CDC advisors green-light Pfizer’s lower-dose COVID-19 vaccine for kids aged 5-11

• An expert panel to the CDC voted Tuesday to offer a low-dose version of Pfizer’s COVID-19 vaccine to kids ages 5-11 in the US.
• The vaccine is the same product that adults and teens receive, but a smaller size.
• Doctors and nurses at the meeting stressed kids shouldn’t die from vaccine-preventable diseases, and parents should not wait to vaccinate them.

Tinier COVID-19 shots, formulated for tinier humans, are almost a reality in the US.

An independent committee of experts advising the Centers for Disease Control and Prevention just voted unanimously 14-0 and wholeheartedly to recommend Pfizer’s lower-dose COVID-19 vaccine for kids aged 5-11, making nearly all school age children eligible to get vaccinated in the US.

The committee’s decision follows an emergency use authorization from the Food and Drug Administration on Friday for Pfizer’s vaccine to be administered to the same age group.

The CDC’s official recommendation still requires a final thumbs up from the agency’s director, Rochelle Walensky, which is expected within just hours.

That will trigger the vaccines to become available to kids and their parents nationwide at hospitals, doctor’s offices, health departments, temporary vaccine clinics at schools and community centers, as well as in pharmacies.

‘One child’ death from COVID is ‘too many’

CDC scientists stressed that having school kids vaccinated could give everyone “greater confidence” to socialize and go to school, knowing that they’re well-protected from the most horrible COVID-19 outcomes. Many of the doctors and nurses advising the agency said they will not hesitate at all to vaccinate their own children and grandchildren against COVID-19, with some becoming audibly tearful thinking about the children who’ve died during the pandemic.

94 children aged 5-11 have died from COVID-19 during the pandemic, making it a leading cause of death for them.

Patsy Stinchfield, representing the National Association of Pediatric Nurse Practitioners at the CDC meeting, said that “even one child” dying from COVID is “too many” when we have a safe, effective vaccine.

But vaccines for kids might not be immediately available everywhere on Wednesday morning because pharmacists can’t use what’s already on the shelf.

Pfizer is shipping out new vials of its COVID-19 for use in kids under 12. Though the vaccine itself is the same exact product as the one given to teens and adults, it’s being administered in smaller doses, with small needles.

A smaller vaccine for smaller people

The Kaiser Family Foundation predicts that “demand for pediatric vaccinations could initially outstrip supply, as providers wait for delivery of children’s vaccines.” Roughly a third of parents with children in the 5-11 age group want to get them vaccinated as soon as possible, according to KFF.

Throughout Tuesday, CDC advisors poured over data from Pfizer on the safety of its vaccine for kids (based on a trial in which more than 1,500 kids 5-11 were vaccinated). Scientists from the FDA stressed that the safety data on this vaccine is already comparable to other vaccines that have been fully approved for use in kids before.

‘Employ it to the maximum’

“We should be very confident” to “employ it to the maximum,” pediatrician Sarah Long, who’s on the CDC committee, said.

The committee also heard from CDC scientists, who’ve concluded that children are at least as likely as adults to be infected with the coronavirus, and that secondary transmission from kids to teachers and parents or other caregivers (including grandparent caregivers, who’ve died in record numbers during the pandemic) is a concern.

The reason why shots for kids lag so far behind adult vaccinations is because pediatric trials, both to determine the proper dosing for kids (lower), and to make sure the vaccine is safe for younger bodies, were not started until more recently than adult trials.

The one lingering risk for childhood vaccinations that advisors weighed over the course of the day was the small, but real, risk of myocarditis after vaccination, which has been an issue for a small number of teenage boys (the risk of myocarditis after COVID-19 infection is far greater, and more dangerous, though.)

Pediatric cardiologist Matt Oster from Children’s Healthcare of Atlanta, who presented about myocarditis during the meeting, said “I believe it’s less likely” that young kids will develop myocarditis after vaccination than teens.

“If we wait, we miss the chance to prevent” COVID-19 infections in kids, committee member Dr. Matthew Daley said, though he recognized some parents may be hesitant, or have concerns.

“We hear you,” Daly said. “I would just encourage you to talk to your child’s pediatrician … they can just help talk through this with you. But, we’re all here to listen.”

“Children are dying,” advisor Dr. Oliver Brooks added. “The vaccine is safe and effective.”