It’s the moment many parents have been anxiously awaiting for months: Children under the age of 5 are now eligible for a vaccine against the coronavirus, among the last Americans to qualify.
Without access to vaccines, parents with young children have faced near-impossible choices since the pandemic began. Many children are expelled from school, family gatherings and other activities, and deprived of normal childhood experiences. Now all of that could change.
On Saturday, the Centers for Disease Control and Prevention recommended the Moderna and Pfizer-BioNTech vaccines for babies under 6 months. The decision means the shots will be given to these young children for the first time, perhaps as early as Tuesday.
Sunny Baker, 35, a mother of two in Oxford, Miss., said she vaccinated her eldest daughter, Hattie Ruth, 5, at the first opportunity, and is eagerly awaiting it. Her 2-year-old daughter, Alma Pearl, qualified.
“Yes yes yes! We would love to be first in line,” she said.
But Ms. Baker is most likely in the minority: A recent Kaiser Health poll found that only a fifth of parents get their young children vaccinated right away. Many plan to keep for now.
As the pandemic drags into its third year and Americans weigh the risks they’re willing to live with, the CDC’s decision leaves parents with young children in a dilemma.
Vaccines have lost some potency against infection with the new variants, although they continue to provide protection against severe illness and death. And a large number of Americans were infected during the Omicron surge, contributing to the misperception that the battle was over.
Consulting services also contribute to customers’ lack of enthusiasm. Daryl Richardson, 37, of Baltimore, said he has no plans to vaccinate his three children, in part because the number of doses recommended is constantly changing.
“First it was a shot, then a booster, and then another booster,” he said.
After studying the dangers of the pandemic with their children for so long, parents are now faced with new questions, some so complex that even regulators and experts must also be confused. Which vaccine is better? How good and for how long will they work? And why bother, if the majority of children have been exposed to the virus?
Both the Pfizer-BioNTech and Moderna injections are considered safe for young children and both yield similar protective blood antibody levels as in adults. But neither offers the magical protection offered by adult vaccines in the early days of the pandemic.
Moderna’s vaccine seems to induce 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 few providers are able to offer it as an alternative to the Pfizer vaccine.
The Pfizer-BioNTech vaccine is more familiar and causes less fever, but children will need three doses to be protected from the virus. While it takes 90 days to achieve the most protective effect, the effect can last longer, compared with the Moderna regimen.
“It will be extremely difficult to do these two rollouts,” said Katelyn Jetelina, a public health expert and author of the widely read newsletter.Your local epidemiologist. ”
“It will take a lot of initiative to talk about the difference between these two factors and the impact of taking advantage of one over the other,” she said.
A head-to-head comparison of the two vaccines might provide some answers for parents, experts said in an interview, but it is neither possible nor advisable. There is just so much variation in the way vaccines are developed and evaluated.
Dr William Towner, who leads vaccine trials for both Moderna and Pfizer at Kaiser Permanente in Southern California, said: “It’s really impossible to say which is better than the other.
The choice may depend more on whether parents are willing to get three or two doses and what vaccines their provider has available, he said.
Many vendors are unfamiliar with Moderna, which has so far relied solely on the Pfizer-BioNTech vaccine. About 350 million doses of that vaccine have been management for Americans overall, compared with 223 million doses of Moderna vaccine and about 19 million doses of Johnson & Johnson vaccine.
For young children, states have Ordered so far 2.5 million doses of Pfizer vaccine and 1.3 million doses of Moderna vaccine. These numbers are lower than expected, with 18 million children in this age group.
Older children are still slow to learn. The Pfizer-BioNTech vaccine is approved for use in children 5 to 11 years old in November, but less than 30 percent in that age group received two injections.
Overall, vaccines have proven to be very safe, but many parents are still hesitant for a variety of reasons. Some are wary because the vaccine is relatively new, or because they consider the risk from Covid-19 to be negligible to their children.
Some parents may not care because their children have out of 75 percent is believed to have been infected. However, the CDC scientists note that vaccination provides stronger and more consistent protection even if a child is already infected.
There are still other parents who have moved on from the pandemic.
In Middletown, Ohio, some parents are more concerned with staying cool during a summer heatwave than with the risks posed by the coronavirus. Tori Johnson, 25, has not been immunized and said she has no intention of immunizing her two daughters, 7-year-old Liliana and 9-month-old Rosalina.
Life has returned to normal, she said.
Simone Williams, 32, said she was hesitant to vaccinate 1-year-old twins Caidon and Arissa and 4-year-old Bryan. “I’ll get it for them if it’s requested, but otherwise I’m in no hurry,” Ms Williams said.
Some pediatricians are preparing to explain to parents the value of immunizations. Even routine immunizations are a hot topic in many parts of the country.
Dr. Lindsey Douglas, pediatrician and medical director of quality and safety at Mount Sinai, said: “Kravis Children’s Hospital in Manhattan.
Dr Douglas added: “Over the last two and a half years, there’s certainly been a lot of information out there. “But there’s also a lot more misinformation out there.”
In some ways, the odds against vaccine use among the youngest children are overlapping.
Both Moderna and Pfizer-BioNTech vaccines have produced spectacular estimates of efficacy in adults, far exceeding expectations and raising hopes for a virus-free future.
But while vaccines are slowly being tested in young children, the virus has mutated rapidly, each new form more elusive and challenging than the previous ones.
The latest versions of the Omicron variant have evolved to partially avoid not only the two-year-old vaccine, but even the immunity created by the Omicron form infection that circulated just a few months ago.
Initial efficacy estimates in adults were 95%. That number has now given way to 51% for two doses of the Moderna vaccine in children 6 to 23 months and just 37% for children 2 to 5 years old.
As low as it may seem, two doses of Pfizer’s vaccine don’t even meet the Food and Drug Administration’s requirement for an immune response, justifying the agency’s decision in February to delay it. vaccine evaluation until the company has tested three doses.
“As a mother, I think it is unacceptable that it takes so long to vaccinate our young children,” Dr. Jetelina said. But “as an epidemiologist, I also know the value of doing rigorous clinical trials and finding the right dosage.”
Based on data, the FDA this week approved two doses of Moderna vaccine and three doses of Pfizer-BioNTech as the “main series” for young children.
If officials determine that even the youngest children need booster shots of the variants in the future, the children will need a third dose of Moderna and a fourth dose of Pfizer.
In bulletins and in data reported to federal regulators, Pfizer estimated the effectiveness of three doses of the vaccine to be 80 percent. However, that calculation was based only on three children in the vaccine group and seven in the placebo group, making it an unreliable metric, CDC advisers noted at a meeting on Thursday. Friday.
Dr Sarah Long, an infectious disease specialist at Drexel University School of Medicine, said: “We should just assume we have no data on efficacy. But Dr Long said she was “comfortable enough” with other data supporting the vaccine’s effectiveness.
Parents of the youngest children may be more willing to choose the Covid vaccine if it can be given alongside other routine immunizations. Dr. Towner said either vaccine would be better than none, but he predicts that more parents may choose Moderna.
“Honestly, it can be a bit difficult for some parents to do three doses instead of two,” he added. “If they have a choice, and if both are available, that might make some parents like Moderna.”
Some parents won’t need convincing. In Alexandria, Va., Erin Schmidt, 37, said the news was “life-changing” because her family was living in an “alternating isolated reality.” After vaccinating her 2-year-old daughter, Sophia, she plans to open a bottle of champagne, take Sophia to a museum and “breathe the world”.
Brendan Kennealy, 38, of Richfield, Minn., said that after his two daughters, 4-year-old Hazel and 1-year-old Ivy, are vaccinated, he and his wife Jocelyn, 35, will drive them to the lakeside town Duluth, where they plan to try the new restaurant and attend an outdoor concert by a local folk band called Tracked by Turtles.
The family had to avoid spending time indoors with his mother, who has lupus and is prone to severe Covid. His children missed the state fair, dropped out of swimming lessons, and gave up gymnastics.
“I’ve been very, very happy a few times in the past, and then they pull the rug out,” Kennealy said of the FDA’s halting progress on children’s vaccines.
“Those glimmers of hope were unnecessarily defeated,” he added. “Until we’re at Walgreens or wherever we take them to get their stuff and their Band-Aids, I’m trying to keep that up.”
Adam Bednar contribution reports from Baltimore, Christina Capecchi from Richfield, Minn., Ellen B. Meacham from Oxford, Miss., and Kevin Williams from Middletown, Ohio.
