The State of Pediatric COVID-19 Vaccination

As the Omicron variant of SARS-CoV-2 has generated the greatest series of outbreaks in the US since the beginning of the COVID-19 pandemic, just one population remains not fully assured against the virus: children younger than 5 years old.

Indeed, as informed by mortality and severe disease risk data, the prioritization, research, and rollout of COVID-19 vaccines since 2020 has started at the oldest age groups and has worked its way down; it was only a couple months ago that emergency authorizations began being granted for mRNA vaccines in children younger than adolescence. Only Pfizer-BioNTech’s BNT162b2 is currently authorized for children aged ≥5 years old thus far.

But the necessity of pediatric vaccination against COVID-19 is a tricky subject, and the decision-making parents and guardians of children are predictably varied in their opinions.

In an interview with HCPLive, Joseph Aracri, DO, Vice Chair of the Primary Care Institute & Family Medicine at Allegheny Health Network (AHN), discussed how the initial pediatric COVID-19 vaccine rollout has played out exactly as he and colleagues expected.

Acrari explained parents are essentially split into 3 even camps: those wanted the vaccine for their children as soon as it was available; those who were hesitant and presented questions on its effects, benefits, and adverse events; and those were outright uninterested in the vaccine.

“It’s exactly what we expected to see,” Aracri said. “We saw an initial surge, and now, as colds and flus are coming through during checkups, the parents are having the conversation.”

Aracri delved into the difficulties of approaching the subject with parents, starting with the obvious fact that children may be the least unaffected population by the pandemic virus. He noted data as of November accounted approximately 100 of the 800,000-plus deaths in the US to young children—and that many of these children had underlying conditions that may have worsened their disease.

“It’s a difficult population to talk to about it, because unlike other vaccines and therapeutics we do, we’re not really protecting the child,” Aracri said. “In a sense, kids have done very well with COVID.”

But while severe disease is far less likely in children and child-to-adult transmission data are currently “very muddy,” Aracri acknowledged that children have their own stakes tied to curbing the pandemic: a return to normalcy.

“Unfortunately, during the COVID-19 pandemic, the virus hasn’t affected the kids, but society has,” he explained. “So anything we can do to normalize these kids’ lives is important, and that’s including the vaccine.”