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COVID-19 Response Team discusses reopening schools, pediatric vaccine trials

January 29, 2021

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Ensuring that schools have the tools they need to reopen was emphasized during a COVID-19 Response Team press briefing at the White House today.

Earlier this week, the Centers for Disease Control and Prevention (CDC) released mitigation tools for K-12 schools, echoing key principles in the AAP COVID-19 Guidance for Safe Schools.

“CDC continues to recommend that K through 12 schools be the last setting to close after all other mitigation measures have been employed, and the first to reopen when they can do so safely,” said CDC Director Rochelle Walensky, M.D., M.P.H.

Data indicate that COVID-19 does not spread rapidly in school settings when mitigation measures like masking, decreasing density and ensuring proper ventilation are followed. Children in schools and camps have fewer symptoms and lower rates of transmissibility than adults. However, when a lot of virus is circulating in a particular area, community-based strategies to reduce transmission also are important for the safe reopening of schools, Dr. Walensky said.

She acknowledged that many communities lack the capacity to meet all mitigation measures. “That is why it is essential that the guidance tools and resources called for in the national strategy for the COVID-19 response and the American rescue plan are provided to communities,” she said.

Although more candidate vaccines are closer to becoming part of the arsenal against the pandemic, they are not all being studied in children.

Novavax announced Thursday that its vaccine, which uses a soluble protein platform, met the primary endpoint with an efficacy of 89.3% in Phase 3 clinical trials in the United Kingdom.

An interim analysis of Phase 3 clinical data shows a single dose of the Janssen/Johnson & Johnson recombinant vector vaccine, which uses an adenovirus-26 platform, appears to be safe and effective at preventing moderate and severe COVID-19 in adults.

Pediatric clinical trials have begun for the Moderna and Pfizer vaccines.

Anthony Fauci, M.D., head of the National Institutes of Allergy and Infectious Diseases, said these trials will not be the same size and scope as adult trials.

Moderna received emergency use authorization (EUA) for people ages 18 years and older, and Pfizer/BioNTech was granted EUA for people 16 years and older. Both are working on age de-escalation trials (e.g., from 18 to 16 years, then from 16 to 12 years, then from 12 to 9 years). Pfizer’s trial is filled, but Moderna is enrolling adolescents ages 12-17.

Data from a smaller trial that demonstrate the vaccine is safe and induces the correlate of immunity in younger ages that can be bridged to efficacy data from the larger adult clinical trials.

“Hopefully, by the time we get to the late spring and early summer, we will have children being able to be vaccinated according to the FDA guidance,” Dr. Fauci said.

As mutant B.117, B.1351 and P.1 variants emerge across the U.S., experts have speculated that the new variants could become more dominant than the wild type.

To improve real-time tracking of mutations, Dr. Walensky said the CDC is urging states to ramp up surveillance and is collaborating with seven universities to scale up surveillance.

“Viruses cannot mutate if they don't replicate,” Dr. Fauci said. “And that’s the reason to continue to do what we're doing, namely, intensify our ability … to vaccinate as many people as possible as quickly as possible.”

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