Kids’ shots possible after Halloween
Pediatricians anticipate rush to get vaccinated
More than 28 million children could become eligible to receive the COVID-19 vaccine days after Halloween, and pediatricians and pharmacists are bracing for a crush.
The demand for shots when the vaccine became available for older adolescents in May gives a sense of what may be in store when 5- to 11-year-olds come on board.
“In the first four days after 12- to 15year-olds were eligible for the Pfizer vaccine, we had nearly 28,000 vaccine doses given in the state,” reaching more than 7% of all the adolescents eligible, said Dr. Umair Shah, Washington’s secretary of health.
With the expanded authorization, almost double that many children will be able to get in line – a full 8.5% of the U.S. population – and there is pent-up demand as many parents are eager to get their kids vaccinated now that they are back at school.
“We’ve already had families inquire when they come in or calling and asking if we’re going to be giving the pediatric dose,” said Dr. Sharon Marshall, a professor of pediatrics at Wayne State University and pediatrician at Wayne Pediatrics at Children’s Hospital of Michigan in Detroit.
But parents need to be prepared to wait a few days after the Food and Drug Administration gives its expected goahead, experts say, while the system gears up to give the new lower-dosage formulation for that age group. On Thursday, Pfizer and BioNTech submitted a formal request to the FDA for emergency use authorization of their vaccines in children 5 to 11.
“Parents need to know this in advance so they’re not angry,” said Dr. Kelly Moore, chief executive officer of Immunize.org, which educates health care professionals about U.S. vaccine recommendations.
“With boosters, we had phones ringing off the hook and people immediately
went to their physicians,” she said. “Public health systems may have to step into the gap and set up clinics to allow parents to come with their children.”
It’s not possible for parents to preschedule shots before the vaccine is authorized, said Dr. Shereef Elnahal, CEO of University Hospital in Newark, N.J.
“There is probably going to be a period of time where demand exceeds supply, very similar to what we saw in doses for adults back in December.”
Dr. Lee Beers, president of the American Academy of Pediatrics, asked parents to be patient. Pediatricians’ offices are still catching up from regular visits missed during pandemic shutdowns and are now in the midst of cold and flu season. They also are doing coronavirus tests for school-age children.
“Be supportive and show some grace to your pediatrician’s office staff,” she said. “They’re faced with some pretty contentious and difficult stuff.”
Where to get shots for kids?
The pediatric vaccine is expected to be available in the same places as adult shots, including pharmacies, doctors’ offices, clinics and, in some areas, mass vaccination sites.
Parents of younger children tend to have many questions and seek a familiar and comfortable setting.
“The younger the child, the more likely the family is to want that child to get their vaccination in a pediatrician’s office,” Beers said.
She expects high demand at first but found through vaccinating 12- to 17year-olds that not every child will get a shot immediately.
“There are about a third of families who are going to want the vaccine right away and another third who have questions they want to have addressed,” Beers said, “and about a quarter to a third who say they’re not interested right now.”
Widening access
States are open to all available venues to help get children vaccinated.
“Just this morning, the director of a children’s museum called to offer the site for a vaccination clinic, so we will explore that option,” said Robert Long of the Maine Center for Disease Control and Prevention.
School districts across the country held summer vaccination programs for 12- to 17-year-olds at local schools.
They’re an easy location for families, said Dr. Marcus Plescia, chief medical officer for the Association of State and Territorial Health Officials. “Every state is going to try because it’s so efficient, but I think everyone is anticipating that may not work so well, so the backup is doctors’ offices,” he said.
One problem with school-based clinics for younger children is they typically want their parents with them when they’re getting a shot. Vaccine and mask mandate protesters also have been targeting school board meetings nationwide.
“There are fears are protesters going to show up. Do you want to bring those angry people onto campus?” Moore said.
Smaller dose, thinner needle
If authorized, the Pfizer-BioNTech shot for children will be a smaller dose given through syringes with thinner needles more suitable for children.
An adult dose of vaccine is 30 micrograms; the proposed children’s dose is 10 micrograms, one-third as much. As in adults, the vaccine would be given to children in two shots at least three weeks apart.
The COVID-19 vaccine for children will come in different packaging and vials than for adults and will require a smaller minimum order, making it easier for doctors’ offices to order more appropriate amounts and use more efficiently.
It also will have a different National Drug Code, allowing health care providers to easily track it in their systems.
How long it will take the FDA to evaluate Pfizer-BioNTech’s child vaccine application isn’t known, but it has scheduled a meeting of its external review committee for Oct. 26.
If the FDA then authorizes the vaccine, a second external committee of the Centers for Disease Control and Prevention will meet Nov. 2 and 3. Once its recommendation on who should get the vaccine is approved by the CDC director, the vaccine can begin to be distributed.
Given that timeline, it’s possible pediatric COVID-19 vaccines could be available days after Halloween.