Zoli’s parents plan to get their 4-year-old son vaccinated against COVID-19 as soon as shots for young children could finally become available later this month.
Shyamli’s father feels cautious about the immunization and won’t race to be first in line but does plan to eventually vaccinate his daughter, also 4.
Lovely and Josh Jr.’s parents worry that there’s not been enough research and won’t vaccinate their 4- and 2-year-old kids unless forced to.
Kids under 5 years old are expected later this month to become the last age group in America approved for vaccines. The Food and Drug Administration has scheduled meetings next week to review the evidence on the pediatric vaccines developed by Pfizer and Moderna, and White House COVID-19 response coordinator Ashish Jha said last week that the first 10 million doses could be available as soon as June 21.
Many parents aren’t sure if they want the shots, or how quickly. Just one in five parents was planning to immediately get their young children vaccinated, according to a national survey released last month by the Kaiser Family Foundation, a nonprofit health organization. More than a third wanted to wait and see how other children responded before getting doses for their own. About 40% are reluctant to get children under 5 vaccinated at all, and more than a quarter said they would “definitely not” get their children the shots, the survey found.
“I don’t feel comfortable,” said Joshua Williams, of Philadelphia, as he watched 4-year-old Lovely and 2-year-old Josh Jr. clamber through a playground clubhouse at Penn Treaty Park. “It’s not like they did a lot of research on the vaccine yet.”
Pediatricians and public health authorities in the Philadelphia region know they will have persuading to do but are relieved to be able to offer families with young children more than advice to take precautions like masking and social distancing.
“This is a population that’s had no options, and they’ve had a lot of challenges,” said Kate Tigue, a Lackawanna County pediatrician and secretary and treasurer of the Pennsylvania chapter of the American Academy of Pediatrics. “We’re going to give them all the information that’s accurate and hope they reconsider.”
For Zoli Jakab’s mother, Beth Beverly, of Elkins Park, access to the vaccine can’t come soon enough. The family is hoping to have the 4-year-old vaccinated before a long-planned trip in the coming months to see her husband’s family in Hungary.
“The only thing I’m nervous about is the way he has a tantrum over shots,” she said.
The coming rollout
The FDA is scheduled to review applications on June 14 and 15 from Moderna and Pfizer as both companies seek approval to offer vaccines to young children. Federal regulators had delayed the rollout of the Pfizer immunization last winter to collect more information.
The first two Pfizer doses — each a tenth of the dose adults receive — are to be delivered within three weeks of each other, with the third coming two months later. Its studies show the series is about 80% effective at preventing illness. The Moderna vaccine comes in two doses given four weeks apart. Trials have shown it to be 51% effective at preventing mild illness for children 2 and younger, and 37% effective for children between ages 3 and 5.
Their approval would open vaccination to more than 19 million American children, according to the U.S. Census, including some 702,000 in Pennsylvania and 518,000 in New Jersey.
Sameep Sehgal expects to proceed with care. A pulmonologist at the Cleveland Clinic who until about six months ago worked at Temple University Hospital, he is concerned about long COVID and planned to get his 4-year-old daughter, Shyamli, vaccinated.
“When it comes to your kids you are a little more cautious than you would be with yourself,” he said.
Such hesitation has played out in vaccination rates for older children. In Philadelphia, just over a third of children ages 5 to 11 have received at least one vaccine dose, in keeping with the national rate for that age range. By comparison, about 94% of Philadelphians 12 and older have received at least one dose.
Reflected in these rates is how COVID can be less dangerous for many children than for adults, said Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia and a member of the FDA advisory board that will evaluate the safety and efficacy of the Pfizer and Modern vaccines for children.
Offit anticipated the vaccination rates for children under 5 years old will be even lower than that for older children, in part because there aren’t vaccine mandates.
“I suspect if the vaccine was available two years ago, the vaccination rates would get much higher,” Offit said. “The vaccines then would have been seen as your ticket out of a lot of restrictive measures.”
COVID’s deadliness among children is comparable to measles, which killed 400 to 500 children a year before vaccines were developed, Offit said, and is worse than chicken pox or influenza. Children routinely receive vaccinations against all three.
Of the more than 1 million Americans killed by COVID since 2020, about 1,300 were age 18 or younger, the CDC reported.
While children are far less likely to get seriously ill or die from COVID, they can still be at risk. The American Academy of Pediatrics reported about 0.1% to 1.5% of children infected with COVID have required hospitalization in a survey of 25 states, though the age range differs by state. And children sick with COVID can infect relatives — not to mention upend entire households by forcing missed days of school and work.
Getting ready for vaccine approval
Pediatricians and health clinics will take the lead on distributing these shots, since federal law prohibits children under 3 from receiving vaccines from pharmacists.
In Philadelphia, about 60% of the 150 medical providers already participating in a federal children’s vaccination program are registered to administer COVID vaccine doses. About 70% of the 1,290 Pennsylvania providers, and 64% of the 925 New Jersey providers, participating in that federal program can provide COVID vaccines.
“The department is placing a special emphasis on reaching out to pediatricians across the state, as we know they have strong and trusted relationships with parents of young children newly qualified for the vaccine,” said Mark O’Neill, a spokesperson for the Pennsylvania Department of Health.
The New Jersey Department of Health is also coordinating with pediatricians, pharmacies, and schools and plans a marketing campaign to promote the doses to parents of children under 5.
Parents eager to get their little ones vaccinated say there are a slew of activities they’ve held off on while waiting.
Martin McLemore, of West Philadelphia, has family on the West Coast. Gabrielle Zaffiro, his wife, hails from Wisconsin. On both sides, relatives haven’t yet met their 7-month-old, Sebastian, because they didn’t want to risk flying with an infant who was born six weeks premature.
“Travel has been the main thing that we’ve not been doing because of concerns for his health,” McLemore said.
Other families feel not being vaccinated against COVID did little to inhibit their children’s options.
Williams, the parent at Penn Treaty Park, and his wife, Alize Vazquez, have their daughter, Lovely, who is 4, wear a mask indoors, and son Josh Jr., 2, is too young to be exposed to many people. They’re unsure what might persuade them to get their children vaccinated.
“If more research is done and it gets really bad, like spikes,” said Vazquez of the virus, “I might consider getting them vaccinated.”
Her husband, who generally doesn’t trust hospitals, was even more reluctant.
“When the school systems make it mandatory,” he said, “that’s probably when they’re going to get it.”