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Editor's note: Dr.
For some parents of young children, the wait for COVID-19 vaccines has been long and agonizing.
Throughout 2021, vaccines against COVID-19 emerged as the most effective way to prevent severe forms of the disease. Vaccines are currently recommended for everyone 5 years and older in
Recent
As a pediatrician specializing in infectious diseases, I have cared for many children with COVID-19 at our medical center. I have also had the opportunity to frequently spend time talking with parents about how to make the best choices to protect their young children from COVID-19.
Here's the latest on the clinical trials and formal review process for vaccines for this important group of patients.
COVID-19 Vaccine Timeline for the Youngest Children
On
The company reported robust antibody responses comparable to what they saw in young adults between 18 and 25 years old. During the omicron surge, however, efficacy against infection was 44% in children 6 months to under 2 years and 38% in children between 2 and 6, the company said. On the same day,
Shortly before, during the height of the omicron surge, Pfizer-BioNTech, the collaboration whose COVID-19 vaccine is the only one currently available for
COVID-19 Vaccines for Young Immune Systems
COVID-19 vaccines have proved highly effective in the prevention of severe COVID-19 in adults and older children.
Prior to use, all vaccines go through rigorous testing in clinical trials, first in adults and then in children, recognizing that there may be biological differences in immune response for different age groups. Going down sequentially in age allows investigators and regulators to evaluate the optimal dose with the least number of side effects.
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However, more recent work, including a study that is not yet peer-reviewed, suggests waning vaccine effectiveness during the omicron variant surge, with more pronounced decline over time in children ages 5 to 11. Reassuringly, protection against hospitalization remained strong, and boosters improved protection among eligible older teens.
How Immune Responses May Differ in Children by Age
Vaccines work by teaching the immune system to make disease-fighting antibodies. Several factors determine how our bodies respond to vaccines, and one of these variables is age. Vaccine responses in particular may differ in the very young, when immune systems may have less memory.
Testing by age groups helps to account for these differences in how the maturing immune system responds to different types of vaccines. It is common for childhood vaccines to be given in series to help train the young immune response to make better and stronger antibody responses with each subsequent dose.
Vaccine Safety
Trials also evaluate vaccine reactions by age. Most COVID-19 vaccine side effects have been mild and short-lived, such as pain at the injection site.
Even after trials are complete and vaccines are authorized or approved, safety monitoring continues. This allows even very rare side effects to be detected. One such example is that of myocarditis, or inflammation of the heart, which can occur in rare cases following COVID-19 vaccination. Reports indicate that these cases typically responded well to supportive care and resolved rapidly.
Few adverse events were reported among nearly 8 million vaccine doses given in those age 5 to 11, indicating even lower rates in this age group compared to in ages 12 and above. Outside of infancy, when babies may be born with congenital heart problems, myocarditis is generally uncommon in younger age groups, so it may prove to be rare following vaccination in young children.
Looking Ahead
If the FDA grants emergency use authorization of a COVID-19 shot for children under 5 years of age following its upcoming review, it will clear the way for the vaccine to be distributed nationwide. The next step will be for the
Young infants under the age of 6 months are not currently included in the vaccine clinical trials, but antibodies produced by mothers from vaccination in pregnancy can be passed on through the placenta to provide protection from COVID-19 during the first few months of life.
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