COVID vaccine for kids: What parents should know

INTERVIEWER: And as you heard during the newscast from National Public Radio, today a federal Food and Drug Administration committee is asking an independent panel of experts to weigh in on whether the Moderna and Pfizer vaccines are safe and effective for young children. The key meeting could determine whether there may finally be a COVID-19 vaccine for kids under the age of five.

Joe Kurland is a vaccine specialist and infection prevention test at Children's Minnesota. He joins us right now to talk about the FDA meeting and what parents and caregivers need to know. Joe, welcome back to Minnesota Now.

SUBJECT: Thank you very much, Kathy.

INTERVIEWER: This past weekend, FDA scientists, as you know, released their own analysis of both vaccines. And according to the report, the Pfizer and Moderna vaccines appear to be safe and effective in very young children. What's today's meeting all about?

SUBJECT: Yeah. Today's meeting is really to share that data publicly, highlight this, and allow the FDA to really confirm that the vaccines are safe, and effective, and are the best option for us moving forward.

INTERVIEWER: What does the science show about the effectiveness of the vaccines in little kids?

SUBJECT: Yeah. I think that's been the tricky point. The first thing I want to say is that the data is really remarkable at just how safe these products really are. And compared to vaccines in the past, these are probably some of the most scrutinized vaccines we've ever had.

And as we're going through this, this pandemic hasn't been monolith. There have been multiple different variants that have come out. And what we had with the original adult strains was the ancestral and the alpha variants had really, really great vaccine efficacy. And what we've seen over time is these new variants have come out, the vaccines haven't been as great at preventing illness.

So you may suffer illness and symptoms if you get exposed. And we're seeing the same thing in the young kids, even with the vaccine, that symptomatic illness still is a breakthrough. But what's really encouraging is that the ER visits-- people that are vaccinated against this, including kids, ER visits, hospitalization, and ICU admissions are just down significantly. And that's really encouraging signs.

INTERVIEWER: Vaccines for young children have followed kind of a convoluted path. There have been some disappointing study results initially, and then delays and changes, two shots, then three. How do you help parents make sense of this?

SUBJECT: Yeah. I think what the manufacturers are trying to do is to walk that fine line of getting the immune system to respond to the antigen or getting them to mount an immune response when the vaccine is given, but not making it such a response that it's going to be problematic for the child or the individual. And Pfizer and Moderna have really worked hard to make sure that they are walking the line as best they can.

And in some ways, it's possible that Pfizer dropped the quantity of that antigen so much that it needed that extra or the third shot to really mount a good response that could be effective at preventing illness. And that was a surprise that it took that extra shot, because the initial data was so promising.

And when they finally got to look at the numbers-- and that's why this has probably been delayed so much-- is that the two-shot regimen from Pfizer really wasn't all that revealing or encouraging. And they went with a three-dose approach, and that's been, actually, a really remarkable outcome.

INTERVIEWER: But I can hear some parents thinking or saying, wow, OK, three shots-- and I'm not sure. It's going to take a bit to get the kids to the doctor, to a clinic to get this done. What about the logistics?

SUBJECT: Yeah. We have three-shot series for other vaccines. The hepatitis vaccine, our Tdap series, Dtaps-- it's not unique to Pfizer or to the COVID vaccine to require three shots. And it's just going to be part of regular clinic visits.

And what we're going to be finding out, I think, in the next few days is exactly what that schedule looks like and what the recommended minimum intervals are. I know that they've proposed from the manufacturers what that should look like. The FDA reviews and licenses it. And then I think the ACIP, with the CDC's committee this weekend, will solidify that and provide clinicians the guidelines and the guardrails on how to practice and administer this safely.

INTERVIEWER: What do you think this will do, Joe, to increase the number of American kids who will be vaccinated against COVID? The uptake hasn't been that great to this point.

SUBJECT: Yeah. And I'm looking at the numbers right now-- Minnesota's reporting that in our 5 to 11-year-olds, only 42% right now are reporting at least one dose. Less than 40% have completed the series. And now that we have boosters available, only 13% are up to date getting their booster shots.

So you're right-- it's not been an overwhelming response like we've seen in the 65-plus population. So I think it's encouraging. I think that those families that are eager and want to prevent this disease are going to go out and get the vaccine.

There's going to be a group of our community that is going to be a little more hesitant. And maybe more wait and see. But what I think is important to point out is kids do get this disease. Kids do get seriously sick from COVID.

And we've seen it in our hospital that very young children can get very sick. And we really don't have good predictions on which kids those will be that will require hospitalization and further care. So in my opinion, and what I've done with my children, is we get them vaccinated because I don't want to be playing that risk every time a new variant pops up-- am I worried about severe outcomes or hospitalization needs?

INTERVIEWER: I was going to ask about that, because, of course, these variants do keep popping up. How do you think the trajectory of the pandemic may change once these vaccines are approved for the littlest kids?

SUBJECT: Yeah. I'm not sure it's going to change the trajectory of the pandemic. This is a coronavirus. And based on other coronaviruses, they circulate year-round. You can have a cold in the summer just as you can have a cold in the winter.

And the goal with the vaccines are really going to be to reduce the likelihood for hospitalization, severe illness, and death. And I think we need to change the mindset about having a vaccine and never falling sick again, and really focus on that this vaccine is going to help protect me and protect my family from needing to get into the hospital, or having a breathing tube, or being put in the ICU.

INTERVIEWER: Or protect maybe grandma and grandpa from getting infected as well by a youngster who has COVID.

SUBJECT: Yeah. I think that's a great point that when we look at the transmission, we have seen that vaccinated people can spread this virus. And that's really kind of disappointing. But compared to an unvaccinated person, your ability to spread this virus is reduced, both in the amount of virus that you're giving off and the amount of time that you have to spread it. So it's really important to get vaccinated, not just to keep you out of the hospital, but also to help limit the amount of spread that can happen in the community.

INTERVIEWER: Do we know how soon the shots would be available?

SUBJECT: So we have our orders placed at Children's Minnesota. We have them in with the state. And we are waiting to hear what our delivery dates are going to be. We're expecting it sometime the week of the 20th. And until we know exactly when that shipment's coming in, we are kind of holding on what our official start date is. But we are planning on hopefully getting shots in arms the week after.

INTERVIEWER: Will you be holding special clinics?

SUBJECT: We're going to be having scheduled appointments that families can call in and make. And like other systems across the state, I think the Minnesota Vaccine Locator tool on the Minnesota Department of Health, MN.gov website, are really great at helping families find where they can go to get doses.

INTERVIEWER: Before you go, what else is missing from this conversation that usually is not brought up?

SUBJECT: Well, I think the other one is that there's a big unknown about what the long-term effects of COVID are going to be. And so there's this post-acute syndromes of COVID, or PASC, or you have what they call long COVID. And children can have those symptoms as well.

And I think we are still learning this, because it just hasn't been around long enough for us to know what the long-term impacts are. But the data that's come out at the FDA this week was really encouraging to show further that what the CDC is seeing as well is that the vaccines are actually showing protection against developing long COVID in all age groups.

So if you're worried about long COVID, you're worried about hospitalization, you're worried about getting sick and spreading it, vaccine is the best way to go. And what also is important is that these variants keep popping up.

And people that got COVID before can have COVID again. I've heard of folks having COVID three, four, or even five times. And prior infection with the virus-- we talked about herd immunity. I think prior infection with the virus or getting sick with COVID isn't reliably providing you that level of protection that will keep you from getting sick, keep you out of the hospital.

And it's just not the best way to go, because you've got to suffer a full-blown illness. And there's no telling what the next variant will be and if it's going to be more severe or less severe than the ones that are circulating now. But the way things are going, the vaccines are showing that they are robust and they are protective against that severe illness and hospitalization in all variant forms to date.

And if that trend continues, if you're worried about getting hospitalized, you're worried about getting sick again, you may have dodged the bullet on the hospital on your last COVID infection, but there's no saying that won't happen again with the next variant.

INTERVIEWER: All right. Joe, thanks for your time.

SUBJECT: Thank you.

INTERVIEWER: Joe Kurland is an infection control practitioner at Children's Minnesota.