When will children get a COVID-19 vaccine? It's going to be a while
Children are not included in the ongoing trials for a COVID-19 vaccine, so it's likely to be well into next year or beyond before they'll be able to get vaccinated against the coronavirus that causes the disease.
Some say that's not a problem because the vast majority of children don't get severely ill from COVID-19.
Others argue that kids can still pass on the virus – to teachers, parents, grandparents – and that we won't be able to truly end the pandemic without vaccinating children.
In a Monday conversation with reporters, Emory University School of Medicine pediatric infectious disease specialist Dr. Evan Anderson called for a rapid expansion of clinical trials to include children, ideally providing results in time for them to be vaccinated before the 2021 school year.
"We owe it to our children not to delay moving forward with initial studies to evaluate promising vaccine candidates," said Anderson, also at Children’s Healthcare of Atlanta, and an investigator for the Moderna-National Institute for Allergy and Infectious Diseases trial of the candidate vaccine mRNA-1273.
Childhood deaths from COVID-19 are approaching those from the annual flu, Anderson said and reported in a paper published Friday with colleagues. Both infection and death rates from COVID-19 are close to those caused by hepatitis A and varicella before those vaccines were introduced, he said.
Despite those statistics, Dr. Barry Bloom, an immunologist at the Harvard T.H. Chan School of Public Health, said he thinks it's better to wait until trials in adults have shown which candidate vaccine is likely the safest for children.
Then, Bloom said, trials should be launched first in areas that have good record-keeping on childhood vaccinations. Good data, he said, is essential to keep track of any side effects from the vaccines.
He suggests vaccinating everyone in a school at once – students, teachers and administrators – "so everyone in that school is equally protected."
Role of young people in disease
Young people ages 15-30 are the biggest transmitters of the coronavirus, Bloom said, because they are the most social and the least likely to wear masks and maintain social distance.
To prevent the virus' spread, it makes sense to vaccinate this age cohort in particular, he said. But this is also a difficult group to reach, because they aren't already on the schedule for vaccinations, and often skip annual physicals.
Children have been largely spared the worst effects of COVID-19, representing more than a quarter of the U.S. population but less than .1% of deaths, said Dr. Paul Offit, director of the Vaccine Education Center and an attending physician at Children's Hospital of Philadelphia.
Offit said he thinks vaccinations for people under 18 should be phased in, starting with adolescents and slowly moving down to younger kids.
Dosage may also be different with age, as it is with the diphtheria and pertussis vaccine, so that will take time to work out, he said.
The drug companies also are taking different strategies to including children and adolescents in clinical trials.
Pfizer has already lowered the age of its trial participants to 16, looking to test the vaccine for safety and effectiveness in older high schoolers. The company also is working with regulators on a plan to study younger children, according to spokesman Steven Danehy.
"The earlier we can understand the safety and efficacy of this population, the sooner they will be able to receive our potential vaccine, if approved, and the sooner we will be able to determine if the vaccination of children could prove an important public health strategy to prevent spread of SARS-CoV-2," he said in an email.
Similarly, Moderna said it is preparing to begin testing in children.
"Now that Moderna has sufficient safety data in adults, we plan to be starting pediatric trials in the near future, subject to regulatory approval," according to a statement from the company, which declined to provide further details.
AstraZeneca, the third company currently testing a candidate vaccine in large, Phase 3 research, plans to keep its focus on adults.
"Our current priority is to gather evidence on the potential of the vaccine to protect populations that are more vulnerable to severe outcomes," a spokesman said. "Enrollment of children will start once sufficient data are gathered in adults, indicating that AZD1222 has the potential to be safe and protective in children."