Paxton Bowers, 5, was vaccinated against Covid at a children’s hospital in Texas in November. Credit … Meredith Kohut for the New York Times
Centers for Disease Control and Prevention on Saturday recommended vaccines against Covid for 6-month-olds, who were among the last Americans to qualify for the vaccines. Parents should be able to start immunizing young children on Tuesday.
Federal regulators have already approved the Moderna vaccine for children aged 6 months to 5 years and the Pfizer-BioNTech vaccine for children aged 6 months to 4 years. (Pfizer-BioNTech vaccine is available for children aged 5 and over from November.)
All children 6 months of age and older, including those who have already been infected with the coronavirus, should be vaccinated against Covid, said Dr. Rochelle P. Valenski, director of the CDC, in a statement.
“Along with science leading the way, we have taken another important step forward in our nation’s fight against Covid-19,” she said. “We know that millions of parents and caregivers are eager to vaccinate their young children, and with today’s decision they can.”
VideoDr. Rochelle P. Valenski, director of the Centers for Disease Control and Prevention, approved the decision after a scientific panel backed the photos, despite reservations about the lack of data. CreditCredit … Centers for Disease Control and Prevention
Following meetings on Friday and Saturday, the agency’s scientific advisers strongly supported the vaccines, despite reservations about the scarce data, especially on the effectiveness of the Pfizer-BioNTech vaccine.
The CDC panel heard evidence supporting the effectiveness of vaccines in young children, but repeatedly urged Pfizer to evaluate it and noted that three doses of this vaccine would be needed compared to two doses of Moderna.
Both vaccines are safe and both produce levels of antibodies similar to those seen in young adults. But CDC advisers struggled with the difficulty of recommending two very different vaccines for the same population.
“Implementing these two implementations will be an incredible challenge,” said Caitlin Jetelina, a public health expert and author of the widely read bulletin “Your Local Epidemiologist.”
“There will have to be a lot of proactive communication about the difference between the two and the consequences of taking one over the other,” she said.
In its clinical trials, Moderna found that two injections of its vaccine, each with a quarter of the adult dose, produced levels of antibodies that were at least as high as those seen in young adults.
The company estimates the effectiveness of the vaccine against symptomatic infection at about 51 percent among children aged 6 to 24 months and 37 percent among children aged 2 to 5 years.
The side effects are minor, although about one in five children has had a fever. Efficacy against severe illness and death is thought to be higher, similar to the effects seen in adults.
Based on these data, the FDA approved two injections of the Moderna vaccine, at four-week intervals.
The Pfizer-BioNTech vaccine also elicited a strong immune response, but only after three doses, company officials told scientific advisers on Friday.
Two doses of the vaccine are inadequate, they said, justifying the FDA’s decision in February to postpone the vaccine’s approval until regulators have data on three doses. Two doses may not have been enough because the company gave children only one-tenth of the adult dose for each injection, some counselors said.
The vaccine has an overall effectiveness of 80 percent in children under 5, Pfizer researchers said Friday. But that estimate is based on only three children in the vaccinated group and seven who received a placebo, making it an unreliable indicator, CDC advisers said.
“We just have to accept that we don’t have data on efficacy,” said Dr. Sarah Long, an infectious disease expert at Drexel University College of Medicine. But Dr Long said it was “comfortable enough” with other data to support the vaccine’s effectiveness.
Three doses of the Pfizer vaccine produced levels of antibodies comparable to those seen in young adults, suggesting that it is likely to be just as effective.
“Pfizer is a three-dose series, but as a three-dose series it is quite effective,” said Dr. William Towner, who is leading vaccine trials for both Moderna and Pfizer at Kaiser Permanente in Southern California.
Any vaccine would be better than none, Dr. Towner added. He predicts that some parents may choose Moderna because taking children to a pediatrician for two injections is easier than arranging to get three.
The Pfizer vaccine was approved for children aged 5 to 11 in November, but less than 30 percent in this age group received two vaccines. In a CDC survey, about half of parents said they would vaccinate their children in February, but by May, only a third of parents said they intended to do so.
Councilors discussed whether vaccination improves protection against serious illness in children who have already been infected. There is little information available on children aged 5 to 11 due to poor vaccine absorption in this age group.
But in adults, infection with an earlier version of Omicron is not enough on its own to protect against newer versions.
Vaccinations will still be needed to protect children from future options, experts concluded. “This combined defense is indeed the safest and most effective,” said Dr. Sarah Oliver, a CDC scientist who led the discussion on Saturday.
Parents of young children may be more likely to choose a vaccine against Covid if it can be offered along with other routine immunizations, Dr. Towner said.
“This is an area where many people are unsure at the moment,” he said. “I hope that some guidelines will be offered.”
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