The COVID-19 Vaccine and Children: What Parents Need to Know

Now that two COVID-19 vaccines are being administered around the globe, families are already wondering what's next. Namely: when will my kids be able to become vaccinated?

It's a worthwhile question, considering more than 3.5 million pediatric cases of COVID-19 have been reported and more than 200 children have died, according to the Centers For Disease Control and Prevention. Of course, the rates of hospitalization and death are significantly lower than any other age group, but experts are still concerned.

"While the overall burden of COVID may be lower among children, preventable infections, hospitalization, and long-term sequelae and deaths are an important public health problem," Sara Oliver, a medical officer with the CDC, said in January. "Clinical trials to evaluate safety and immunogenicity of COVID vaccines in children are essential."

Do Children Even Need a COVID Vaccine?

It does seem that most kids are relatively unaffected by COVID — the total pediatric cases of COVID are extremely low — but the CDC has also acknowledged that there is likely a significant undercount due to many cases being mild. In fact, the actual case rates for children age 5 to 17 years may be close to those for age 18 to 49.

Pediatricians are also concerned about a rare but serious condition linked to COVID-19 known as multisystem inflammatory syndrome in children. At least 1,659 cases have been reported nationwide, and 26 children have died from it.

"The pediatric burden of disease is not as high as it is in older adults, but it still is significant," Dr. Emily Erbelding, a director at the National Institute of Allergy and Infectious Diseases, said at a recent CDC meeting. "There's a disproportionate burden among children in minority communities, and there's both direct and indirect effects to children and all of society. This burden will continue if we don't vaccinate and we just wait for herd immunity to occur over time."

Why Isn't a COVID Vaccine Available to Children Yet?

Children's immune systems are not the same as those in adults — and immune responses can be different at different pediatric stages. Because of that, studies need to examine more specific age groups in youth populations, which is also why impending trials plan to segment infants and young children from older kids and teenagers.

What Ages Has the Vaccine Been Approved For?

Pfizer's vaccine has already been authorized for people as young as 16 years old — it's so far the only COVID vaccination available to anyone in the youth population. The Moderna shot, however, is only authorized for those 18 and older.

When Will Eligible Teens, 16 Years and Up, Be Able to Receive Their Vaccine?

Because the vaccine is being rolled out on a needs basis — with first doses being administered to front-line healthcare workers, essential workers, and those in higher age groups, starting with those 75 years and older — teens in the eligible age bracket will be in the final group to receive it. Parents of these teens can expect to receive their shots first, with the earliest estimates of availability being in spring 2021.

The only exceptions to this will be individuals 16 and up with high-risk health conditions as well as individuals 16 and up who are essential workers. They may have the opportunity to get the vaccine sooner.

When Can We Expect a Vaccine For Infants, Kids, and Younger Teens, ages 0 to 15?

The best-case prediction is that a full pediatric vaccine will be available by late 2021, but it depends entirely on the ramp-up and success of trials — both in safety and efficacy. Then, just like the initial COVID vaccines, it will need to be reviewed by the Food and Drug Administration (FDA), ideally authorized for emergency use, and then mass-produced and distributed.

In late January, Pfizer announced that its trial in adolescents age 12 to 15 was underway following a full enrollment of more than 2,200 children.

On March 31, Pfizer released some of its initial data from the these trials, sharing that the vaccine "demonstrated 100 percent efficacy and robust antibody responses, exceeding those reported in trial of vaccinated 16- to 25-year-old participants in an earlier analysis, and was well tolerated." The company plans on submitting this data to the FDA to request emergency-use authorization of the two-dose vaccine "with the hope of starting to vaccinate this age group before the start of the next school year."

During the last week of March, a new three-phase study of the Pfizer vaccine in kids ages 6 months to 11 years began, starting with 5- to 11-year-olds. The 2- to 5-year-old group will be initiated into the cohort in the first week of April, and although the timing hasn't been shared yet, the group consisting of infants and toddlers will be initiated sometime after that.

Moderna's clinical trials for 12- to 17-year-olds began in mid-December, but the company is struggling to enroll enough of the 3,000 volunteer participants needed to complete the 13-month study. (Parents interested in having their child participate can check eligibility and sign up on Moderna's site.) Moderna's CEO Stéphane Bancel has said the company doesn't anticipate clinical data until 2022.