As of November 2, everyone ages 5 and older is eligible for the COVID-19 vaccine. But since the vaccines have yet to be authorized for use in children under 4, a big question remains: When will younger children be able to get their shots?
While it’s true that most children rarely get very sick from COVID-19 — the Centers for Disease Control and Prevention (CDC) estimates that COVID-19 hospitalization rates are 80 times higher among adults older than 85 than they are among children between the ages of 5 to 17 — many parents won’t (and shouldn’t) feel comfortable returning to life as normal until their children are fully vaccinated, too, says Sean O’Leary, M.D., M.P.H., vice chair of the Committee for Infectious Diseases at the American Academy of Pediatrics and professor of Pediatric Infectious Diseases at the University of Colorado Anschutz Medical Campus/Children’s Hospital Colorado.
Here’s when vaccines may become available for your little one, and how to keep kids safe in the interim.
When will kids be able to get the COVID-19 vaccine?
There are three COVID-19 vaccines currently available in the U.S. Two, the Moderna and Johnson & Johnon/Janssen Pharmaceuticals vaccines, are authorized for emergency use in adults 18 and older, while the Pfizer-BioNTech vaccine has full approval from the U.S. Food and Drug Administration (FDA) for those 16 and older, and is also authorized for emergency use in those 5 and up.
As of November 2, children ages 5 to 11 and adolescents ages 12 to 15 are eligible for the Pfizer-BioNTech vaccine. In clinical trials of the Pfizer-BioNTech vaccine in 5- to 11-year-olds and 12- to 15-year-olds, the vaccine was shown to be safe and effective at preventing symptomatic COVID-19. These age groups had similar side effects as 16- to 25-year-olds, such as sore arms or fevers.
Although there are still a lot of unknowns, children younger than 5 will likely have to wait to receive the COVID-19 vaccine. Pfizer is studying the use of its vaccine in kids ages 2 to 4 and expects trial results before the end of the year, CEO Albert Bourla said in a interview at an event with The Atlantic. Submission to the FDA for approval would follow thereafter. Pfizer is also currently conducting a trial with children ages 6 months to 2 years old.
Why weren’t children included in the first COVID-19 clinical trials?
Children’s immune systems are very different from those of adults, and their immune responses can vary according to their age, explains Dr. O’Leary.
While a teenager may respond to a vaccine similarly as an adult, an elementary school-age child, a toddler or an infant could have a very different reaction. That’s why it’s so important to always hold clinical trials in kids separately.
The trials in children go through two stages. The first stage looks at different dose levels — specifically doses that are one-quarter, one-half or equal to the doses given to adults, explains Rajeev Fernando, M.D., an infectious disease expert in Southampton, New York, and member of the What to Expect Medical Review Board. As a next step, those doses are then tested against placebo injections.
About 24 percent of the U.S. population — around 74 million people — is under 18, and experts say getting kids vaccinated is key to ending the pandemic.
“It’s crucial to get these vaccine studies done in children,” explains Dr. Fernando. “In order to reach herd immunity — the point where enough people have achieved immunity to the COVID-19 vaccine to stop its spread — at least 70 to 80 percent of the entire population needs to be vaccinated. That means we absolutely have to include children.”
Will the COVID-19 vaccines be safe for children?
Yes. As with all vaccines, the COVID-19 vaccines have undergone a rigorous approval process before they were made available to children.
Both the Pfizer-BioNTech and Moderna vaccines work by injecting a genetic material called mRNA, which tells your body how to make a viral protein that triggers a protective immune response against 2019-nCoV, the form of coronavirus that causes COVID-19.
The Johnson & Johnson vaccine also triggers a protective immune response, but it does so by injecting a disabled cold virus, known as an adenovirus, to deliver the instructions.
There’s no live COVID-19 virus involved in any of the these vaccines. Your body breaks down the mRNA or adenovirus molecules, which then disappear, explains Dr. Fernando.
Since the initial clinical trials to evaluate the safety and efficacy of the three COVID-19 vaccines involved tens of thousands of people, the age-related testing on teens and children is done using much smaller groups, says Dr. O’Leary. Once the trials are complete, they still need to be reviewed and approved by the Food and Drug Administration (FDA), which adds another layer of safety to the process.
You also don’t need to be worried that the mRNA COVID-19 vaccines will alter your child’s DNA. Anthony Fauci, M.D., chief medical adviser to President Biden, has stressed that the mRNA has no way of entering human cells, so it can’t change their genetic profile at all.
How can parents keep children safe before they get the COVID-19 vaccine?
Since it may still be a while before your littlest ones can get vaccinated, it’s important to continue following the same safety measures you’ve used throughout the COVID-19 pandemic, says Kyle Monk, M.D., a pediatrician at Cedars-Sinai Medical Center in Los Angeles, California and member of the What to Expect Medical Review Board.
This includes wearing masks, practicing social distancing and frequent handwashing. “You still need to hold off on unmasked playdates or sleepovers until children are vaccinated,” adds Dr. Monk.
Finally, parents and caregivers should get vaccinated as soon as possible. “There’s research to suggest vaccination can help reduce transmission rates, so if you do contract COVID-19, you’re less likely to pass it to your children,” says Dr. Monk.