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  • Children over 5 years old now have access to COVID-19 vaccines in the United States.
  • But parents with younger children are still waiting.
  • Experts say key data are expected at the end of this year.

Parents with young children have been waiting for months for vaccines to be made available for them in the United States. This week, the Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC) gave the go-ahead for children ages 5 and over to get a COVID-19 vaccine.

But parents with children under 5 years old are still waiting to find out when or if their kids can get the COVID-19 vaccine.

The good news is the wait may be over in the coming months.

What studies are going on right now?

“Vaccine trials in children ages 6 months to 5 years are underway in the United States and under careful supervision by the FDA,” said William Schaffner, MD, professor at Vanderbilt University School of Medicine in Nashville, Tennessee.

Key data about how vaccines affect children from 6 months and older are expected to be released in the coming months.

In September, Pfizer and BioNTech released early data from vaccine trials including children as young as 6 months and up to 11 years old. They estimated that key data would be available about the vaccine efficacy and safety for children ages 6 months to 5 years by the end of the year or early 2022.

How children are affected by COVID-19 compared to adults

Throughout the pandemic, children have been less likely than adults to have serious reactions to COVID-19, although thousands have been hospitalized and hundreds have died.

One reason is that children have low levels of a specific enzyme in their respiratory tract compared to adults.

“Young children have low levels of the angiotensin-converting enzyme (ACE) in the cells of the respiratory tract. This ACE enzyme facilitates the attachment of the coronavirus to the mucosa,” said Kunjana Mavunda, MD, pediatric pulmonologist at KIDZ Medical Services in South Florida.

Since they have low levels of the enzyme that accept the coronavirus into the body, they don’t get easily affected.

Some children still do have long-term effects of the disease.

“Unfortunately, some young children develop severe systemic symptoms after infection with COVID-19 — and then can either have more deaths or develop long-term chronic complications that may affect the heart, lungs, and brain,” said Dr. Mavunda.

As the research is ongoing, a key factor for FDA researchers and CDC panel experts who review safety data will be examining if children have a higher risk of complications if they develop COVID-19 than if they get a COVID-19 vaccine.

Currently, serious adverse reactions to COVID-19 vaccines have been extremely rare.

Over 30,000 kids were hospitalized with COVID-19, particularly in August when the Delta variant was rapidly spreading, and 587 children have currently died from COVID-19.

Some children have also had symptoms of long COVID or in rare cases a post COVID-19 syndrome called multisystem inflammatory syndrome in children or MIS-C, that can result in needing to be hospitalized.

Studies of children may take longer than those for adults

Studies among children may take longer than in adults.

“There are other physiological aspects that need to be considered when studying the effects of the vaccine,” said Mavunda. “Therefore, it will take many more months before a vaccine is available for this age group (children under 5 years old).”

One key factor during these studies is figuring out the right dosage. For children ages 5 to 11 they will get about one-third of the dose given to people over 12 years old.

The right dosage for kids is quite different from adults and needs to be accurate for it to be harmless. “Scientists and pharmaceuticals are very cautious when they conduct vaccine trials, especially with young children,” said Mavunda.

If data from Pfizer and BioNTech studies of children ages 2 to 5 and 6 months to 2 years old show that the vaccine is safe and effective, there will be more steps before the vaccine is authorized for younger children.

Dr. Schaffner said that while the full study data hasn’t been released, the current evidence is promising.

And he said that the vaccine is “certainly much safer than developing COVID-19.”

“I anticipate that the use of COVID-19 vaccines in young children may be very safe compared to the other vaccines routinely used in children,” said Schaffner.

Will parents be hesitant?

A September survey with more than 1,500 adults discovered that 23 percent of parents said that they would get their children under 5 years vaccinated immediately once it’s ready while approximately 35 percent were against that idea.

Generally, “it is up to the people who live with these young children to prevent exposing them to the coronavirus — at least till there’s a vaccine,” Mavunda said.

At this point, concerned parents can take steps to safeguard young children from COVID-19, and a key step remains vaccines.

“The most effective way of doing this is to make sure that all eligible children over 5 years and adults get the COVID-19 vaccine. By getting the vaccine, they may be less likely to carry the coronavirus and transmit it to younger children,” Mavunda said.

 



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