June 21, 2022, 3:42 p.m. David Mitchell — The AAFP has approved the CDC’s call for all eligible Americans ages 6 months and older to receive COVID-19 vaccinations.
CDC Director Rochelle Walensky, M.D., on June 18 endorsed the recommendation issued by the agency’s Advisory Committee on Immunization Practices that all children 6 months through 5 years of age should be vaccinated against COVID-19.
Walensky and the ACIP took action swiftly after the FDA issued emergency-use authorizations June 17 for vaccines manufactured by Moderna and Pfizer-BioNTech. The CDC noted in a news release that the recommendation expands eligibility for vaccination to nearly 20 million additional children.
The AAFP approved the advisory committee’s recommendation after conducting an expedited review of the evidence and has updated its COVID-19, COVID-19 Vaccine and COVID-19 Vaccine for Children and Adolescents webpages with the latest information.
“The availability of a safe and effective COVID-19 vaccine for children in this age group is a relief for family physicians, parents and caregivers who have anxiously awaited the safety review and authorization of these vaccines,” said AAFP President Sterling Ransone, M.D., of Deltaville, Va., who noted in a statement that children can be vectors of SARS-CoV-2 and also can suffer severe illness themselves. “These newly authorized vaccines safely provide effective protection from serious illness.”
The CDC said in its news release that distribution of vaccines for this age group was already underway, and it noted that pediatric patients may receive vaccines from either manufacturer.
Pfizer-BioNTech’s vaccine is administered in three doses of 3 micrograms each for children 6 months to 4 years old. The initial two doses are administered three weeks apart followed by a third dose at least eight weeks after the second dose.
Moderna’s vaccine is administered in two doses, one month apart, of 25 micrograms each to children 6 months to 5 years old. A third primary series dose, at least one month following the second dose, has been approved for immunocompromised individuals in this age group.
The CDC noted that parents eager to vaccinate their children can visit vaccines.gov to see where COVID vaccines for children are available in their communities.
Just how eager parents will be remains to be seen. Vaccine approval for this younger group of patients comes more than a year and a half after COVID immunizations were first approved for individuals 16 and older. The CDC subsequently recommended COVID vaccines for children ages 12 to 15 more than a year ago and expanded eligibility to children ages 5 to 11 last fall.
However, a recent Kaiser Family Foundation poll found that a little more than half of parents with children ages 6 months to 5 years said they did not have enough information about the vaccines’ safety and effectiveness in young children.
Family physicians and other clinicians can expect questions from parents in light of the latest recommendation. Less than 20% of parents with children younger than 5 who responded to the Kaiser poll planned to get their children vaccinated right away. More than one-fourth said they would “definitely not” get their children vaccinated, and more than 10% said they would not do so unless required.
“COVID-19 vaccines are the most closely monitored vaccines in U.S. history, with excellent safety profiles and with ongoing monitoring for all ages,” said Pamela Rockwell, D.O., of Ann Arbor, Mich., the AAFP’s liaison to the ACIP. “Parents can be assured that COVID-19 vaccines for young children have been carefully studied in thousands of children at the lowest effective dose to produce immunity to COVID with mostly mild side effect profiles, as seen with other vaccines given to this age group.”
Although children are at lower risk of serious illness and death from COVID-19 than adults, family physicians and other health care professionals can help parents understand that the risk is real, and that vaccination is their family’s best defense.
Ransone said family physicians are one of the “most trusted sources for vaccine-related information and services,” capable of providing vaccine counseling and education to families and caregivers for patients of all ages.
As of June 12, there have been more than 578,000 cases of COVID-19 among U.S. infants and nearly 2 million cases among children ages 1 to 4 years, according to the CDC. Among patients ages 6 months to 4 years who were hospitalized with the disease during the omicron surge, nearly one-fourth required intensive care and more than 6 percent required ventilators.
Healthy children aren’t exempt. A March Morbidity and Mortality Weekly Report based on data from 14 states showed that during the omicron surge, 63% of hospitalized infants and children had no underlying medical conditions. The same report found that hospitalization rates among children ages 5 to 11 were twice as high in unvaccinated patients.
Finally, Rockwell noted that parents should be informed that a child with a history of COVID-19 infection does not necessarily have protection from reinfection with the omicron variant.
“Data shows that a history of prior SARS-CoV-2 infection plus vaccination offers more immunity to children to prevent hospitalization against omicron than just having had a history of COVID-19 infection in the past,” she said.
The ACIP is expected to vote on a recommendation regarding Moderna’s two-dose COVID-19 vaccine in children ages 6 to 17 years when it meets again June 22-23.