Small Needles, Short Lines and Few Tears: Biden’s Plan to Vaccinate Young Children
White House officials, anticipating the approval of coronavirus shots for 5- to 11-year-olds within weeks, will rely on doctors, clinics and pharmacies instead of mass inoculation sites.,
WASHINGTON — The campaign to vaccinate young children in the United States against the coronavirus will not look like it did for adults. There will be no mass inoculation sites. Pediatricians will be enlisted to help work with parents. Even the vials — and the needles to administer doses — will be smaller.
Biden administration officials, anticipating that regulators will make the vaccines available to 5- to 11-year-olds in the coming weeks, is laying out plans to ensure that some 25,000 pediatric or primary care offices, thousands of pharmacies, and hundreds of school and rural health clinics will be ready to administer shots if the vaccine receives federal authorization.
The campaign aims to fulfill the unique needs of patients largely still in elementary school, while absorbing the lessons from the rollout of vaccines to other age groups.
This month, Pfizer and BioNTech asked the Food and Drug Administration to authorize emergency use of their vaccine for 5- to 11-year-olds, a move that could help protect more than 28 million people in the United States. A meeting to discuss the authorization is set for Oct. 26, and an F.D.A. ruling could come in the days after, possibly clearing a path for the Centers for Disease Control and Prevention to make recommendations on a pediatric dose in early November.
If that happens, the Federal Emergency Management Agency will provide reimbursement for “full funding to states to support vaccinations and outreach,” said Sonya Bernstein, a senior policy adviser for the White House Covid-19 Response Team. That support would involve site setup as well as logistical help like providing transportation to and from vaccine sites.
“We know that access is going to be critical here,” Ms. Bernstein said, adding that the administration has in recent weeks looked at ways to provide a “kid-friendly experience that makes sure that we’re getting shots in arms with trusted providers in ways that makes parents feel comfortable.”
The process will not look or feel the way it did when other groups in the United States were first authorized to receive vaccines. The 5-to-11 age group, with 28 million children, is far larger than the 12-to-15 group, with 17 million, who became eligible for the Pfizer-BioNTech vaccine in May. But the younger group will not be expected to line up at mass vaccination sites: “We don’t want lines of kids,” said Ms. Bernstein, who pointed out that children tend to be more sensitive patients. (Read: They cry.) Pediatrician’s offices, children’s hospitals and pharmacies with in-store clinics will be the preferred options.
The needles that administer the vaccine and the vials that hold it will need to be smaller to be more easily stored. (The Pfizer dose for children ages 5 to 11 is expected to contain 10 micrograms, rather than the 30-microgram dose used for ages 12 and up.) To keep doses from spoiling, the child-size vials can be stored for up to 10 weeks at standard refrigeration temperatures, and six months at colder temperatures, according to a memo administration officials plan to make public on Wednesday.
Taking cues from what worked when shots were opened to teenagers, whose vaccinations generally require parental consent, officials are also leaning heavily on local health experts, who they believe are more trusted in their communities and can help reach high-risk children. “Children’s hospitals and health systems will be a critical part of our efforts to advance equity and ensure access for our nation’s highest-risk kids, including those with obesity, diabetes, asthma or immunosuppression,” the memo said.
But while the administration aims to eliminate the types of availability and efficiency problems that plagued the initial vaccine process, reluctance has persisted among parents.
What to Know About Covid-19 Booster Shots
The F.D.A. authorized booster shots for a select group of people who received their second doses of the Pfizer-BioNTech vaccine at least six months before. That group includes: vaccine recipients who are 65 or older or who live in long-term care facilities; adults who are at high risk of severe Covid-19 because of an underlying medical condition; health care workers and others whose jobs put them at risk. People with weakened immune systems are eligible for a third dose of either Pfizer or Moderna four weeks after the second shot.
Regulators have not authorized booster shots for recipients of Moderna and Johnson & Johnson vaccines yet. A key advisory committee to the F.D.A. voted unanimously on Oct. 14 to recommend a third dose of the Moderna vaccine for many of its recipients. The same panel voted unanimously on Oct. 15 to recommend booster shots of Johnson & Johnson’s one-dose vaccine for all adult recipients. The F.D.A. typically follows the panel’s advice, and should rule within days.
The C.D.C. has said the conditions that qualify a person for a booster shot include: hypertension and heart disease; diabetes or obesity; cancer or blood disorders; weakened immune system; chronic lung, kidney or liver disease; dementia and certain disabilities. Pregnant women and current and former smokers are also eligible.
The F.D.A. authorized boosters for workers whose jobs put them at high risk of exposure to potentially infectious people. The C.D.C. says that group includes: emergency medical workers; education workers; food and agriculture workers; manufacturing workers; corrections workers; U.S. Postal Service workers; public transit workers; grocery store workers.
For now, it is not recommended. Pfizer vaccine recipients are advised to get a Pfizer booster shot, and Moderna and Johnson & Johnson recipients should wait until booster doses from those manufacturers are approved. The F.D.A. is planning to allow Americans to receive a different vaccine as a booster from the one they initially received. The “mix and match” approach could be approved once boosters for Moderna and Johnson & Johnson recipients are authorized.
Yes. The C.D.C. says the Covid vaccine may be administered without regard to the timing of other vaccines, and many pharmacy sites are allowing people to schedule a flu shot at the same time as a booster dose.
According to polling by the Kaiser Family Foundation published in late September, only about one in three parents of 5- to 11-year-olds planned to get their children inoculated “right away” once a vaccine is authorized. Another third said they wanted to “wait and see” how the vaccine affected children. But that same polling showed that reluctance among parents of teenagers had dropped in the months since vaccines had become available, and nearly half of parents of those ages 12 to 17 said their teenagers had received at least one dose.
Hospitalizations and deaths from Covid-19 are uncommon in children, according to data collected by the American Academy of Pediatrics, but experts point out that children are still susceptible to serious or long-haul versions of the illness.
“Of course, adults are going to have much more severe diseases, but that doesn’t mean that children are not affected as well,” said Dr. Flor Munoz-Rivas, an associate professor of pediatric infectious diseases at Baylor College of Medicine. “Children are typically ones that are vectors of transmitting the virus,” she said, and preventing them from getting infected “could potentially also have some effect” in slowing the spread of the virus.