Children as young as 12 years old might begin receiving COVID vaccines as soon as next week.
The FDA is expected to rule early in the week on whether to expand the emergency use authorization for the Pfizer vaccine. A federal vaccine advisory committee is then scheduled to meet Wednesday. That committee could recommend to the CDC that kids aged 12 to 15 be allowed to get the vaccine. Currently, Pfizer's vaccine is approved for anyone over 16.
"I don't see any reason why the FDA and then the CDC wouldn't go and change the emergency use authorization to include those patients 12 and over," said Dr. Lloyd Fisher, president of the Massachusetts Chapter of the American Academy of Pediatrics.
"[Pfizer has] really shown amazing efficacy and safety, that is at least as good as the adult population, and in some respects may actually be better in terms of efficacy for that 12 to 16 year old group," Fisher said.
Cambridge-based Moderna announced Thursday that its vaccine, which is currently approved for ages 18 and up, showed 96% efficacy in kids aged 12 to 17. The company hasn't applied yet for an expansion of its "emergency use authorization" to include that age group, but is expected to do so soon.
While vaccine hesitancy in Massachusetts has been among the lowest in the country, Fisher acknowledged that some parents may be more reluctant to have their children get a shot.
"I would say for all parents who are wondering what is best for their child, to listen to the experts," Fisher said. "Listen to the pediatricians, listen to the scientists and the infectious disease doctors. And then if they have questions, talk to their own child's care provider."
Among the reasons parents might not rush to get kids vaccinated, Fisher said, is that children don't tend to get as sick from the virus as older people.
"It is absolutely true that children are less likely to suffer the severe consequences. And we also have seen good evidence that younger children are less likely to spread the virus, which is what's made us comfortable with encouraging and promoting the full reopening of schools and other child activities," Fisher said. "However, the risk is still there. There are some children that get severely ill. There are some children who have been hospitalized, and a very small number — but they are out there — that have, unfortunately, died from this illness."
And importantly, Fisher said, vaccinating kids could bring down the overall spread of COVID-19.
"In order for us to really move on from this pandemic, we need to do everything we can to reduce the amount of disease that's in the community," he said. "And we do that by immunizing as much of the population as possible. And children, if they are not immunized, could be asymptomatic carriers and they could transmit it to other people, especially their family members."
Some high schools around the state are already hosting clinics to vaccinate eligible students. About 100 students were vaccinated at North Quincy High School on Wednesday, said the school's principal, Rob Shaw.
"With the country, the state opening up a little bit more, I think it could give them a little bit more sense of security going into the summer," Shaw said.
And they're discussing holding more clinics to offer vaccines to the rest of the high school, if the federal government expands the age range, he said.
"I can't see why we wouldn't look to expand, especially before we get to the end of the school year, because they're still here, engaged with us for the next month or so," he said.
Students aged 16 and over were also vaccinated this week at Brockton High School, and school district spokesperson Jessica Silva-Hodges said they're hoping to start vaccinating younger students as soon as next week, pending the federal approval.
"The vaccine is optional for our students at this point, they can get it if they'd like to," Silva-Hodges said. "I think that many of our always-remote students are excited about it because it means that they're that much closer to getting back to school."
While other vaccinations are mandatory for public school students, Governor Charlie Baker said Wednesday that it's too soon to decide if the COVID vaccine will be required to attend in-person classes next fall.
"We're going to wait and see what guidance we get from the feds," Baker said about a vaccination mandate for students. "We're going to wait and see where we are with respect to COVID generally. I'm much happier pursuing incentive policies and making it more available, and encouraging people to get it. I've said that many times before, and I think we're a long way away from making a decision about that."
Baker said he's also waiting for guidance about vaccinating kids aged 12 and up.
"The feds were very clear to us that until decisions are made by the review board, they won't be delivering any kind of information to us around distribution protocols or that type of thing," he said. "They're not going to get ahead of the review process, in other words. So we're waiting to hear from them."
The Massachusetts Chapter of the American Academy of Pediatrics supports the existing school mandates for vaccines, Fisher said. But he agreed with Baker that it's too soon to be talking about mandates for coronavirus, especially since any decision next week wouldn't include kids younger than 12.
"It is unlikely we're going to see a vaccine approved for anyone under 12 before the fall school year begins next fall," Fisher said. "And I think we have to see where we are in the pandemic as the vaccine becomes approved for the younger age groups. If we're at a point where the disease burden in the community continues to be quite low, as we've immunized all of the adults and hopefully a good portion of the teenagers, then a mandate may not be necessary."
But, he said, if the state is still seeing consistent cases in the fall, mandating coronavirus vaccinations for eligible students may make sense at that point.
"Especially as we start to think about the world where we don't have masking and distancing, which I think we all want to get to that place, especially in the schools," he added.
Already, the rates of pediatric vaccinations in Massachusetts are beginning to show some of the same demographic disparities seen in adult vaccination, said Alan Geller, a senior Lecturer at the Harvard T.H. Chan School of Public Health. Geller has been studying the disproportionate impact that the pandemic has had on lower-income communities in the state. While some of those cities have had the highest infection rates, they’ve been among the slowest to get vaccinated. Geller said an initial look at vaccination rates for kids under the age of 19, the same disparities are evident, as compared to wealthier communities.
“We see that in Newton, Needham, Wellesley and Sudbury, the rate of pediatric vaccination already, just one or two weeks into this, is five or six times greater than it is for cities with the highest COVID rates and cities with the lowest adult vaccination rates," Geller said.
The hardest hit communities Geller looked at include Brockton, Chelsea, Lynn and Revere. Geller said there needs to be an aggressive education campaign about pediatric vaccination in those communities, efforts to make vaccines available at schools and other convenient venues, and vaccines provided to pediatricians and family physicians there.
