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Will Kids Need Boosters?
It’s been 6 months since the FDA authorized Pfizer’s COVID-19 vaccine for kids ages 12 to 15, prompting some parents to ask whether their children will need boosters, especially in the face of the Omicron variant and waning efficacy in adults.
Pfizer has requested authorization of boosters for kids ages 16 and 17 — but the company told MedPage Today it’s not currently conducting a clinical trial of boosters in younger children.
When asked if there were any plans to ask for authorization of a booster for those children, Pfizer spokesperson Jerica Pitts told MedPage Today in an email, “We have not finalized any plans for a booster study in this age group and happy to keep you updated on that front.”
Pfizer didn’t respond to follow-up questions about clinical trials of boosters for children; nor did Moderna return a request for comment on kids’ boosters (though their vaccine isn’t yet authorized in kids under 18).
Infectious disease and pediatric experts have noted that there isn’t yet a rush to boost young kids. The American Academy of Pediatrics, for instance, said it has no position on booster shots for children at this time.
According to CDC data, those under 18 have had the lowest rate of breakthrough cases, and adults over 65 have had the highest breakthrough death rates. The rate of hospitalization for vaccinated children ages 12 to 17 was 0.3 per 100,000 at the end of September compared with 3.8 per 100,000 for adults.
Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, told CNN that young people are simply better equipped to fight disease, and their immunity via the vaccine may last longer.
“It may be that they will go a much longer period of time before they start to wane,” he said. “They have a very robust immune system. So I would not be surprised that they will have a protection that will go way out beyond that 6 months.”
Paul Offit, MD, of Children’s Hospital of Philadelphia, agreed, though he believes most people don’t need boosters, with the exception of older adults, the immunocompromised, and people in long-term care facilities.
If the goal of a vaccine is to prevent serious illness, he said, then two doses are still doing just that.
Children hospitalized with COVID at Offit’s facility have been, for the most part, unvaccinated, he said.
That younger people are at greater risk of myocarditis as a side effect of the mRNA vaccines shouldn’t be ignored when considering third doses, Offit said.
“It’s a very, very rare risk, but it’s a real risk, and it’s not a trivial problem. Which is fine, as long as the benefits clearly and definitively outweigh the risks,” he said, noting that he’d like to see evidence of better protection against serious illness with the booster in kids before they are widely recommended.
Offit and other experts have said that vaccinating the unvaccinated — adults and children alike — is more urgent at this time.
Allison Agwu, MD, ScM, of Johns Hopkins University School of Medicine in Baltimore, told MedPage Today that the priority should be to “assure that we are still doing our best to mitigate spread (no matter how sick we are of COVID) and that the millions of individuals who have yet to be vaccinated, get vaccinated.”
Indeed, CDC Director Rochelle Walensky, MD, MPH, has strongly encouraged everyone ages 18 and up to get booster shots, especially with the emergence of the Omicron variant.
But Offit countered that “we will do far better taking these third doses for people who are already, for the most part, protected against serious ailments and sending them to the developing world.”
About 69% of the U.S. population has received at least one dose of a vaccine compared with only 6% of countries classified as “low income.” Countries in West and Central Africa, as well as Yemen, Syria, and Papua New Guinea, have some of the lowest rates of vaccination.
Créditos: Comité científico Covid
