An advisory panel to the Centers for Disease Control and Prevention voted Wednesday to recommend Pfizer's Covid-19 vaccine for use in kids ages 12 to 15. The vote was 14-0, with one abstention.
The vote comes two days after the Food and Drug Administration amended its emergency use authorization for Pfizer's vaccine to include this age group and is considered one of the final steps needed before shots start going into arms.
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Indeed, it is expected that CDC's director, Dr. Rochelle Walensky, will accept the Advisory Committee on Immunization Practices, or ACIP, recommendation quickly — clearing the way for the shots' use in the 17 million young people in this age group.
Some states, such as Delaware and Georgia, began administering the shots immediately after the FDA's action. But most major pharmacies and clinics said they would wait for the CDC's input before vaccinating kids ages 12 to 15.
Vaccinating this age group is seen as a key way for middle and high schools to reopen fully by this fall.
The shots will be given in the exact same way they're given to adults — three weeks apart — with the same dosage. This is not unusual; doses of flu shots, for example, are also given at the same dosage levels for kids and adults.
Covid-19 has not sickened adolescents as significantly as older adults, though as of Thursday, more than 3.8 million cases had been reported in children, according to the American Academy of Pediatrics. That represents 14 percent of total cases in the U.S.
But there has been a gradual increase in the Covid-19 hospitalization rate among 12- to 17-year-olds over the past two months, Dr. Sara Oliver, a medical epidemiologist with CDC's National Center for Immunization and Respiratory Diseases, said during the Wednesday ACIP meeting. Sixty-one percent of those teens had at least one underlying condition, most commonly obesity and asthma.
Covid-19 is also linked to a condition called multisystem inflammatory syndrome in children, or MIS-C.
As of May 3, Oliver said that more than 3,700 MIS-C cases had been reported, and they tended to be more serious in teenagers than in younger children — adding evidence for the potential benefits of vaccination.
More than 2,200 participants ages 12 to 15 were included in Pfizer's Phase 3 clinical trial in the U.S. About half got the real vaccine, while the others received placebos.
The shot was found to be 100 percent effective. Eighteen people in the placebo group developed symptomatic Covid-19, compared to zero cases among those who got the real shots.
Side effects mirrored those of adults: sore arms, fatigue, headache and chills. Fever was also more likely to be reported following the second dose of vaccine. No cases of severe allergic reactions, called anaphylaxis, were reported in study participants. No cases of Bell's palsy, a type of facial paralysis, were reported either.
While no serious adverse events were reported during the trials, it is possible that very rare side effects could be identified once the vaccine is administered widely in this age group.
A chance to catch up
Getting young teens to the doctor for their Covid-19 vaccination may also be a good time for kids to catch up on any shots they missed during the pandemic, Dr. Kate Woodworth, a pediatrician in the CDC's Division of Birth Defects and Infant Disorders, said during Wednesday's meeting.
However, the CDC currently advises against people of any age getting other types of vaccinations within two weeks of the Covid-19 vaccination. During the Wednesday meeting, the panel discussed recommending changing this guidance, to allow for so-called co-administration.
"The need for catch-up vaccination in coordination with Covid-19 vaccination is urgent as we plan for safe return to in-person school," Woodworth said. According to the CDC, the number of vaccine orders from providers within the Vaccines for Children Program over the past year is down by 11.7 million doses, compared with 2019.
The largest gaps are found for shots normally given to adolescents: the HPV vaccine, which protects against human papillomavirus; the Tdap vaccine, for tetanus, diphtheria and pertussis; and the meningococcal vaccine, to protect against meningitis.
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But some panel members were reluctant to advise giving teens Covid-19 vaccinations at the same time as other vaccinations, mainly because the practice has not been studied.
Dr. Sarah Long, a professor of pediatrics at Drexel University College of Medicine in Philadelphia, told the panel that "there is no question that there is a signature inflammatory response that is different from every other vaccine that we've given," referring to the Covid-19 vaccine.
"I'm not at all comfortable with deciding right now how these vaccines can be used concurrently with anything without any data," Long said.
The CDC panel acknowledged it is unknown whether giving other vaccinations at the same time as Covid-19 shots will lead to a significant increase in side effects and suggested physicians weigh risks of whether any particular patient is behind or at risk of falling behind on recommended vaccinations.
Meanwhile, the American Academy of Pediatrics released a statement in favor of giving children vaccinations for both Covid-19 and other illnesses concurrently.
"We've seen the harm done to children's mental and emotional health as they've missed out on so many experiences during the pandemic," Dr. Lee Savio Beers, president of the American Academy of Pediatrics, said in the statement. "Vaccinating children will protect them and allow them to fully engage in all of the activities — school, sports, socializing with friends and family — that are so important to their health and development."