As the timeline for approval and eventual distribution of a coronavirus vaccine begins to solidify, the question of when the vaccine will be available to different demographics (from frontline care workers to high-risk populations to the general public) is on most people’s minds. Particularly, for parents, it’s understandable that you’d be wondering when children might be considered for the coronavirus vaccine.
While the initial plans remain still very much in flux, experts say that the majority of children are likely not going to be considered for the vaccine until late 2021 — at least until after the school year starts. In an interview with NBC’s Meet The Press on Sunday, Director of the National Institute of Allergy and Infectious Diseases Dr. Anthony Fauci said that the necessary testing to okay the vaccine for children is in progress or just beginning for the vaccines from the leading pharmaceutical companies developing them. Though the results from the aforementioned companies have been promising, he says that authorities are understandably cautious when it comes to testing newly developed drugs on kids under 18 — as children’s immune responses differ from adults.
“Before you put it into the children, you’re going to want to make sure you have a degree of efficacy and safety that is established in an adult population, particularly an adult, normal population,” Fauci said.
20/ I worry about kids, since we haven’t even begun to test vaccines in them. But if we can reach herd immunity by vaccinating everybody else (incl. teachers), we may not need to obsess about reaching kids, particularly the youngest ones (who are at low risk for illness/spread).
— Bob Wachter (@Bob_Wachter) December 2, 2020
While there may be expedited approval from the U.S. Food and Drug Administration (FDA) for age groups older than 12 in the future, depending on what the data show, as the Washington Post notes, the testing timeline and the previously stated Centers for Disease Control and Prevention (CDC) intentions are to prioritize distribution of the vaccine to Healthcare personnel, workers in essential and critical industries, people at high risk for severe COVID-19 illness due to underlying medical conditions and people 65 years and older. As children infected with COVID-19 have been shown to experience less severe illness for the most part, paired with the timeline for testing and getting approval, they are most likely considered less than ideal candidates for this early wave (but would absolutely benefit from the boost to herd immunity coming from adult demographics getting vaccinated.)
While this does make sense, pediatric health experts have expressed concerns about the lag for getting children on track to be vaccinated. American Association of Pediatrics President Sally Goza wrote in a letter Secretary of the U.S. Department of Health and Human Services Alex Azar to urge agencies to prioritize pediatric trials and to act with urgency.
“Beyond the direct impact of the infection, children have been greatly affected by the pandemic, with large disruptions to in-person school and early learning, limited social interactions with peers and relatives, and curtailed access to playgrounds, sports activities, and other activity that helps develop social and emotional well-being,” Goza writes. “We know that lengthy time away from school and associated interruption of supportive services often results in social isolation, making it difficult for schools to identify and address important learning deficits as well as child and adolescent physical or sexual abuse, substance use, depression, and suicidal ideation. As such, it is counter to the ethical principle of distributive justice to allow children to take on great burdens during this pandemic but not have the opportunity to benefit from a vaccine, or to delay that benefit for an extended period of time, because they have not been included in vaccine trials.”
She notes that including children in vaccine trials is the best means of understanding safety concerns and “unique immune responses” that may come up in children.
“Questions about unknown safety concerns will not be answered by posing questions, but only through carefully designed trials which include children. It would also be less than desirable to have one or more SARSCoV-2 vaccines licensed or available under Emergency Use Authorization (EUA) at a time when no data have been collected on the safety, tolerability, dose, and regimen for children,” Goza adds. “For these reasons, we urge the inclusion of children in vaccine trials as we move forward in the development of a SARS-CoV-2 vaccine.”
Deciding who gets the vaccine and when
According to Johns Hopkins Center for Health Security, the ethical framework for deciding which parties should get access to the vaccine has a lot to do with considering what measures will save the most lives and a number of difficult triage decisions as we approach it being nearly a year since the pandemic was declared.
Prioritizing healthcare workers is a no-brainer on that front as it “accomplishes multiple objectives at once: it protects essential services, enables economic activity more broadly, targets a group at high risk of infection, expresses reciprocity, and helps to reduce higher rates of severe COVID-19 illness experienced by Black and Latino people, who have high rates of employment in essential jobs.”
However, they say that there can be other ethical questions about whether including school workers in the early wave of infrastructure workers (which would get kids back to school safer and sooner and avoid further disruption to their educational lives) is something that can also be considered as part of the ethical “trade-off” as it “would help stimulate the economy.” However, they note that outcome would be at odds with “allocating the vaccine to save the most lives” and likely not the path we’d take.
Before you go, check out these natural cold remedies for kids: