Health experts, legislators weigh timing, requirements for vaccinating children
A COVID-19 vaccine deemed safe enough for children is not expected until late next year, placing them last in line to be inoculated.
Testing in children as young as 12 began in October, with the recently approved Pfizer and BioNTech vaccine only authorized for those 16 and older. So as for mandating a vaccine for children when it becomes available, legislators say it’s not a concern to weigh just yet.
While children make up a small portion of people who contract or die from COVID-19, as compared to other children’s diseases, coronavirus is a morbid one, said Dr. Carlos Oliveira, a Yale Medicine pediatric infectious disease physician and assistant professor at the Yale University medical school.
“In my mind, mandatory vaccinations is a no-brainer. It’s the best way to protect the kids and I would hope that that conversation comes up before the next school year reopens.” Dr. Carlos Oliveira, a Yale Medicine pediatric infectious disease physician and assistant professor at the Yale University medical school
Since April, at least 184 children have died from the disease in the U.S. and thousands more have been hospitalized, a third of whom were critical cases, Oliveira said. More than 1 million children have had the virus.
He worried the number of children infected would rise substantially if they become the last group to be vaccinated.
“In my mind, mandatory vaccinations is a nobrainer,” he said. “It’s the best way to protect the kids and I would hope that that conversation comes up before the next school year reopens.”
But Gov. Ned Lamont said in a Wednesday press briefing that consideration on a mandatory vaccination for children or teachers is “very premature” because for the next four months vaccination demand will heavily outpace supply.
Health care and nursing home workers are at the forefront of immunizations, along with medical first responders. They are followed by critical workforce personnel, adults over 65 and adults with serious health risks.
Remaining adults are under phase two, along with people under 18. This phase is expected to begin in June next year.
Children may be added to the roll out after vaccine testing is complete, according to the state’s plan.
“As of now, it’s not a front burner issue, but if the information changes, who knows, everything in this pandemic situation changes rapidly,” said Senate president pro tempore Martin Looney, DNew Haven, of mandating COVID-19 vaccines.
Looney said the General Assembly will concern themselves with rolling back the religious exemption currently in place for mandatory immunizations rather than coronavirus vaccine issues.
State Rep. Jonathan Steinberg, D-Westport, is chairman of the General Assembly’s public health committee, which took up legislation on the removal of religious exemptions for school immunizations.
Steinberg said they’ll take up the same legislation again, although it’s controversial and this time will be colored by the pandemic.
“It’s not our intention to make the COVID vaccine mandatory for children,” he said.
As for teachers, Steinberg said he thinks many wouldn’t have to be asked twice to be immunized and the same will probably be true of most of the general public. “We hope that gets us most of the way there and we won’t need to have the conversation on making it mandatory,” he said.
Looney said the pandemic will affect the religious exemption conversation in that “it will provide additional momentum for that bill to pass.
“People have become too casual about vaccination because of the success of vaccination, but now we’re confronted with a disease where there’s been no safeguard against it, until recently, and no very effective treatment,” he said. “It’s a reminder that this is a life and death issue that needs the utmost concern.”
There is some precedent for mandatory immunization in schools, though, and now is the time to discuss how it relates to COVID-19, said Mark Sommaruga, an attorney with Pullman & Comley who specializes in education and school law.
Sommaruga said even if a children’s vaccine is far off, the state should start thinking now about how it will be implemented, including whether to make it mandatory in schools.
He said the state may decide to leave COVID-19 immunization requirements to the districts, but it could expose them to more legal risk.
“When you do it on a local level, each school has to make its own decision, which can be good and bad,” he said. “Do you want to have 159 rules for immunization?”
Whether or not a vaccine is mandated for children, how it’s implemented will matter greatly from an equity standpoint, Oliveira said.
In children hospitalized for coronavirus, 75 percent are Black or Hispanic, according to a study from Connecticut, New York and New Jersey.
“I really do think there needs to be thought about is prioritizing communities of color in vaccination if there’s a priority to protect children,” he said.
It may be a year before young children are immunized because of lengthy vaccine testing processes, but it should be done immediately, Oliveira said.
Pfizer began testing in October in children as young as 12 and that is expected to take several more months. The U.S. Food and Drug Administration will decide when there’s enough data to allow emergency use for younger children.
Similarly, Moderna started testing in children 12 years old to 17 years old for its vaccine in early December and will track the results for a year, the Associated Press reported.
Testing in children younger than 12 is expected to start in early 2021, the AP reported.
Moderna’s current application for emergency use does not include use for people younger than 18.
AstraZeneca’s COVID-19 vaccine development included trials in children older than 5 years old, but the drugmaker recently removed children from a mid-to-late stage vaccine trial in Britain, according to Reuters.
“Given how relatively infrequently children have been infected, it’s going to take a longer time or a much larger number of children to be able to say the vaccine works,” Oliveira said.
While nearly 17 million adults have been infected with the virus, more than 1 million children have had it, according to a report produced by the American Academy of Pediatrics and the Children’s Hospital Association in November.
The summer months may also extend the testing process because warm weather may partially supress the virus and children aren’t in school, he said.
From the start of the pandemic, children have been more insulated than adults, which also makes it difficult to know how much impact children have in spreading the disease, Oliveira said.
“To be able to say children aren’t as infectious as adults, it’s hard to say, because of how we’ve limited their ability to transmit,” he said.
Until a safe vaccine is made widely available, the best Connecticut could do is “cocoon” children by surrounding them with adults who are vaccinated, Oliveira said. This makes the odds of children getting coronavirus much lower.
“I think at some point the virus will only transmit among schools and it’ll be a pediatric disease so we need to immunize them,” Oliveira said.