Dr. Lee Savio Beers, President, American Academy of Pediatrics
As COVID-19 vaccine rollout expands around the world (although inequitably), experts are hopeful that enough of the global population will be protected against the SARS-CoV-2 virus to slow the pandemic’s spread. Certain countries have set aggressive target dates for vaccinating all adults, a move applauded by public health officials as a key mitigation strategy. However, this approach leaves one large group at risk: children.
Currently, children comprise only a small proportion of COVID-19 infections and, in general, those who test positive show few symptoms. But the numbers are growing and there is uncertainty about how to prioritize children and adolescents as part of mass vaccination efforts. Most of the initial clinical trials for COVID-19 vaccines excluded those under age 16 due to safety concerns, so there are limited data on the impact of these vaccines on children – a challenge now that the urgency to vaccinate children is mounting.
This week’s edition of Rabin Martin’s COVID-19 Briefing examines the complexities associated with vaccinating children against COVID-19. Can clinical trials that include children progress fast enough to help the world reach herd immunity? Will vaccine hesitancy cause parents to refuse vaccinations for their children as vaccines become available? Our earlier COVID-19 Briefings are available here.
Globally, 710,843,670 vaccines have been administered. The U.S. continues to forge ahead with mass vaccination campaigns: 33 percent of the total population has received at least one dose.
Global pandemic spread (Johns Hopkins University)
Around the U.S., vaccine uptake is increasing, especially for those who work with children, such as teachers, and rates are expected to rise even further in the coming weeks. On Tuesday, April 6, U.S. President Biden announced that all adults in the U.S. should be eligible for vaccination by April 19, ahead of the Administration’s previous May 1 deadline. As of Tuesday, April 6, nearly 80 percent of school staff members and childcare workers in the country had received at least one dose of a COVID-19 vaccine.
The situation is very different for children: timing for an approved pediatric COVID-19 vaccine is still unknown. Once a vaccine becomes available, there are concerns that hesitancy among parents may slow pediatric rollout. A recent Axios/Ipsos poll found that nearly half of U.S. parents do not plan to get their children vaccinated as soon as they are eligible.
This reluctance is worrisome given that children in the U.S. represent an increasing proportion of those infected. There were 63,862 new cases reported among children the week ending April 1 – comprising 18 percent of total infections nationwide. In Michigan, pediatric infections (ages 10-19) are increasing faster than any other age group, jumping 133 percent in the past month. Officials are warning that, in some instances, children are driving the spread of the new variants. “Until now we haven’t seen transmission like this in kids in the pandemic,” said Dr. Michael Osterholm, Director of the Center for Infectious Disease Research and Policy, University of Minnesota.
What’s more, health authorities are reporting new findings about a serious COVID-19 related condition, Multisystem Inflammatory Syndrome in Children (MIS-C). On Tuesday, April 6, the Journal of the American Medical Association released a study showing that most cases of MIS-C were preceded by asymptomatic or mild COVID-19 infections. The study, led by researchers at the U.S. Centers for Disease Control and Prevention (CDC), highlights the health complications children experienced from MIS-C. Most went into shock, with about 60 percent being admitted for intensive care – underscoring the importance of vaccinating children to safeguard their own health as well as to help achieve herd immunity.
COVID-19 Vaccine Pediatric Clinical Trials
Companies have started clinical trials of their vaccines in children as young as six months. Experts are optimistic that these trials will yield positive results and could introduce another key tool to end the pandemic. “The chances of a good pediatric vaccine coming soon are high,” said Dr. Shruti Gohil, Medical Director of Infection Prevention, University of California, Irvine. “There is no reason to think that the vaccine will have any untoward effects on children that we haven’t already noted in adults.”
The Agency stressed that even with this newly defined side effect, the benefits of the vaccine far outweigh the risks and continued to encourage countries to administer the vaccine. The data analysis, which showed that these adverse events were seen most often in younger women, prompted a review by the U.K. vaccine advisory group. The group suggested young people ages 18-29 be offered an alternative vaccine when available. Australia has similarly suggested that adults under 50 be given an alternative vaccine when available. Other countries, including the Philippines and South Korea, have temporarily paused use of the vaccine in people ages 60 and under.
From the Experts
“We have so much to look forward to, so much promise and potential of where we are, and so much reason for hope, but right now I’m scared.”
Dr. Rochelle Walensky, Director, U.S. CDC
Monday, March 29
“It’s kind of like a race between the potential for a surge and our ability to vaccinate as many people as we possibly can. And, hopefully, if you want to make this a metaphorical race, the vaccine is going to win this one.”
Dr. Anthony Fauci, Director, National Institute of Allergy and Infectious Diseases
Friday, April 2
“We are only safe if everybody is safe, and nothing tells us this like the new variants, because if we have large populations that are not vaccinated, then there is the risk that we will see new variants pop out and they will continue to spread across the world.”
Dr. Seth Berkley, Chief Executive Officer, GAVI Alliance
Sunday, April 4
“Scaling up production and equitable distribution remains the major barrier to ending the acute stage of the COVID-19 pandemic. It’s a travesty that in some countries health workers and those at-risk groups remain completely unvaccinated.”
Dr. Tedros Adhanom-Ghebreyesus, Director-General, World Health Organization
Tuesday, April 6
“We do have to remember that there are 100 million-plus adults that still haven’t been vaccinated [in the U.S.]. They’re not there yet, and you don’t win the war until you bring everybody over with you.”
Andy Slavitt, Senior Advisor, White House COVID-19 Response
Tuesday, April 6
What We’re Reading
- In the COVID-19 Vaccine Push, No One is Speaking Gen Z’s Language – Nicholas Florko, STAT News
- African Immigrant Health Groups Battle Trans-Atlantic Tide of Vaccine Disinformation – Eva Tesfaye, National Public Radio
- Should Health-Care Workers Be Required to Get Coronavirus Shots? Companies Grapple with Mandates. – Amy Goldstein, The Washington Post
- Why You Can’t Compare COVID-19 Vaccines – Madeline Marshall and Kimberly Mas, Vox
- The Mysterious Aftermath of COVID Infections – Roxanne Khamsi, The New York Times
- COVID-19 Reinfections Are Rare — But Without Better Data, We Don’t How Rare – Andrew Joseph, STAT News
Reports from International Governments and Bodies
- WHO COVID-19 Information and Guidance
- WHO Weekly Epidemiological Update: April 6
- WHO Weekly Operational Update: April 5
- CDC Coronavirus Resource Page
- COVID-19 Health Systems Response Monitor
- NCD Alliance COVID resources relevant to NCDs
Funding and Policy Trackers
- International Monetary Fund Policy Tracker
- Kaiser Family Foundation Coronavirus Policy Tracker
- U.S. Chamber of Commerce Foundation Corporate Aid Tracker
- Devex Interactive Funding Tracker
Resource Pages and Market Research Literature
- JAMA Resource Center
- The Lancet COVID-19 Resource Centre
- 2019 Novel Coronavirus Research Compendium (NCRC)
- National Academy of Medicine COVID-19 News and Resources
- WIPO COVID-19 IP Policy Tracker
- The COVID Tracking Project
- PharmaIntelligence: Coronavirus – What will the Impact Be?
- Health Affairs Resource Center
- STAT News COVID-19 Tracker
- Global Health NOW’s COVID-19 Expert Reality Check
- International Association of National Public Health Institutes COVID-19 Resources
- Center for Strategic and International Studies The Reopening and Take as Directed Coronavirus Crisis Update Podcast
- Primary Health Care Performance Initiative Forum
- U.S. Global Leadership Coalition COVID-19 Issue Briefs
- Prevent Epidemics Weekly Science Review
- COVID-19 Watch Weekly Updates
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About Rabin Martin
Rabin Martin is a global health strategy firm working at the intersection of private sector capabilities and unmet public health needs. Rooted in our mission to improve health for underserved populations, we design strategies, programs and partnerships that both deliver public health impact and drive business results. We leverage our deep knowledge and networks across a wide range of geographies and health areas to develop tailored solutions for every client engagement. We have helped many clients create bold global health initiatives and innovative multi-sector partnerships. Our specific areas of expertise include infectious disease and vaccines, non-communicable diseases, rare diseases, maternal and child health, and universal health coverage. Our clients and partners include multinational health care companies, multilateral institutions, government agencies, large foundations and leading NGOs. Rabin Martin is part of the Omnicom Public Relations Group.
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