COVID-19 Briefing: The Urgency of COVID-19 Vaccines for Kids

08 April 2021

“Having a COVID-19 vaccine available for children is essential for our nation to end the pandemic. We need to apply the same urgency to vaccinate children as we have for adults.”
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.

Pandemic Spread

As of Thursday, April 8 at 3:30pm ET, Johns Hopkins University reported 1,33,499,369 cases of COVID-19 and 2,893,112 deaths due to COVID-19, globally. The U.S. accounts for about a fifth of global cases, reporting 30,968,429 cases and 559,849 deaths.

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)

Pediatric Vaccination

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.”

Pfizer has begun to share positive data on its trials in adolescents ages 12-25. On Wednesday, March 31, Pfizer announced that the vaccine it developed in partnership with BioNTech provided 100 percent efficacy in adolescents ages 12-15, exceeding results seen in an earlier analysis of adolescents ages 16-25. Also in March, Pfizer dosed the first participants in a clinical trial of the vaccine’s safety and immunogenicity in children under age 12.

Moderna is currently testing its two-dose mRNA vaccine in adolescents ages 12-17 and hopes to generate results in Spring 2021 in order “to provide a safe vaccine to provide protection to adolescents so they can return to school in a normal setting.” Johnson & Johnson announced on Friday, April 2, that the company has begun vaccinating adolescents ages 12-17 in ongoing Phase 2A trials of its adenovirus based vaccine. Currently the trial is recruiting adolescents in Spain and the U.K. and will begin U.S. recruitment shortly. Additionally, on Monday, April 5, Novavax said it plans to expand its vaccine trials to include children and teens in the second quarter of this year. (Novavax’ vaccine has yet to be approved by a regulatory body.)

At the same time, challenges affecting adult clinical trials are having spillover effects on pediatric trials. Amidst fears about the AstraZeneca-University of Oxford COVID-19 vaccine’s association with blood clots, on Tuesday, April 6, the University of Oxford paused trials of the vaccine designed to test safety and efficacy for use in children 6-17 years old.

Industry Updates

On Wednesday, March 31, Johnson & Johnson (J&J) announced that a routine quality control check found a production error at an Emergent BioSolutions site in Baltimore that had been manufacturing drug substance for J&J’s one-shot COVID-19 vaccine. The mistake, which contaminated 15 million doses, stemmed from a variety of human errors: viral cross-contamination, bacterial contamination, inadequately trained workers, lack of sufficient quality control managers, among other issues. J&J swiftly confirmed that the ruined doses never advanced to the finishing stages of manufacturing and announced its intentions to increase its technical oversight at the Baltimore facility. On Saturday, April 3, the Biden Administration directed J&J to take full responsibility for manufacturing drug substance at the Baltimore plant. The Administration has also pushed to stop production of the AZ vaccine at the Baltimore facility. Notwithstanding the ruined doses, J&J expects to deliver nearly 100 million doses to the U.S. government by the end of May.

Weeks after reports began to surface of people experiencing blood clots following receipt of the AstraZeneca-University of Oxford vaccine, the European Medicines Agency said on Wednesday, April 7, that “unusual blood clots with low blood platelets should be listed as very rare side effects” of the AZ vaccine. It is estimated that the serious blood clots affect only 1 in 100,000 people.

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

Additional Resources

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

Resource Pages and Market Research Literature

Communications Toolkits

For more information or should you have any questions, please contact us.

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.

About Omnicom Public Relations Group

Omnicom Public Relations Group is a global collective of three of the top global public relations agencies worldwide and eight specialist agencies in public affairs, marketing to women, fashion, global health strategy and corporate social responsibility. It encompasses more than 6,000 public relations professionals in more than 330 offices worldwide who provide their expertise to companies, government agencies, NGOs and nonprofits across a wide range of industries. Omnicom Public Relations Group delivers for clients through a relentless focus on talent, continuous pursuit of innovation and a culture steeped in collaboration. Omnicom Public Relations Group is part of the DAS Group of Companies, a division of Omnicom Group Inc. that includes more than 200 companies in a wide range of marketing disciplines including advertising, public relations, healthcare, customer relationship management, events, promotional marketing, branding and research.

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