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For American parents, especially those with young children, the past few months have been more than dizzying and frustrating.
In early February, federal regulators announced they would be evaluating Pfizer-BioNTech’s coronavirus vaccine for the youngest children – only to shelve that plan after 10 days, citing doubts about the vaccine’s effectiveness in that age group.
Soon after, scientists discovered that the vaccine was only weak protector against infection with the Omicron variant among children aged 5 to 11 years, and offer a little defense Against moderate Covid disease among adolescents aged 12-17.
On Monday, Florida’s surgeon general cited these data as saying that healthy children no need to be vaccinatedThe advice, which White House press secretary Jen Psaki described as “deeply disturbing.”
Despite all this, experts noted that although the Omicron variant can penetrate immune defenses and infect humans, vaccines still continue to support vaccines. prevent serious illness and death – and it can do that for years.
The Centers for Disease Control and Prevention found: record number of children The hospitalization of children under the age of 5 during the Omicron surge highlighted the need for vaccinations for these children. But the agency has since said that 90 percent of Americans can safely stop wearing masks in closed public places, even in schools with young children.
Who can blame the parents for feeling confused?
st. “The confusing part is that there doesn’t seem to be a clear and correct answer anymore,” said Anne Gonzalez, a 41-year-old mother of two who manages volunteers for a large religious nonprofit in St. “I got to a point where I thought the only thing I could do was right for my family.”
Fortunately, the coming weeks should bring some clarity. Both Pfizer and Moderna plan to report the results of trials of their vaccines in young children. The results, if positive, should lead to a new round of regulatory scrutiny that could allow vaccinating tens of millions of young people, perhaps as early as April.
But these findings will come as the Omicron variant disappears in the United States, complicating parents’ decisions about whether or not to vaccinate children.
Less than one in four children aged 5 to 11 are currently fully vaccinated. More than half of adolescents aged 12 to 17 years were fully vaccinated, but only about 12 percent received a supplemental dose. These percentages even lower in rural areas United states.
Children are less likely to experience illness, so the balance of risk and benefit has never been the same as adults. And so far, 95 percent of the country is protected from the virus to some degree due to vaccines or previous infection. Latest data from CDC.
Experts worry that the latest findings make it even more difficult to persuade some parents to vaccinate their children.
“The data should disappoint us — we wish it was better,” said Luciana Borio, former acting chief scientist for the Food and Drug Administration. “But in the near term, it’s important that parents continue to vaccinate children.”
He said the country could still see a surge in the fall or winter, and the best protection for kids would be to get at least two vaccinations before then.
Vaccines continue to prevent serious illness and death, even with the Omicron variant. A physician at the University of Maryland School of Medicine and a member of the infectious diseases committee of the American Academy of Pediatrics, Dr. James Campbell said this trend is particularly evident in hospitals.
Dr. Campbell said of her pediatric patients who were sick enough to need a mechanical ventilator or die, “every one is unvaccinated.”
A Dosing Conundrum
Recent research shows that the problem is the dose rather than the vaccine.
In trials in adults in 2020, vaccine manufacturers made the best guesses at the correct dose and chose short intervals between vaccines to protect people as quickly as possible during the initial surge.
Pfizer-BioNTech and Moderna vaccines have proven to be safe and potently protective in clinical trials and are soon authorized for use. Trials in children, however, were complicated by the arrival of the Delta and Omicron variants, and the vaccine appeared to be less protective in children aged 2 to 4 years.
Currently, the Pfizer-BioNTech vaccine is the only vaccine allowed for children. (The vaccines by Modernna and Johnson & Johnson are approved for adults only.)
In the Pfizer trials, adolescents aged 12 to 17 years were given 30 micrograms, the same dose given to adults. But children aged 5 to 11 years were given 10 micrograms, and children 6 months to 5 years old were given only three micrograms.
These doses may be too low to elicit an adequate and sustained response. But federal officials who saw the data told The New York Times that higher doses produced too much fever in children.
What should you do if you cannot give a high enough dose to protect children against the Omicron variant due to side effects? That’s the problem scientists and federal officials are grappling with right now.
Pfizer and BioNTech are now testing a third dose in children under 12 to determine if it can provide the level of protection that two doses failed. The FDA is still evaluating the Moderna vaccine for use in children ages 6 to 11. rejected an application For authorization of the Indian-made vaccine Covaxin for children.
There are other Covid vaccines that may work for children, such as those made by Novavax and Sanofi. Experts said federal health officials should consider all these options and test whether a different dose or a longer interval between doses would improve the immune response.
Dr. “It seems to me that vaccines for children are taking longer than they should, given the importance of protecting this population,” Borio said. “The sooner we energize our search for safe and effective vaccines for children, the better we will be.”
Masks in Schools
The disappointing findings, combined with the falling Omicron surge, have greatly complicated policy decisions for local health officials.
Opposing Florida’s recommendations, Louisiana and California will require schoolchildren to be vaccinated by the fall of 2022, and the District of Columbia has set a March 1 deadline for full immunization of students aged 12 and older.
Hemi Tewarson, executive director of the National Academy of State Health Policy, a neutral organization, said other states could adopt similar policies, but only if the FDA gives full approval for the vaccine for use in school children.
“For many, this will be the key to making vaccines mandatory,” he said.
A school vaccination requirement would alleviate the fears of many families with children with medical vulnerabilities.
Nearly every member of Heather Keever’s family, including her 14-year-old son, Wesley, has heart disease, high blood pressure, and kidney disease. However, Ms. Keever, 42, a counselor in suburban Chicago, said they are not technically qualified for accommodation at work or school because they are not immunocompromised.
“They forget that some of us are literally the ones who can’t take the mask off,” he said, at least until the odds drop much more. “I felt like I was unimportant, unimportant, and arguably expendable. And I still do.”
Some scientists have also said they will continue to wear masks until the numbers drop due to the risk of infection.
“I would be very hesitant to ask a child under the age of 5 to remove a mask indoors,” said Akiko Iwasaki, a longtime immunologist at Yale University who has worked on Covid-19. long after the acute infection has resolved.
Given the mixed results on the efficacy of vaccines and mixed messages on the benefits of masks, families are weighing the risks themselves and coming to very different conclusions.
Jennifer Steinberg, a management consultant in Wilmington, Del., has two daughters who share time with her and their immunocompromised father.
Ms. Steinberg said of the vaccine, “Yes, it’s great, it protects against serious diseases.” “But if your children are still going to be infected, that is a major disruption in their family life. I’ll probably stay masked for the foreseeable future.”
Katie Sunderland of Arlington, Va. has long been ready to let go of the masks. If her 7- and 5-year-olds get infected, “if they can unmask and see faces, that’s fine with me,” she said.
“I am not convinced that wearing a mask will significantly reduce the risk of contracting Covid – especially not the kind of masks I see most children wearing,” said Ms Sunderland, 37. “It doesn’t make sense to me to hinder my children’s development for this very, very, very low risk.”
But many other parents are still unsure of what to do. Ms. Gonzalez said she has a niece and nephew with congenital heart defects and problems with lung capacity and that she will continue to wear masks to protect them.
But if his son’s school lifts the mask requirement, “we don’t know what to do yet”.
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