T
he one question I have been getting lately from parents in my practice is, "When can our kids get a COVID vaccine?"I have been giving them all the disclaimer that my opinion is just that, and largely speculation, because there is very little available information about this issue. It is however, a very important question because, in order to achieve community immunity from COVID-19, we will likely need to vaccinate more than just adults. The American Academy of Pediatrics have been pleading that clinical trials with children begin as soon as possible, with the goal of moving toward more comprehensive protection for children and the community, and also to restore a more typical school and extracurricular life experience.
This causes some ambivalence among parents, since children are less often severely affected by COVID-19. But many parents realize that as mildly affected or asymptomatic carriers of SARS-CoV-2, kids can be a highly effective delivery system for the virus to get to those who are vulnerable. We have seen this previously with influenza. When the kids are protected, the vulnerable benefit dramatically. But, especially since kids are not the primary victims, it is as important as ever to ensure that the vaccines are safe and effective, and that takes time.
Typically clinical trials take years, but because of the advances in efficiency of development and production of COVID-19 vaccines, and because the virus is so common in the community, clinical trials can occur more expeditiously than traditionally — while still adhering to rigorous standards of evaluation.
Moderna and Pfizer have enrolled kids down to age 12 in their clinical trials, and I'm hoping we will see the results of those trials soon, which could mean kids down to age 12 may be able to receive protection before the next school year. Recently, Moderna announced it was seeking to enroll 6,750 children ages 6 months to 12 years for trials. The first stage will be trials with children 2 years to 12 years, giving either a 50 microgram- or a 100-microgram dose to test for adequacy of response with fewest side effects. Next they plan to include children from ages 6 months to 2 years who will receive either a 25-, 50- or 100-microgram dose to assess for ideal response with minimal side effects.
This is exciting news. If we want to get back to a more normal life where young people can sit closer than 3 to 6 feet at school, have play dates and birthday parties, and go to Disneyland, then we need to pursue a safe and effective vaccine option for children. Time will tell whether the vaccines will be modifiable to protect against variants, but what can be counted on is that the fewer opportunities the virus has to replicate in the community, the fewer its chances to develop variants.
Fortunately, in the Advisory Committee on Immunization Practices, there are strong advocates for the health and well-being of kids, committed to ensuring the safety and effectiveness of vaccines given to children. This panel is composed of the best and brightest from pediatrics, internal medicine, vaccinology, immunology, infectious disease, epidemiology and public health. These are just the right experts to be entrusted with guiding us all to a safer world.
Matt Thompson is a pediatrician at Spokane's Kids Clinic.
