As we move into fall 2021, many parents have been calling and asking about COVID vaccines for children, influenza vaccine timeline, and mask recommendations.

COVID-19 Vaccines for Under 12 years

    Pfizer began studying its COVID vaccine in children under 12 years starting March 2021.   Moderna started soon afterwards.  The FDA notified both manufacturers that they must double their trial size to investigate for particularly rare side effects in July, which delayed the trials.   However, currently Pfizer expects to submit its finished trial data in September 2021 for Emergency Use Authorization (EUA).   Typically, it takes at least a month for the FDA and the CDC’s ACIP to review the information and make a determination. 

   This means that there may be an FDA EUA for Pfizer’s COVID vaccine in October of 2021.  The first group would be children 5-11.  Soon after it is expected that Pfizer will submit data for down to 6-month-old.  Moderna is not expected to submit until early 2022.

    When the studies are released and peer reviewed, Heritage Pediatrics will thoroughly review the information in order to comment on the safety and efficacy of this vaccine.  At this time, there is not enough published information to give any solid recommendation.   If it is determined to be safe and effective, Heritage Pediatrics anticipates being able to administer this vaccine immediately.  Questions on whether or not to vaccinate your child are best answered by discussing with your individual doctor and when there is more clinical data available.

Off-Label COVID Vaccines for Kids Under 12 years

   We are currently not giving any “off label” doses of vaccine to children under 12 years.   The studies are critical to follow before doing this.   Importantly, the optimal dose for these children appears to be different and may be only 1/3 of the dose of the adolescents and adults.

Flu Vaccines

Heritage Pediatrics will continue annual flu vaccination in the coming months.   We have not yet received our shipments but anticipate receiving soon.  It is likely we will start drive-thru clinics in September in anticipation of having to do October and November drive thru clinics for COVID vaccines.  You may follow our Facebook page or check into our website for signups as they occur.   We do not plan on doing joint influenza/COVID vaccines at this time due to organizational demands.

It is unclear if/when flu season will occur this winter.  Traditionally it peaks between December and February.   Last year there was no significant season, presumably due to all the mechanisms to reduce COVID.   We do expect a bigger season than last year but it is difficult to predict severity beyond that.

Masks and School

No doubt you have all been aware of the contentious public discourse about masks.  Heritage Pediatrics has heard from every angle on this discussion.   At this time, particularly while the positivity rate is high and Delta is surging, we feel that masking indoors with those who are unvaccinated remains the best way to keep our schools open.   Everyone wants to keep our schools open.  No one wants our kids to have to wear masks.   To achieve this, we encourage masking right now, particularly during this surge, to reduce time away from school and interrupted learning.

Delta Delta

     Currently, the Delta variant has changed the conversation about COVID-19.    It is important to put the risks into context.   The Delta variant is much more contagious than previous iterations.  This means more children will get it and they can now spread to adults and other peers.   There is no evidence, however, that Delta is any more severe on children on a case-by-case basis than any other variants.   As with all COVID, most children and teenagers do fine with mild flu-like symptoms for less than 5 days.   Less than 2% of children are hospitalized and death is exceedingly rare, less than 1/10,000.  70% of hospitalized children have underlying conditions such as obesity, heart or immune conditions.

    The severity appears not to have changed.   Simply the number of cases and thus the absolute number of children getting hospitalized has risen.  This is why the hospital cases are up, not because this strand is more harmful or lethal.   Add to this the nursing shortage and RSV peaking, our pediatric hospitals are quite taxed for resources.