As Pfizer vaccine for kids under 5 nears authorization, parents weigh risks

WASHINGTON (TND) — As polls show most parents of young children are reluctant to line them up for COVID-19 vaccine shots, the surgeon general acknowledged Friday much is still uncertain despite Pfizer’s application for emergency use authorization from the Food and Drug Administration to administer its vaccine to children under 5.

“We do not know yet if this vaccine is going to be safe and effective for children under 5,” Surgeon General Dr. Vivek Murthy told CNN. “That’s exactly why the FDA is beginning a process of rigorous review and that’s going to be a transparent process.”

Pfizer and its partner BioNTech applied for authorization for a two-dose regimen this week at the FDA’s request, even though officials announced in December that two shots did not produce a sufficient immune response in children ages 2 to 4. Trials are still underway for a third dose, but data will not be available until late next month.

Murthy suggested the spread of the omicron variant, which resulted in record numbers of pediatric infections and hospitalizations, changed the calculation and added urgency to the process. Officials still believe three shots will ultimately be necessary, but two doses might provide some protection against severe illness.

Independent advisers to the FDA and the Centers for Disease Control and Prevention will review Pfizer’s application later this month. The White House said Wednesday officials are preparing to “hit the ground running” to distribute and administer vaccines once they are authorized, but the regulatory review must be completed first.

“What the FDA will not do is cut corners when it comes to the quality of the assessment because they know the country depends on them as a gold standard for safety,” Murthy said.

The unusual review process could feed further skepticism from parents who doubt the vaccines are necessary for children or who have concerns about the relatively rapid development of the new drugs. Vaccine uptake among children in the U.S. is significantly lower than for adults, and public health experts see short-term and long-term risks in leaving the younger population vulnerable to the virus.

According to a Kaiser Family Foundation poll released this week, 31% of parents of children under 5 plan to get them vaccinated right away once a shot is authorized. That figure is up nearly 10 points since September, but nearly 40% of parents still do not want to get their young children immunized at all.

“With the undercurrent of misinformation and fear parents are being hit with, the number [who want the vaccine] is actually higher than I had anticipated,” said Amber Reinhart, a health communication expert at the University of Missouri-St. Louis.

The survey also indicated there are few parents of older children who have not already gotten their child vaccinated but plan to do so soon. About 80% of parents whose children are unvaccinated say the spread of the omicron variant has not changed their views.

“They’re stacking the decision about what they know about the vaccine versus their perception of how dangerous COVID-19 is for their children,” said Jennifer Reich, a sociologist at the University of Colorado Denver and author of “Calling the Shots: Why Parents Reject Vaccines.”

Children infected with COVID-19 rarely experience severe symptoms or death, but they can transmit the virus to others who are more vulnerable and much is still unknown about the lasting ramifications of the illness. Still, Dr. Scott Ratzan, executive director of CONVINCE USA at the City University of New York, said it is not surprising that parents might have greater reservations about getting their children immunized than receiving the shots themselves.

“We always have shown a difference in people willing to take their own risk versus children,” Ratzan said. “People are always a little more concerned to wait and see.”

According to the Kaiser survey, half of all parents are very or somewhat worried their child will become seriously ill from the virus. Low-income families and parents who are Black or Hispanic were significantly more concerned about infections than others.

The Kaiser poll also underscored the extent to which the pandemic continues to disrupt family life, with 41% of parents saying their child was either quarantined or forced to revert to virtual learning at some point in January. Black and Hispanic parents were four times more likely than white parents to have chosen to keep their child home due to the risk of infection.

“Parents tend to take a view that vaccines are a necessary evil,” Reich said. “They’ll take vaccines if they’re important, but it’s better to have as few as possible.”

The weeks ahead could be crucial to efforts to bolster parents’ confidence in the COVID-19 vaccines. Even some vocal proponents of immunization have signaled reticence in the absence of complete data, but the FDA and CDC reviews may help allay those fears.

“I would wait until we find that the vaccines are safe and effective, and I’m not sure that we can say that at the moment because we just don’t have the data,” Dr. Leana Wen, an emergency room physician and professor at George Washington University, said earlier this week.

If the vaccines are deemed effective for children under 5, convincing parents young children need the shots presents a new messaging challenge for health officials. However, experts say the most effective approach to combatting vaccine hesitancy is similar, regardless of the age group: clear and honest communication through trusted messengers in the community.

“We have to get rid of the misinformation that they cause sterilization, implant chips in people’s minds We need to address that with facts and trustworthy sources,” Ratzan said.

According to Reinhart, communication should focus on parents who appear to be persuadable. Medical professionals can make the case to them that the benefits of vaccinating young children before another wave of infections arrives or another variant emerges far outweigh the risks.

“The ‘wait-and-see’ group of parents need messages that demonstrate how waiting can lead to a higher chance their child will get COVID since the omicron variant is so contagious,” Reinhart said. “Messages need to focus on what is gained by vaccinating your kids, and we need honest messaging about the potential risks for not vaccinating them.”