COVID-19 vaccines may be available for younger teens by the end of the year, with research studies underway involving elementary-school-age children and babies. But what are the risks? And what are families supposed to do in the meantime?
As COVID-19 vaccine production ramps up and more and more Americans are immunized (over 20 percent of the population had received at least one dose by mid-March), it’s easy to start dreaming about your family’s return to normal life — taking that postponed vacation, visiting relatives, letting your kids go to summer camp and then back to school full-time in the fall.
But then it dawns on you that while you may soon be vaccinated (if you haven’t been already), children aren’t going to get their shots for quite some time.
“It’s possible we will have approved vaccines for children 12 to 15 by late 2021,” said Robert Jacobson, MD, a pediatrician and medical director for the population health science program at the Mayo Clinic in Rochester, Minnesota, who shared insights at a media briefing. For kids under 12, the wait is going to be even longer.
What does that mean for your family and for society’s hope of returning to some degree of normalcy?
How COVID-19 Is Impacting Children
Fortunately, children have proven to be much less likely than adults to develop COVID-19. According to Dr. Jacobson, some 2.4 million children under age 18 have contracted the novel coronavirus. This compares with nearly 30 million adults with confirmed cases, according to Johns Hopkins University, which is tracking the virus.
Those children who do get sick generally have mild cases, many with no symptoms at all, reports the Centers for Disease Control and Prevention (CDC).
This is why children make up less than 1 percent of deaths from COVID-19, Jacobson said. Still, because the disease is so widespread, this has meant more than 300 kids have died.
Of course, as with adults, some children are more vulnerable to severe disease than others. Kids with underlying medical conditions do worse, the CDC reports, especially those with asthma, diabetes, sickle cell disease, genetic heart defects, obesity, or an immunocompromised condition, along with babies under 1 year old.
In rare cases, children can develop a serious medical complication not seen in adults. It is unclear what makes a child susceptible to this condition, known as multisystem inflammatory syndrome in children (MIS-C). According to the CDC, over 2,600 children in the United States have developed MIS-C, resulting in 33 deaths.
One Vaccine Is Currently Authorized for Older Teens
In order to gain approval for their COVID-19 vaccines, pharmaceutical companies first test their most promising candidates in adults. Pfizer-BioNTech studied its vaccine in countries where 16 is the age of consent to participate in clinical trials. Because Pfizer therefore had data on its vaccine in 16- and 17-year-olds, the Food and Drug Administration (FDA) granted emergency-use authorization for Americans 16 and older.
Moderna tested its vaccine in individuals 18 and over, and therefore the FDA authorized it for people only in this age group. The same is true for Johnson & Johnson’s vaccine, developed by its subsidiary Janssen Biotech.
Researchers Are Testing COVID-19 Vaccines in Younger Adolescents
Once pharmaceutical companies prove that their vaccines are safe and effective for adults, companies can begin the next round of studies, in younger adolescents. This order is necessary because review boards at hospitals and other institutions that conduct the research will be more likely to green-light a vaccine after they have these safety results from adults, Jacobson says.MORE ON CORONAVIRUS
In September 2020, Pfizer began enrolling kids ages 12 to 15 for its next study; Moderna started recruiting kids 12 to 17 starting in December 2020 and launched a trial for children ages 6 months to 11 in March 2021. Johnson & Johnson is reportedly planning a round of clinical trials in children, possibly including infants.
The Pfizer and Moderna studies for kids 12 and up are expected to be completed sometime this summer. If the research confirms safety and effectiveness, the FDA will likely extend emergency use authorization to these age groups.
Experts are optimistic this will be the case. “There’s no reason to suspect the vaccines won’t work as well in children as they do in adults,” says Marcos Mestre, MD, chief medical officer of Miami’s Nicklaus Children’s Hospital, although he notes no one can be certain until the data is in.
Studying Vaccines in Children Is Difficult
Conducting a clinical trial involving minors is more challenging than research that studies adults, Jacobson said at the media briefing.
Government rules require that no child be put at unreasonable risk. This is why having safety data on adults helps ensure children will not be endangered from participating in the research.
Plus, for these studies, “you have to recruit both the parent and the child,” Jacobson pointed out, since the process requires a commitment from both. And because anyone can leave a clinical trial at any time for any reason, researchers have to select the families they think will be least likely to change their minds.
Some Vaccines React Differently in Children
The history of vaccine research shows that children sometimes don’t have the exact same immune reaction as adults. “One reason we rely on studies of children rather than make extrapolations is that age can go both ways,” Jacobson said at the media briefing.
For example, children under 6 months can’t be immunized for flu because they don’t develop any antibodies after the injection. Similarly, MMR vaccines (for measles, mumps, and rubella) don’t work as well in babies under age 1.
On the other hand, children have stronger reactions than adults to other vaccines, notably for the human papillomavirus (HPV). This is why children under 15 need only two doses, while older teens and adults require three.
“It may be that as we get into the younger ages, we will have to change the dose or the schedule of the COVID-19 vaccines,” Jacobson said.
Because of their more robust immune systems, children might also experience stronger side effects than adults, as young adults have been found to do with the COVID-19 vaccine. But even if they do, temporary symptoms like body aches, fever, and the like are far outweighed by the benefits of being protected from this deadly disease, Jacobson stressed.
What Your Family Should Do Until Kids Are Vaccinated
As adults continue to get immunized, COVID-19 rates in many communities are expected to decline. If this happens, parents might be able to loosen some of the constraints their children have lived with for nearly a year.
For example, it may be okay for children to have more social experiences this summer than last, Dr. Mestre says, including seeing friends or traveling.MORE ON CORONAVIRUS
Still, when participating in these activities, children should continue to wear masks, social distance, and follow all guidelines — just as adults should do, Mestre says.
If you’re evaluating a summer camp, ensure that they, too, plan to follow social distancing and masking indoors, and that they will hold most activities outside. Mestre advises asking a prospective camp about the staff’s vaccination rate (the higher the better), and monitoring the rate of virus spread in the community where the camp is located, since high levels of community spread make infection more likely.
Some Children Remain at High Risk
Of course, if you or your child have a preexisting condition that raises the risk of COVID-19 complications, make sure to take all the right precautions to keep the virus out of your lives.
That’s especially true in households where one or more adults cannot receive a vaccination, such as those with prior allergic reactions to ingredients in the vaccines.
For the rest of us, once we’ve gotten our shots, we should feel more comfortable being around our children, confident that they cannot unwittingly make us sick, Mestre says. But until the virus is fully vanquished around the country, it’s still important to recognize the threat.
Article originally posted on EveryDayHealth
