By The Herald Editorial Board
Again, the decision — correctly — is being left to Dr. Mom.
Sometime this week, the Centers for Disease Control and Prevention is expected to approve the lower-dose covid-19 vaccine for children, ages 5 to 11, made by Pfizer-BioNTech, following the U.S. Food and Drug Administration’s decision Friday to grant emergency-use authorization for the vaccine, having found it to be safe and more than 90 percent effective in preventing symptomatic covid-19.
As was heard previously when the Pfizer vaccine was approved for youths ages 12 to 15 in May, state and county health officials, as well as Gov. Jay Inslee and state schools Superintendent Chris Reykdal, aren’t gearing up any time soon to add the covid vaccine to the list of vaccines for childhood diseases that are required of students to attend public schools in the state.
County health officials, last week, wrote the state Board of Health, asking it to wait before considering a mandate. While recognizing the importance of pediatric vaccination to protect vulnerable children, the county health officials urged the state board to stick to the rigorous process it uses in considering the inclusion of vaccines required for school, as well as an additional unwritten criteria.
“Although not specified in the existing criteria, we believe that full FDA approval of a vaccine product should be a prerequisite for consideration of a requirement for child-care or school entry, wrote the state’s county health care officers, including Snohomish County’s Dr. Chris Spitters.
There is a distinction between the two levels of authorization. While, the Pfizer vaccine received full approval from the FDA in August for those over 16 years of age — allowing for the consideration of vaccine mandates for certain adults — its emergency-use authorization has remained for those 12 to 15 years old; the same authorization that has now been approved for younger children.
Why two levels of authorization?
In the interest of getting the vaccines out to the public quickly to better control the pandemic’s spread and limit illness, hospitalizations and deaths, the FDA approved emergency-use authorizations — a policy in place since 2001 — following studies and review of data that significantly proved the vaccines’ safety and efficacy. But that approval still lands short of more detailed and lengthy reviews mandated for a drug’s full authorization.
That prudence by local and state officials to wait for full approval, however, shouldn’t be seen as a lack of confidence in the safety or efficacy of the vaccine for youths or in its ability to bring under tighter control a pandemic that has ebbed and flowed worldwide, nationally and locally for nearly two years and has now claimed more than 5 million lives worldwide and some 746,000 in the U.S.
Vaccinations for children aren’t expected to be widely available until next week. Initially, about 15 million doses should be available in the United States, with about 28 million children between the ages of 5 and 11 to serve.
But after an initial surge of vaccinations among younger children, demand could taper off as the effort runs up against parents who are hesitant and those who are adamantly against vaccination.
A little more than 1 in 4 parents — 27 percent — say they intend to vaccinate their younger children immediately, according to a recent Kaiser Family Foundation poll; while 1 in 3 said they would wait and see. Another 5 percent said they vaccinate their child if required, but 3 in 10 said they will not vaccinate their children.
Those numbers look similar to what’s been seen among older adolescents. The Snohomish Health District’s most recent vaccination report shows that since jabs were first available 58 percent of those 12 to 15 in the county have received at least one dose of vaccine, while nearly 52 percent are fully vaccinated. The vaccination rates for those 16 to 19 — similar to those for older adults — are higher, with 74 percent having received at least one dose and nearly 67 percent fully vaccinated.
Parents’ reasons for hesitation, according to the Kaiser poll, included concerns about the possible long-term effects of the covid-19 vaccine, side effects and impacts on future fertility as well as taking time off work to schedule a vaccination.
While it’s understandable that some parents might believe they have more control over limiting their child’s risk for infection than they do over the perceived risks of a new vaccine, they may be overestimating their ability to keep their child safe from infection.
Currently, children 14 and younger made up 22 percent of the new cases of coronavirus in Snohomish County, as of Oct. 10. Nationally, children under the age of 18 make up 25 percent of covid cases, according to recent state-level data collected by the American Academy of Pediatrics.
Nationally, weekly infections among children have declined recently, from a peak of more than 250,000 the week of Sept. 2, to 118,000 as of Oct. 21, but a total of 6.3 million children have tested positive for covid-19 since the start of the pandemic, the pediatrics academy reported.
While severe illness among children from covid-19 is uncommon, the APP report said, more data is needed on the longer-term impacts of the pandemic on children, “including ways the virus may harm the long-term physical health of infected children, as well as its emotional and mental health effects.”
Health and other officials are taking the correct path — at least until one or more vaccines have full approval from the FDA for children — by leaving the decision on vaccination of children to parents. But that decision also leaves to those parents a higher level of responsibility for the health of their children and that of others to make an informed choice.
Those who are hesitant or who have questions or doubts about the vaccine and the risks of covid-19 to their children, should seek out the advice of their child’s doctor.
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