doctors expect to see as many as 2 cases of myocarditis for every million people over the course of a week. The risk of myocarditis increases to about 11 cases for every million doses of mRNA vaccine given to men between the ages of 25 and 30. This is between 37 and 69 cases per million doses in boys between the ages of 12 and 24.
But experts say the possibility of this rare risk should not deter parents from vaccinating younger children. Here’s why: the risk of myocarditis is higher after COVID-19 infection than after vaccination. Younger children also have a lower risk of myocarditis compared to teenagers and young adults, suggesting that this side effect may occur less frequently in this age group, although it has yet to be seen.
It is also expected that the smaller dose authorized for children will further reduce the risk of myocarditis.
The CDC says parents should call their doctor if a child develops pain in their chest. breathing problems or feel like they have a beating or fluttering heart after vaccination.
A drop in cases?
Models looking at the impact of vaccines in this age group predict that cases nationally will decrease by about 8% if children are vaccinated.
The models also suggested that vaccination of children of this age would delay the emergence of new variants – though not stop.
For every million doses, the CDC’s modeling predicts that more than 56,000 COVID-19 infections will be prevented in this age group, along with dozens of hospitalizations and post-COVID conditions such as Multisystem Inflammatory Syndrome in Children (MIS-C).
CDC experts also estimate that only 10 children should be vaccinated over 6 months to prevent a single case of COVID-19.
Vaccination of children can help slow the transmission of the virus and will give parents and other caregivers greater confidence to participate in school and extracurricular activities, the CDC said.
CDC experts said they would use a variety of systems, including hospital networks, the Open Vaccines and Adverse Events Reporting System (VAERS) database, the mobile-based V-SAFE application and insurance claims databases to eye out for any rare adverse events associated with the vaccines in children.