What do we know about COVID-19 Vaccines for Children?

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Reese H. Clark, MD, Veeral N. Tolia, MD, Curtis B. Pickert, MD

Introduction 

Our goal is to review the current literature on the safety and efficacy of COVID-19 vaccines in children, some of which will be out of date before the end of the month. There is still much to be learned about vaccines to prevent COVID-19 in children. 

The accumulating data in adults is encouraging. Authorized mRNA vaccines are highly effective in preventing SARS-CoV-2 infection and severe disease when administered in real-world conditions. Vaccines attenuated the viral RNA load, risk of febrile symptoms, and duration of illness among those who had breakthrough infection despite vaccination. (1) 

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CDC conclusion (23,24) 

The Advisory Committee on Immunization Practices conducted a risk-benefit assessment and continues to recommend the Pfizer- BioNTech COVID-19 vaccine for all persons aged ≥12 years. 

AAP recommendations (25) 

The AAP recommends COVID-19 vaccination for all children and adolescents 12 years of age and older who do not have contraindications using a COVID-19 vaccine authorized for use for their age. 

After full approval of the Pfizer-BioNTech COVID-19 vaccine, the AAP released a statement strongly discouraging the off-label use of this vaccine in children 11 years old and younger. Clinical trials for the COVID-19 vaccine in children ages 11 years old and younger are actively enrolling patients to evaluate the safety and efficacy of the COVID-19 vaccine in this age group. (26,27) 

Vaccines available as of August 23, 2021 

As of June 11, 2021, the FDA endorsed only the Pfizer-BioNTech vaccine for emergency use in 12- to 17-year-olds. Moderna applied Thursday, June 10, 2021, for authorization for its shot in adolescents aged 12 to 15. No vaccine is authorized or approved for younger children. 

All linked websites were last accessed on September 11, 2021. 

References: 

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  27. https://clinicaltrials.gov/ct2/results?cond=covid-19+vaccines 

Funding Source: None. 

Financial Disclosure: The authors have indicated they have no financial relationships relevant to this article to disclose. 

Conflict of Interest: The authors have indicated they have no potential conflict of interest relevant to this article to disclose. 

Corresponding Author
Reese H. Clark, MD

Reese H. Clark, MD
Pediatrix Medical Group, Inc.
1301 Concord Terrace
Sunrise, FL 33323-2825
Telephone: 864 907-9887
E-mail address: reese_clark@pediatrix.com

Veeral N. Tolia, MD

Veeral N. Tolia, MD
Pediatrix Medical Group, Inc.
1301 Concord Terrace
Sunrise, FL 33323-2825
Department of Neonatology,
Baylor University Medical Center and Pediatrix Medical Group,
Dallas, TX.

Curtis B. Pickert, MD

Curtis B. Pickert, MD
Pediatrix Medical Group, Inc.
1301 Concord Terrace
Sunrise, FL 33323-2825

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