Vaccinating children ages 5 to 11 against COVID-19 will require an approach that differs from vaccinating adults, and the White House on Wednesday announced additional steps it is taking to prepare states for new protocols to vaccinate school-age kids even though the shots are not yet authorized.
The United States has enough supply to vaccinate the 28 million kids in this group who could become eligible once the Food and Drug Administration authorizes the shot, which is expected as early as next week. In the first week after the anticipated authorization, the administration plans to ship 15 million doses for this group.
"Kids have different needs than adults, and our operational plan is geared to meet those specific needs," White House COVID-19 response coordinator Jeff Zients told reporters on Wednesday.
Vaccine needles for kids will be thinner, and vials will look different because the doses are smaller. Packaging will also be available in smaller configurations to make it easier for vaccine providers to administer the shot and avoid wasting doses.
Since kids returned to in-person schooling this fall, pediatric COVID-19 case numbers have climbed dramatically. More than 1.1 million children tested positive for COVID-19 over the past six weeks, according to the American Academy of Pediatrics. Young children are very unlikely to die of the coronavirus, but a positive test in a classroom can lead to lengthy quarantines, and some children can become quite sick.
All the administration's vaccination plans are pending approval by the FDA and the Centers for Disease Control and Prevention. FDA vaccine advisers will meet on Oct. 26 to discuss Pfizer's request for emergency authorization of its vaccine in kids ages 5 to 11, and CDC vaccine advisers plan to meet Nov. 2-3 to discuss recommendations for administering the shots to this age group. Once both agencies sign off on their advisers' recommendations, young kids can begin rolling up their sleeves.
The White House wants to ensure that the vaccination effort is accessible to all kids and will rely in part on pediatricians to lead the push.
More than 25,000 pediatricians' offices and other primary care sites are expected to be ready to administer vaccines to kids. The administration is also working with more than 100 children's hospitals across the country to set up vaccination sites, and the hospitals will work with local partners to set up vaccination clinics. The White House is additionally helping states stand up vaccination clinics in schools.
Vaccine hesitancy is relatively high among parents of children in this age group. Roughly two-thirds of parents of kids ages 5 to 11 will not immediately get their children vaccinated against COVID-19 once the shot is available, according to Kaiser Family Foundation polling released last month.
To combat such hesitancy, the Biden administration is preparing a national public education campaign to inform parents of the benefits of COVID-19 vaccinations in children and the risks for the unvaccinated of getting the disease. This includes sending informational pamphlets to schools, religious institutions and community organizations.
Zients says he expects parents’ willingness to vaccinate their kids to increase over time, just as adults increasingly gained confidence in vaccines for themselves.
"We expect more and more kids to get vaccinated across time," Zients said.
The CDC will continue to recommend masking in schools when the vaccine is initially available for young kids because it will take a while to get kids protected against the virus, CDC Director Rochelle Walensky told reporters.
But masking decisions are still left up to states and individual school districts. Nine states have enacted policies that prohibit school mask mandates.
Children's hospitals across the country are encouraging states to continue mask mandates and other strategies to reduce virus transmission.
“As pediatricians, it is our responsibility to advocate for universal masking to facilitate safe in-person schooling for all children,” said Sarah Schaffer DeRoo, a pediatrician at Children’s National Hospital. “Children have readily adapted to masking during the pandemic, and continuing this practice in schools is not a significant change from their recent experience.”