Vaccines for infants are coming, but many parents are asking difficult questions

It’s a moment many parents have been waiting for for months. Children under the age of five are eligible to be vaccinated against the coronavirus among the last Americans to qualify.

Since the beginning of the pandemic, infant parents have faced nearly impossible choices without access to vaccines. Many children have been alienated from activities such as school and family gatherings and have been deprived of their normal childhood experience. Now everything can change.

On Saturday, the Centers for Disease Control and Prevention recommended Moderna and Pfizer-BioNTech vaccines for 6-month-old children. This decision means that these infants will be given their first shots, perhaps as early as Tuesday.

Sunny Baker, 35, a mother of two in Oxford, Mississippi, vaccinated her eldest daughter, Hatty Ruth, 5, on her first chance, and her two-year-old daughter, Almapar, qualifies. obtain.

“Yes, yes, yes! We want to line up,” she said.

However, Mr. Baker is very likely to be a minority. A recent Kaiser Health poll found that only one in five parents was immediately vaccinated against their young children. Many will postpone it for now.

As the pandemic spreads in the third year and Americans weigh the risks they are willing to live with, the CDC’s decision puts infant parents on the spot.

Vaccines continue to provide protection against serious illness and death, but lose some of their potency against infection by new mutants. And during the Omicron surge, a huge number of Americans were infected, causing a false sense among many that the battle was over.

Changing advice also contributes to the lack of enthusiasm. Daryl Richardson, 37, from Baltimore, said she has no plans to vaccinate her three children, partly because the recommended doses are constantly changing.

“First one shot, then a booster, then another booster,” he said.

After overcoming the dangers of a pandemic with their children for a long time, parents are now faced with new questions. Some are so complex that even regulators and experts are confused. Which vaccine is better? How well and how fast will they work? And if the majority of infants are already exposed to the virus, why bother?

Both Pfizer-BioNTech and Moderna shots are considered safe for young children, and both provide blood levels of protective antibodies similar to those found in young adults. However, neither provides the miraculous protection provided by the adult vaccine early in the pandemic.

The modelna vaccine appears to provide a strong immune response to infants, the protection of which is completed within 42 days of the first dose. However, the vaccine causes fever in one in five children and may be offered as an option by fewer providers than the Pfizer vaccine.

The Pfizer-BioNTech vaccine is more familiar and has less fever, but children need to be vaccinated three times to protect against the virus. It takes 90 days to achieve peak protection, but the effect can last longer compared to the Moderna regimen.

“Implementing these two deployments will be very difficult,” said Caitlin, a public health expert and author of the widely read newsletter “Your Local Epidemiologist.” Jeterina says.

“We will need a lot of active communication about the difference between the two and what it means to take over one to the other,” she said.

Experts may get some answers to their parents by directly comparing the two vaccines in an interview, but that is not possible and is not recommended. There are too many differences in the way vaccines are prescribed and evaluated.

Dr. William Towner, who led both Moderna and Pfizer vaccine trials at Kaiser Permanente in Southern California, said:

He said the choice might be more dependent on whether parents are willing to give three doses instead of two, and the vaccine their donors have.

Many providers are new to Moderna and have so far relied solely on the Pfizer-BioNTech vaccine. Approximately 350 million doses of the vaccine have been given to all Americans, compared to 223 million doses of the Moderna vaccine and approximately 19 million doses of the Johnson & Johnson vaccine.

For infants, the state has so far ordered 2.5 million doses of Pfizer vaccine and 1.3 million doses of Moderna vaccine. Given the 18 million children in this age group, these numbers are lower than expected.

Even older children are slow to take in. The Pfizer-BioNTech vaccine was approved for children aged 5 to 11 years in November, but less than 30% of that age group received two doses.

Vaccines have proven to be very safe overall, but many parents hesitate for a variety of reasons. Some are wary because the vaccine is relatively new, or because they recognize that the risk of Covid-19 is negligible for children.

Some parents may not be interested because they were included in 75% of the children who are already believed to be infected. However, CDC scientists said vaccination provides stronger and more consistent protection, even if the child is already infected.

Yet other parents have moved out of the pandemic.

In Middletown, Ohio, some parents were more interested in keeping cool during the hot summer months than the risk of coronavirus. 25-year-old Tori Johnson said he was not vaccinated and would not immunize his two daughters, 7-year-old Liliana and 9-month-old Rosalina.

Life had already returned to normal, she said.

Simone Williams, 32, said she was hesitant to vaccinate her 1-year-old twins Kaidon and Alyssa and 4-year-old Brian. “If necessary I would get it for them, but otherwise I wouldn’t be in a hurry,” Williams said.

Some pediatricians were preparing to explain to their parents the benefits of vaccination. Even regular immunity is a hot topic in many parts of the country.

“We’ve been struggling with the flu vaccine and the standard doses of measles, mumps, rubella, and chickenpox for many years,” said Lindsey, a pediatrician at Mount Sinai and director of quality and safety. Dr. Douglas said. Kravis Children’s Hospital in Manhattan.

“There is certainly more information out there in the last two and a half years,” Dr. Douglas added. “But there is more misinformation there.”

In some respects, the odds were cumulative for the youngest children’s use of the vaccine.

Both the Moderna and Pfizer-BioNTech vaccines provided stunning estimates of adult efficacy far beyond expectations, raising expectations for a virus-free future.

However, while the vaccine was gradually tested in young children, the virus changed rapidly and each new form was more elusive and challenging than the previous one.

The latest version of the Omicron variant has evolved to partially dodge not only the vaccine two years ago, but even the immunity produced by the infection in the form of Omicron, which was prevalent just a few months ago.

Initial efficacy estimates for adults were on the order of 95%. This figure was 51% for children aged 6 to 23 months with two doses of Moderna vaccine and 37% for children aged 2 to 5 years.

Two doses of Pfizer’s vaccine may not appear to meet the Food and Drug Administration’s standards for immune response. This justifies the February authorities’ decision to postpone the evaluation of the vaccine until the company tests three doses.

“As a mom, I don’t think it’s acceptable for our children to take this long to vaccinate,” said Dr. Jeterina. But “as an epidemiologist, I also know the value of conducting rigorous clinical trials and finding the right dose.”

Based on the data, the FDA has approved two doses of the Moderna vaccine and three doses of Pfizer-BioNTech this week as the “primary series” for young children.

If authorities determine that even the youngest child needs booster shots for future variants, the child will need to receive a third dose of Moderna and a fourth dose of Pfizer.

In news releases and data reported to federal regulators, Pfizer estimates 80% efficacy with three doses of the vaccine. However, the calculation was based on only three children in the vaccine group and seven who received the placebo, making it an unreliable metric, a CDC adviser said at a meeting on Friday.

Dr. Sara Long, an infectious disease expert at Drexel University School of Medicine, said: However, Dr. Long said it was “comfortable enough” with other data supporting the efficacy of the vaccine.

Parents of the youngest child may be willing to choose the Covid vaccine if it can be provided with other regular immunity. Dr. Towner said neither vaccine was better than nothing, but predicted that more parents might choose Moderna.

“To be honest, it can be a little difficult to do three doses instead of two,” he added. “If they have a choice and both are available, it can shake some parents to Moderna.”

Some parents do not need convincing power. In Alexandria, Virginia, 37-year-old Erinschmidt said the news “changes her life” because her family lived in “a kind of alternative isolated reality.” After vaccination of her two-year-old daughter, Sophia, she plans to open a bottle of champagne, take Sophia to the museum, and “blow her mind about the world.”

Brendan Kennery, 38, from Litchfield, Minnesota, said he and his wife, Joselin, 35, were in the lake town after their daughter, 4-year-old Hazel, and 1-year-old Ivy were vaccinated. He said he would drive him. In Duluth, we plan to try out new restaurants and attend outdoor concerts by a local folk band called Trampled by Turtles.

The family suffered from lupus and had to avoid spending time indoors with their mother, who was susceptible to severe Covid. His children missed the state fair, stopped swimming lessons and gave up gymnastics.

“I’ve been very, very happy several times in the past, and then they pulled back the rug,” Kennery said of advances in the FDA’s suspension of vaccines for children.

“The impact of these hopes was unnecessarily defeated,” he added. “I keep it away until we go to Walgreens or take them to get their pork and band-aid.”

Adam Bednar Contributed to the report from Baltimore, Christina Capetti From Litchfield, Minnesota. Ellen B. Meecham Oxford, Miss, and Kevin Williams From Middletown, Ohio.

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