November 3, 2021
Clinician Update--COVID-19:
Pfizer’s Pediatric mRNA Vaccine Green Lighted for Implementation
in Children 5-11 Years of Age
Requested Action
- Implement the Centers for Disease Control and Prevention’s (CDC’s) recommendation for COVID-19 vaccination among children 5-11 years of age.
- Be aware of resources for pediatric COVID vaccination. Families with questions are encouraged to visit DOH’s web page VaccinateWA.org/kids for information about vaccines and kids.
- Be aware that the dose and formulation for this use is different than for adults. Do NOT use adolescent/adult preparations or doses for children <12 years of age.
- Be aware that this vaccine can be given simultaneously and/or without respect to timing of other vaccines.
- Keep an eye out for updated Interim Clinical Considerations from CDC for additional details addressing this expansion of the vaccination effort.
- Consider becoming a pediatric COVID vaccine provider if you have not done so already (contact: covidvaccine@snohd.org for more information).
Background
Yesterday, CDC’s Advisory Committee on Immunization Practices (ACIP) voted unanimously to recommended use of the Pfizer’s pediatric SARS-CoV-2 mRNA vaccine as a two-dose series in children ages 5-11, noting that “the desirable consequences clearly outweigh undesirable consequences in most settings.” This recommendation follows the Food and Drug Administration’s (FDA’s) granting of emergency use authorization to Pfizer for this indication last week. Moderna and Johnson&Johnson have not yet pursued authorization from FDA for COVID-19 vaccine use in this age group.
This recommendation was based primarily on results from a phase II/III clinical trial involving more than 3,000 vaccinated children aged 5-11 years. Immunogenicity was similar to that seen in adolescents and young adults. Vaccine efficacy in preventing symptomatic, confirmed infection over the three month follow-up period was 91%. No confirmed cases of myocarditis attributable to vaccination were found during the 7-day post-vaccination period. No severe adverse events related to the vaccination were noted during follow-up. This recommendation is made without respect to prior infection. Demonstration of evidence of prior infection (e.g., via serology or prior positive PCR) should not be used or pursued as an exclusion to vaccination—the vaccine is recommended for all children regardless of prior COVID-19 status.
CDC estimates that for every million children 5-11 years of age vaccinated, the following will be prevented: 19-58K infections, 80-226 hospitalizations, and 42-132 intensive care admissions. Additional benefits include likely reductions in multi-system inflammatory syndrome, deaths, and transmission to others along with greater confidence in return to school and social interactions.
In a CDC survey, parents’ top preferences for vaccination venue were their regular health care provider and local pharmacies. The Health District’s COVID-19 vaccine and school teams have been working on implementation plans. The primary emphasis is upon parents/guardians seeking vaccination for these children through existing healthcare and community pharmacy resources. A safety net of school-based opportunities for students whose parents cannot get them into other existing vaccination settings is under development.
Meanwhile, the Health District’s vaccination site will continue to focus on vaccinating individuals 12 years of age and older. For reasons related to patient safety and logistics, children 5-11 years of age will not be eligible for vaccination at this Health District drive through setting (currently only Ash Way).
Families with questions are encouraged to visit DOH’s web page VaccinateWA.org/kids for information about vaccines and kids. DOH is updating Vaccine Locator and will add an option for “Pfizer-BioNTech Pediatric” vaccine in the coming days. If you have questions or need help scheduling an appointment, call the state’s COVID-19 hotline at 833-VAX-HELP. Language assistance is available.
Due to the state’s initial limited pediatric vaccine supply of roughly 315,000 doses, during the first couple weeks families may need to reach out to more than one provider to find vaccines for their kids. Over time, supply will increase and there will be enough vaccine for all eligible children.
Additional Resources