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One week after reporting promising results from the trial of their COVID-19 vaccine in children ages 5 to 11, Pfizer and BioNTech announced they’d submitted the data to the FDA. But that hasn’t stopped some parents from discreetly getting their children under age 12 vaccinated.
“The FDA, you never want to get ahead of their judgment,” Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, told MSNBC on Tuesday. “But I would imagine in the next few weeks, they will examine that data and hopefully they’ll give the OK so that we can start vaccinating children, hopefully before the end of October.”
Lying to Vaccinate Now
More than half of all parents with children under 12 say they plan to get their kids vaccinated, according to a Gallup poll. Among those who say they’re “very worried” or “somewhat worried” about their children catching COVID, that number goes up to 90% and 72%, respectively.
Dawn G. is a mom of two in southwest Missouri, where less than 45% of the population has been fully vaccinated. Her son turns 12 in early October, but in-person school started in mid-August.
“It was scary, thinking of him going to school for even 2 months,” she says. “Some parents thought their kid had a low chance of getting COVID, and their kid died. Nobody expects it to be them.”
In July, she and her husband took their son to a walk-in clinic and lied about his age.
“So many things can happen, from bullying to school shootings, and now this added pandemic risk,” she says. “I’ll do anything I can to protect my child, and a birthdate seems so arbitrary. He’ll be 12 in a matter of weeks. It seems ridiculous that that date would stop me from protecting him.”
In northern California, Carrie S. had a similar thought. When the vaccine was authorized for kids ages 12-15 in May, the older of her two children got the shot right away. But her youngest doesn’t turn 12 until November.
“We were tempted to get the younger one vaccinated in May, but it didn’t seem like a rush. We were willing to wait to get the dosage right,” she says. “But as Delta came through, there were no options for online school, the CDC was dropping mask expectations — it seemed like the world was ready to forget the pandemic was happening. It seemed like the least-bad option to get her vaccinated so she could go back to school, and we could find some balance of risk in our lives.”
Adult vs Pediatric Doses
For now, experts advise against getting younger children vaccinated, even those who are the size of an adult, because of the way the human immune system develops.
“It’s not really about size,” said Anne Liu, MD, an immunologist and pediatrics professor at Stanford University School of Medicine. “The immune system behaves differently at different ages. Younger kids tend to have a more exuberant innate immune system, which is the part of the immune system that senses danger, even before it has developed a memory response.”
The adult Pfizer-BioNTech vaccine contains 30 micrograms (mcg) of mRNA, while the pediatric dose is just 10 mcg. That smaller dose produces an immune response similar to what’s seen in adults who receive 30 mcg, according to Pfizer.
“We were one of the sites that was involved in the phase I trial, a lot of times that’s called a dose-finding trial,” says Michael Smith, MD, a co-investigator for the COVID vaccine trials done at Duke University. “And basically, if younger kids got a higher dose, they had more of a reaction, so it hurt more. They had fever, they had more redness and swelling at the site of the injection, and they just felt lousy, more than at the lower doses.”
At this point, with Pfizer’s data showing that younger children need a smaller dose, it doesn’t make sense to lie about your child’s age, says Smith.
“If my two options were having my child get the infection vs. getting the vaccine, I’d get the vaccine. But we’re a few weeks away from getting the lower dose approved in kids,” he says. “It’s certainly safer. I don’t expect major, lifelong side effects from the higher dose, but it’s going to hurt, your kid’s going to have a fever, they’re going to feel lousy for a couple days, and they just don’t need that much antigen.”