It’s a time many parents have been waiting anxiously for months: children under the age of 5 are now eligible for coronavirus vaccination, among the last Americans to qualify.
Without access to vaccines, parents of young children have faced almost impossible options since the pandemic began. Many children were abstained from school, family reunions, and other activities, and were deprived of normal childhood experiences. Now all that could change.
On Saturday, the Centers for Disease Control and Prevention recommended the Modern and Pfizer-BioNTech vaccines for children as young as 6 months old. The decision means vaccinations will be given to these young children for the first time, perhaps as early as Tuesday.
Sunny Baker, 35, a mother of two in Oxford, Mississippi, said she vaccinated her eldest daughter, Hattie Ruth, 5, at the first opportunity, and that she was looking forward to her 2-year-old daughter, Alma. Pearl, qualify.
“Yes yes Yes! We would love to be first in line,” he said.
But Ms. Baker may be a minority: A recent Kaiser Health survey found that only one in five parents will vaccinate their young children immediately. Many plan to hold on for the time being.
As the pandemic spreads to a third year and Americans weigh in on the risks they are willing to live with, the CDC’s decision puts parents of young children in place.
Vaccines have lost some of their potency against infection with new variants, although they continue to offer protection against serious illness and death. And a large number of Americans became infected during the rise of Omicron, which contributed to the mistaken feeling among many that the battle was over.
Change tips have also contributed to the lack of enthusiasm. Baltimore’s Daryl Richardson, 37, said she had no plans to vaccinate her three children, in part because of constant changes in the number of recommended doses.
“First it was a blow, and then it was a reinforcement and another reinforcement,” he said.
After navigating the dangers of the pandemic with their children for so long, parents are now faced with new questions, some so complex that they have puzzled even regulators and experts. Which vaccine is better? How well, and when will they soon work? And why bother, if most young children have already been exposed to the virus?
Both Pfizer-BioNTech and Moderna traits are considered safe for young children, and both produce blood levels of protective antibodies similar to those seen in young adults. But neither offers the miraculous protection provided by adult vaccines in the early days of the pandemic.
The Moderna vaccine appears to produce a strong immune response in young children and its protection has been completed in 42 days after the first dose. But the vaccine causes fever in one in five children, and fewer providers are likely to offer it as an option over the Pfizer vaccine.
The Pfizer-BioNTech vaccine is more familiar and produces fewer fevers, but children will need to receive three doses to protect themselves from the virus. Although it takes 90 days to achieve maximum protection, the effect can last longer compared to the Moderna regime.
“Implementing these two releases will be incredibly difficult,” said Katelyn Jetelina, a public health expert and author of the widely read newsletter, “Your Local Epidemiologist.”
“There will have to be a lot of proactive communication about the difference between the two and the implications of getting on top of each other,” he said.
A direct comparison of the two vaccines could provide some answers for parents, but this is neither possible nor advisable, experts said in interviews. There are too many differences in the way vaccines were formulated and evaluated.
“It will be impossible to say that one is better than the other,” said Dr. William Towner, who led vaccine trials for both Moderna and Pfizer at Kaiser Permanente in Southern California.
The choice may depend more on whether parents are willing to take three doses instead of two, and what vaccine their providers have on hand, he said.
Many vendors are not used to Moderna, as so far they only rely on the Pfizer-BioNTech vaccine. In all, about 350 million doses of this vaccine have been administered to Americans, compared to 223 million doses of the Modern vaccine and about 19 million of the Johnson & Johnson vaccine.
For young children, states have so far ordered 2.5 million doses of the Pfizer vaccine and 1.3 million of the Modern vaccine. These figures are lower than expected, taking into account the 18 million children in this age group.
Absorption has been slow even for older children. The Pfizer-BioNTech vaccine was approved for children ages 5 to 11 in November, but less than 30 percent of that age group have received two injections.
Vaccines have generally been shown to be very safe, but many parents continue to be hesitant for a number of reasons. Some are wary because the vaccines are relatively new or because they perceive the risk of Covid-19 to be insignificant to their children.
Some parents may be disinterested because their children were among the 75 percent who were thought to be already infected. But vaccination provides more powerful and consistent protection even if a child has already been infected, CDC scientists said Saturday.
Still other parents have gone through the pandemic.
In Middletown, Ohio, some parents were more concerned about staying cool during the summer heat wave than the coronavirus risks. Tori Johnson, 25, is not vaccinated and said she did not intend to immunize her two daughters, Liliana, 7, and Rosalina, 9 months.
Life was back to normal, he said.
Simone Williams, 32, said she was hesitant to vaccinate her 1-year-old twins, Caidon and Arissa, and 4-year-old Bryan. “I would get them if I needed to, but otherwise I’m in no hurry,” Ms. Williams.
Some pediatricians were preparing to explain to parents the merits of getting the vaccine. Even routine vaccinations are a complicated issue in many parts of the country.
Pediatricians “have struggled with this for many, many years with the flu vaccine and the standard dosage for measles, mumps, rubella, and chickenpox,” said Dr. Lindsey Douglas, a pediatrician and medical director of quality and safety on Mount Sinai. Kravis Children’s Hospital of Manhattan.
“In the last two and a half years, there’s definitely a lot more information,” Dr. Douglas added. “But there’s also a lot more misinformation.”
Somehow, the odds piled up against the use of vaccines in younger children.
Moderna and Pfizer-BioNTech vaccines provided spectacular estimates of effectiveness in adults, far beyond expectations, and raised hopes for a virus-free future.
But while vaccines were being tested gradually in younger children, the virus quickly transformed, each new form more elusive and challenging than the previous ones.
Newer versions of the Omicron variant have evolved to partially dodge not only two-year-old vaccines, but even the immunity produced by an Omicron-shaped infection that circulated just a few months ago.
The original estimates of effectiveness in adults were in the order of 95 percent. This figure has now risen to 51 percent for two doses of the Moderna vaccine in children aged 6 to 23 months, and only 37 percent for children aged 2 to 5 years.
As low as it may seem, two doses of the Pfizer vaccine did not even meet the Food and Drug Administration’s limit for an immune response, which justified the agency’s decision in February to delay vaccine evaluation until the company has tested three doses.
“As a mother, I think it’s unacceptable that it took so long to vaccinate our little ones,” Dr. Jetelina said. But “as an epidemiologist, I also know the value of conducting rigorous clinical trials and finding the right dose.”
Based on the data, the FDA has this week authorized two doses of the Modern vaccine and three doses of Pfizer-BioNTech as a “primary series” for young children.
If officials determine that even younger children need booster injections against future variants, children will need to receive a third dose of Moderna and a fourth dose of Pfizer.
In press releases and data reported to federal regulators, Pfizer has estimated an 80 percent effectiveness for three doses of its vaccine. But that estimate was based on only three children in the vaccine group and seven who received a placebo, making it an unreliable metric, CDC advisers said at a meeting Friday.
“We should assume we don’t have efficacy data,” said Dr. Sarah Long, an infectious disease expert at Drexel University School of Medicine. But Dr. Long said he was “comfortable enough” with other data supporting the vaccine’s potency.
Parents of younger children may be more willing to opt for a Covid vaccine if it can be offered along with other routine vaccinations. Dr. Towner said any vaccine would be better than none, but predicted that more parents could opt for Moderna.
“I’ll be honest, this can be a little difficult for some parents to do three doses instead of two,” she added. “If they have a choice, and if both are available, that may influence some parents in the Modern.”
Some parents will not need to be persuaded. In Alexandria, Virginia, Erin Schmidt, 37, said the news “changed lives” because her family has been living in a “kind of alternative isolated reality.” After vaccinating her 2-year-old daughter, Sophia, she plans to open a bottle of champagne, take Sophia to a museum, and “blow her mind about the world.”
Brendan Kennealy, 38, of Richfield, Minnesota, said that after his daughters, Hazel, 4, and Ivy, one year, were vaccinated, he and his wife Jocelyn, 35, were vaccinated. they would drive to the lake town of Duluth, where they plan to try new restaurants and attend an open-air concert by a local folk band called …