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What is happening with COVID-19 vaccines for kids under 12?

Families with young kids have been waiting for months for news on when children under 12 would be eligible for vaccines. That time is coming soon.

A teenage student receiving a dose of the Pfizer-BioNTech vaccine.
A teenage student receiving a dose of the Pfizer-BioNTech vaccine.
REUTERS/Mike Segar

For many Minnesotans, COVID-19 vaccination has brought about a return to normal: gathering with grandparents, seeing friends, attending events.

But things are different for families with young kids. Since no vaccines were approved for people under age 12, those families have been advised to keep up some precautions to protect their youngest members from COVID-19.

Some relief for families keeping their lives on hold because of unvaccinated kids is likely to come soon, with federal health officials expected to approve the Pfizer vaccine for kids ages 5 to 11 within weeks.

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Here’s what you need to know about vaccinations and younger kids.

When will 5 to 11-year-olds become eligible for COVID-19 vaccines?

During a Wednesday briefing, Minnesota Department of Health Commissioner Jan Malcolm estimated the green light to start vaccinating 5 to 11-year-olds will come around November 4.

That’s because a couple things have to happen before vaccines can actually be given out to kids.

First, the Food and Drug Administration’s advisory committee has to recommend the vaccinations. They will meet Oct. 26 to review safety and efficacy evidence on Pfizer’s vaccines for 5 to 11 year-olds.

Then, the Centers for Disease Control’s Advisory Committee on Immunization Practices (ACIP) has to give recommendations on administering the vaccines. The ACIP is scheduled to meet November 2 and 3. Both the FDA and the ACIP meetings are public.

What did the trials look like for the Pfizer vaccine in this age group?

The clinical trials for 5 to 11-year-olds looked a lot like the trials for 12 to 15-year-olds.

Pfizer included 2,268 kids in its trial in the 5 to 11 age group. Two-thirds of them got the Pfizer vaccine in two doses; three weeks apart, while one third got placebo injections. Data show kids who got the vaccine had a strong immune response.

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As it was with adults, the Pfizer vaccine would initially be approved under emergency use for 5 to 11-year-olds.

Are the vaccine shots for kids the same as the ones for adults?

While the formulations are the same, kids are likely to get smaller doses than adults. The Pfizer trials tested doses of 10 micrograms in 5-t0-11-year-olds. That’s a third of the 30 microgram doses people ages 12 and up get.

Pharmacies can’t use existing vaccine supplies to vaccinate kids. Instead, the children’s doses will come in smaller vials that will be shipped with smaller needles that are better-suited for kids’ arms.

Where can kids get vaccinated?

Once the shots are approved, kids will be able to able vaccinated at heath care providers, in community health centers and eventually should be able to be vaccinated in clinics set up in schools, Malcolm said.

Will there be enough supply?

Federal health officials said in a news conference Wednesday that they are prepared to ship kids’ doses to states.

“As soon as the vaccine is authorized by the FDA we will begin shipping millions of doses nationwide,” White House COVID-19 response coordinator Jeffrey Zients said in a briefing Wednesday.

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The federal government will allocate kids’ vaccines to states on a per capita basis,  Malcolm said Wednesday, and she is expecting supply to be robust.

As with other age groups, it’s unlikely Minnesota will be vaccinating the entire 5 to 11-year-old age group as soon as vaccines are approved.

Minnesota kids need a parent’s permission to get vaccinated. In a September survey, the Kaiser Family Foundation found that 34 percent of parents of 5 to 11-year-olds nationwide will get their child vaccinated as soon as possible. That share had increased from 26 percent since July.

Since vaccines were approved for their age group in May, 5o percent of Minnesotans age 12 to 15 are fully vaccinated.

What do the side effects look like for kids?

Probably a lot like they do for everyone, though specific data aren’t available yet, said Dr. Jill Amsberry, a pediatrician and the medical director for pediatrics at CentraCare.

“That’s what the FDA is reviewing right now, but what we’ve been told is that the side effect profile looks very similar to the side effect profile in the other age groups,” Amsberry said.

More serious side effects for older children were uncommon. In rare cases, teens who were vaccinated experienced myocarditis or pericarditis, or inflammation of the heart, post-vaccination.

Those cases were extremely rare, tended to be minor and many went away without treatment. Data show myocarditis is a bigger risk with COVID-19 infection than it is post-vaccine. Similar data on younger kids aren’t yet available.

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Dr. Beth Thielen, an infectious disease physician at the University of Minnesota Medical School and M Health Fairview with expertise in pediatrics, said families should be encouraged by the level of scrutiny the vaccines have held up to.

“I think it should be really reassuring to parents that this has been well-studied,” Thielen said. “We have data in hundreds of millions of people around the world, of all ages and this vaccine is safe and effective.”

How should I talk to my kids about getting vaccinated?

Amsberry said she has two kids in the age range expected to be approved for vaccination soon — a 6-year-old and an 11-year-old — so this is something she’s been working on first-hand.

Being open and honest is key, she said: make sure kids know the vaccine might hurt a little, and they might not feel great for a day or two, with aches or a fever, but that those symptoms will go away — and that the symptoms don’t mean they’re sick, they mean the vaccine is working.

“It’s actually a really good sign that their body is doing exactly what it’s supposed to, to get those antibodies or what I call immune soldiers up and ready to go to fight off the infection, should they be exposed to it in the future,” Amsberry said.

Will kids be required to be vaccinated against COVID-19 to go to school?

It’s a possibility, but it doesn’t look likely in the near-term. Both the Minnesota Department of Health and the Legislature have the authority to add vaccines to the state’s required immunizations list for students.

Action by the divided Legislature seems unlikely. In August, MDH Infectious Disease Director Kris Ehresmann said that on one hand, requiring the vaccines would make sense, given that schools and child care settings are clearly settings where COVID-19 transmission happens.

“However, there’s a lot of considerations as it relates to multiple products and the timing of licensure and approvals, and there’s extreme polarization within the population right now. We want to make sure that we’re doing what’s in the best interest of public health, but also being thoughtful about where people are at,” she said.

As for whether individual school districts can require vaccinations, the legal landscape is a bit murkier.

What about kids younger than five? 

Vaccine trials are underway for kids in the 6 month to 4 year age range.

Thielen said it’s not yet clear when approval will come for younger kids, but she’s heard guesses of early 2022.

In Minnesota, there could be opportunities to get small children vaccinated sooner: the University of Minnesota is currently enrolling kids ages 6 months to 11 years in Moderna trials.

Why should my kid get vaccinated if they’re not likely to get very sick?

They’re not likely to get very sick, but it certainly can happen.

As of this week, 140 Minnesota 5-to-9 year olds had been hospitalized due to COVID-19; 34 in the ICU. Two kids in this age group died of the virus. In the 10 to 14 age group, 238 kids have been hospitalized; 47 in the ICU, with no deaths. Pediatric hospital beds are currently in short supply in Minnesota, Malcolm said Wednesday.

Hospitalizations aren’t the only risk, though. Kids can get long COVID, complications from the virus that still aren’t well understood and can last for months or longer after initial symptoms have subsided.

Not all the effects of COVID-19 are related to physical health. This is now the third school year that has been interrupted by COVID-19, with kids having to do school from home due to case surges or quarantines, which data show is affecting kids’ test scores and their mental health.

Getting kids vaccinated is also an important component of bringing the pandemic under control.

“We need our pediatric population to help us get through this, as they represent such a significant portion of our population, and are very good at spreading germs, particularly in the school setting,” Amsberry said.