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COVID-19 vaccines may be ready for teens this summer


Encouraging news continues to arrive about COVID-19 vaccines. During the first month of vaccination, no unusual safety issues arose when 13.8 million doses of Pfizer and Moderna vaccines were administered in the United States, the U.S. Centers for Disease Control and Prevention reported on February 19th. Vaccines also appear to slow the spread of coronavirus (SN: 2/12/21).

But the available data on COVID-19 vaccines, as well as access to them, focus almost entirely on adults. Most children are not yet allowed to receive the shots. An exception are 16- and 17-year-olds; last year, Pfizer extended the adult test to these older teens. They were included in Pfizer’s emergency use permit in the United States, although few have been vaccinated, as the group still has no priority in receiving the shots. The World Health Organization has also recommended emergency use of this vaccine for 16- and 17-year-olds.

Work to fill the data gap on childhood vaccines and COVID-19 is gaining strength. Pfizer is testing its vaccine in teens up to 12 years old. Modern is currently recruiting for a clinical trial for 12- to 17-year-olds. And on February 12, AstraZeneca announced the start of a trial for its beating on children ages 6-17.

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As for when a COVID-19 vaccine could have good use in U.S. teens, "it would be optimistic for the summer," says infectious disease physician Emily Erbelding, who heads the Division of Microbiology and Infectious Diseases at the National Allergy Institute. and Infectious Diseases in Rockville, Maryland. It would probably be the Pfizer vaccine, as the company is the most distant along with testing in teens. Younger children will wait longer to obtain a COVID-19 vaccine, with most trials not yet underway for children under 12 years of age.

Overcome the pandemic

Proving that shots are safe and effective for children is a crucial first step in vaccinating this population and protecting children’s health. Although severe COVID-19 disease is much less common in children than in adults, children did not come out unscathed. According to the American Academy of Pediatrics, more than 3 million cases of COVID-19 have been reported in children in the United States. Black and Latino children have a disproportionate share of SARS-CoV-2 infections, according to researchers in Pediatrics in October 2020.

There have also been more than 2,000 cases of multisystem inflammatory syndrome in children or MIS-C (SN: 03/03/20), a rare but serious complication of a SARS-CoV-2 infection. The weight of these cases was among black and Latino children. And the indirect damage from the pandemic continues to increase, as disruptions in children’s education and social life endanger their health.

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Also, vaccinating children is part of how society goes from pandemic. There are about 73 million children in the United States. “To reach a level of immunity in the herd in our population where we can get rid of this virus, we will have to vaccinate our children,” says Kawsar Talaat, a vaccine researcher and doctor of infectious diseases at Johns Hopkins University in Bloomberg. School of Public Health.

Along with the establishment of herd immunity, vaccination of children is necessary to curb the emergence of more variants (SN: 2/5/21). "If you don't vaccinate a population … that means you're still allowing the virus to have new mutations," as it continues to spread, says Dr. Sharon Nachman, a doctor in pediatric infectious diseases at Stony University's School of Renaissance Medicine. Brook. York.

Tests in children

To pave the way for children to be vaccinated against COVID-19, vaccines will be tested in this group to evaluate efficacy, safety, and dosage. Trials will proceed differently for younger individuals than for adults.

To measure the proper functioning of adult vaccines, clinical trials evaluated whether vaccines prevented symptomatic disease. This required tens of thousands of participants, so there would be enough cases of symptomatic COVID-19 to compare the cases between those who were vaccinated and those who were not vaccinated and to determine the effectiveness of the vaccines (SN: 10/4/20).

But to do so in children, the trials “would have to be even older,” Erbelding says, because symptoms are less likely to occur in children than in adults. Instead, researchers will see how children’s immune systems respond to the vaccine by measuring antibodies, for example. With data from adult immune responses as a guide, trials can assess whether vaccines work for children.

Tests for children will also monitor the safety of vaccines. The fact that the shots have been shown to be safe in adults – both in testing and in vaccine follow-up – is a good sign, as there is no reason to expect tremendously different reactions in children than in adults. Some researchers have questioned whether MIS-C is a risk after vaccination, as children diagnosed with the syndrome have higher levels of antibodies than children with COVID-19. However, a similar form of this complication in adults, MIS-A, has not been reported in immunized adults. “That should give you some peace of mind,” Erbelding says.

When figuring out the dosage, the goal is to “see what brings you to the sweet spot of a good immune response” and the manageable side effects of the shot, Nachman says. Some of the expected side effects with COVID-19 vaccines are pain at the injection site, headache, and fatigue. Test participants in adolescents receive the same dose as adults. But younger children are younger and their immune system usually responds very well to vaccines, so there may be a different “sweet spot” for them. Vaccine trials for children are designed to test smaller doses as needed when moving to ages 7 to 11, 2 to 6, and less than 2 years.

It’s still a big question about how many children could be vaccinated before the start of the next school year. But it will take everyone's vaccination to stop the virus so that children "can go back to school normally – without masks, without social distance, without all the things we have enacted in the last year." of Talaat.

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