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Opinion Finally, young children will no longer be left behind in the pandemic

A child receives the Pfizer-BioNTech coronavirus vaccine at Hartford Hospital in Hartford, Conn., on Nov. 2. (Joseph Prezioso/AFP/Getty Images)
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Finally, relief for parents of young children is here: Children under 5 years old will almost certainly be able to get their coronavirus vaccines starting next week. This will make a huge difference to many families — mine included — who have been desperate to protect their kids against the coronavirus.

External advisers to the Food and Drug Administration voted unanimously on Wednesday to recommend authorization of both the Pfizer-BioNTech and Moderna vaccines for children 6 months to 5 years old. An advisory committee to the Centers for Disease Control and Prevention will now meet Friday and Saturday. Given the strength of the data and the pressing need to make vaccines available to all, I expect the CDC will follow with its own green light.

The Biden administration has already made 10 million doses available for pre-order by states, pharmacies and health centers. That means parents may begin taking their young kids to be vaccinated by early next week.

Submit your questions for Dr. Leana S. Wen’s coronavirus reader Q&A on June 17

I will be among those eager parents. Throughout the pandemic, my concern about covid-19 has not been for me and my husband, but for our children. Our daughter was born in April 2020 in the height of uncertainty and fear. Our son, now almost 5 years old, had to stop preschool when the coronavirus first hit. Even after school resumed, we kept him out of many childhood activities and only recently resumed extracurriculars and indoor playdates.

It’s true that young children like mine are unlikely to suffer severe outcomes from covid-19. But it’s also true that some kids have. More than 400 children under 5 years old have died from covid-19. Thousands have been hospitalized. The risk of long covid for children is probably far less than for adults, but it remains a major concern for many families.

Parents have to assess all kinds of risks for our kids. As I’ve maintained throughout the pandemic, the risk of any activity has to be balanced against its value. Just because something is risky doesn’t mean we have to avoid it — which is how I’ve thought about in-person, mask-optional school and the resumption of social activities for our unvaccinated kids. But I’ll have more peace of mind if I can reduce their risk with an intervention that’s safe and effective.

And that’s what these vaccines are. The FDA’s analyses of company data show both the Pfizer and Moderna vaccines induce a robust antibody response that’s as strong as the response in adolescents and young adults. In all other age groups, this level of antibody increase correlates with protection against severe disease, and it stands to reason that it does in this younger age group, too.

Plus, both vaccines protect against symptomatic disease. In preliminary studies, Pfizer’s reduces covid-19 by 76 percent for 6-month to 23-month-olds and 82 percent for 2- to 5-year-olds. Moderna’s is 51 percent and 37 percent effective for 6-month to 23-month olds and for 2- to 5-year olds, respectively.

These numbers are comparable to the protection for older age groups against omicron. Pfizer’s possible higher efficacy could be due to the fact that its vaccine for young kids is a three-dose series, with the first two doses given three weeks apart and the third dose administered at least eight weeks after the second. Moderna’s, on the other hand, is a two-dose vaccine given four weeks apart. (Data increasingly suggest that the coronavirus vaccines are at least three-dose vaccines, and Moderna is testing a third dose as well.)

The other key difference between the two vaccines is the dosage. Pfizer’s vaccine is 3 micrograms, which is one-tenth of the adult dose. Moderna’s is 25 micrograms, or one-quarter of the adult primary series. Both dosages, either as three shots or two, were found to be safe, with no new adverse reactions and no cases of myocarditis in the thousands of children in clinical trials.

I am convinced by these data and reassured by the thoughtful, rigorous process undertaken by federal regulators. Many families will be, too, though they are in the minority. According to a Kaiser Family Foundation survey, less than 1 in 5 parents intend to vaccinate their kids under 5 years old right away. Another 38 percent say they’ll wait and see. These numbers track with the uptake of pediatric coronavirus vaccines overall; only 29 percent of kids 5 to 11 years old have been vaccinated, despite overwhelming evidence for safety and effectiveness.

Even if it’s unlikely to change the trajectory of the pandemic, having this youngest age group eligible for vaccination is an important milestone. It’s been a year and a half since adults first started their inoculations. Finally, our youngest children will no longer be left behind.

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