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Pediatricians received gratitude and encouragement from the White House and got answers to some of their most frequently asked questions about COVID-19 vaccines during the latest AAP town hall.
The event came on the heels of long-awaited authorization of COVID-19 vaccines for children under 5 years.
“This is so important to us to make sure we’re getting vaccines into communities in the places where parents are used to getting their kids vaccinated,” B. Cameron Webb, M.D., J.D., senior adviser to the White House COVID-19 Response Team, told pediatricians. “That puts more onus on offices like yours, members of AAP or family providers. Primary care spaces are the places where we really do get the shots in arms and in this instance, in thighs.”
He added his thanks to the AAP for helping strategize and said the administration is doing its best to support vaccinators. He also stressed the pandemic is not over.
“We know there are always going to be variants that are staring us in the face,” he said. “We have to be ready to meet those moments. We start by making sure we’re delivering on giving these vaccines to the youngest folks in this country.”
The town hall also featured experts from the AAP Committee on Infectious Diseases (COID) who answered questions about whether they preferred the Moderna or Pfizer-BioNTech vaccine for young children, coadministration with other vaccines and the timing of vaccination in several scenarios.
Preference between vaccines
Outgoing COID Chair Yvonne “Bonnie” A. Maldonado, M.D., FAAP, and incoming COID Vice Chair James D. Campbell, M.D., M.S., FAAP, have been involved in vaccine trials with multiple manufacturers between the two of them and said they do not have a preference for one vaccine over another for young children. The Pfizer-BioNTech vaccine is a three-dose series. Moderna is two doses, but a third dose eventually may be recommended.
“They’re low reactogenicity, high safety, excellent immune responses for both of them, so whatever is available and easy to get I think is the way to go,” Dr. Campbell said.
Coadministration with other vaccines
The AAP recommends pediatricians coadminister COVID-19 vaccines and routine childhood vaccinations to keep children and adolescents up to date. After a year of doing so for adolescents, Dr. Maldonado said there have been no safety concerns.
“The main reason (for coadministration) of course is that’s what we do with other vaccines, and we also think we really need to make sure children get vaccinated with all of their vaccines as appropriately and as soon as possible,” she said.
Children entering a different age group between doses
Some children will enter another age group with a different dosage and schedule during their COVID vaccine primary series, which had led to confusion.
“For both vaccines, the easy and default thing to do is just give them the dose they should be getting based on the age they are on the day they come in,” Dr. Maldonado said.
However, if a child enters an older age group but is given the lower dose, Dr. Campbell said there is no need to repeat the dose.
The AAP has created a dosing guide to help clarify the dosage and products that should be used at every age.
Delaying vaccination until fall
Questions have arisen about whether families should wait on young children’s primary series or older children’s booster dose until fall as health officials have predicted a potential winter surge and have asked manufacturers to develop an omicron-containing booster.
“I think trying to game the system, if you will, trying to predict when the next surge is going to be, when the omicron-related vaccines are going to be available, I think it’s a mistake,” Dr. Campbell said. “ ... We know that boosters both increase the height of your antibody (response) and the breadth of coverage.”
Dr. Maldonado also advised that young children start receiving their primary series right away. Starting now with the Pfizer-BioNTech vaccine means they wouldn’t have full protection until fall.
“I know it’s quiet right now, but I can tell you in our hospital this week we’ve already had six admissions, two on ventilators,” she said. “Little kids. Not with COVID but for COVID. … So we’re still seeing COVID in the community.”
Timing of vaccination after infection
People with a COVID-19 infection should wait on vaccination until they have recovered from their illness and have completed the isolation period recommended by the Centers for Disease Control and Prevention (CDC).
Antibody levels after an omicron infection seem to drop off rapidly, so Dr. Maldonado said she would recommend not waiting more than two months after infection to get vaccinated.
- CDC information on COVID-19 vaccine boosters
- CDC clinical considerations for administering COVID-19 vaccines
- Information from the CDC on COVID-19 vaccination of children and teens
- AAP COVID vaccination resources
- AAP pediatric COVID-19 vaccine dosing quick reference guide
- AAP/Health and Human Services COVID vaccine toolkit
- Information from HealthyChildren.org on preparing children for a COVID-19 vaccine