Shots in Little Arms: When Can Kids Get the Vaccine?

School children wearing facemasks walk outside Condit Elementary School in outside Houston, Texas. Photo: François Picard/AFP via Getty Images

On Monday, every adult became eligible for a COVID-19 vaccine. So when will children be able to get their shots? While children under 16 have not been approved to receive any of the currently available shots, clinical trials to get shots in little arms are underway. Delivering the vaccine to children will be necessary to tame the virus, experts say, and could remove uncertainty around when students will fully return to in-person learning as they already prepare for the upcoming fall 2021 school year. Here’s what we know so far about the vaccine and children.

Trials are underway

Drug companies have launched critical trials for younger children and their results are expected to be released to the public by the summer. Both Pfizer and Moderna are testing their two-dose vaccines in children as young as 6 months old. (Clinical trials in children require permission from their legal guardians.) According to Dr. Megan Freeman, a specialist in infectious diseases in children at UPMC Children’s Hospital of Pittsburgh, when they’ll be “just depends on how quickly they’re able to turn around that data.” Already, Pfizer announced a trial of its vaccine in kids 12 to 15 years old showed it was safe and fully effective. The drugmaker has requested the FDA’s permission to allow teens in that age group to receive the shots.

Given that most kids are at low risk for complications from COVID, the need for a pediatric vaccine for the disease may not seem pressing. Research even suggests younger children are less likely to transmit the virus than teens. “We know that kids tend to do pretty well with this infection, but they certainly can spread it to others,” Freeman says. It is therefore crucial to have vaccines available for kids to curb the spread of the coronavirus and to protect high-risk young people, she adds.

Freeman is hopeful that the Pfizer vaccine will be made available for kids as young as 12 within the next couple of months. Anthony Fauci, the nation’s top infectious-disease specialist, said on Sunday that he predicts all kids will be able to receive a vaccine against COVID-19 by the beginning of 2022.

“Getting kids vaccinated all the way down to infant years is going to be a key for the whole community to be protected,” Dr. James Wood, a pediatrician and professor of pediatrics at the Indiana University School of Medicine, told Intelligencer. “Until that has occurred, we don’t expect to reach that herd immunity level,” the theoretical point at which the virus would start to run out of people to infect.

Where will vaccines be available?

Once the FDA approves a vaccine, the challenge will be getting it to kids. As of now, pediatricians such Wood don’t have a clear picture of what the rollout is going to look like.

“I anticipate we can use a lot of the lessons we learned early on to improve the organization and access of the vaccine rollout in kids,” Wood said. “There is a lot of talk right now in pediatricians’ offices about getting prepared to vaccinate kids and how we’re going to do it.”

The American Academy of Pediatrics, for instance, has already started giving guidance to pediatricians’ offices about how to prepare to vaccinate kids. But while children getting jabs at their pediatrician’s office is something Wood expects to happen, he anticipates that the rollout for children will be similar to the initial rollout of adult vaccines “in terms of utilizing both vaccination sites, pharmacies as well as doctors’ offices.”

Freeman says vaccines being available at a pediatrician’s office would be really convenient for families, but the freezers required for their storage might not be standard equipment. At least in the beginning, she imagines it’d be a “more centralized distribution, whether it’s at pharmacies or children’s hospitals.”

Because many adults will have had their opportunity to get vaccinated and our supply just keeps increasing day by day, Freeman is hopeful that when we get to the point where we’re adding children to the immunization drive, “our supply will be a little more available to them.”

What does it mean for the next school year?

Though the timetable for children under the age of 12 to be vaccinated is likely winter 2021 or early in 2022, Wood says “we’ve shown that with the proper precautions and proper resources, schools can be open safely without all the children being vaccinated.” One CDC review found little difference in prevalence of the virus between counties with elementary schools open and those with remote learning.

“I think that getting kids vaccinated before school is great and it’s a great goal,” Wood adds. “But I don’t think it’s a requirement to go back to in-person learning.”

Complicating matters is youth sports, which have been blamed for outbreaks in places such as Michigan, experiencing a surge of the disease. “Vaccination is going to be that additional layer of protection that is going to really help us out,” Freeman says. “We’re still seeing a ton of infections throughout the country, so we’re not quite able to declare victory yet. We’ve got to keep at it.”

What about the variants?

There’s growing concern about whether the highly contagious B.1.1.7 variant first detected in the United Kingdom could be causing more infections in children. “There does seem to be maybe a signal that kids are getting that UK variant in particular — the B.1.1.7 variant — a little bit more than previously. That said, I don’t think we can say just yet that it’s more transmissible in children or that it’s more severe,” Wood says.

The good news, though, is that the vaccines we have available “will offer at the very least some protection against the variants, if not full protection,” Wood says. “As time goes on and the quicker that we can get everybody immunized, the less likely we’ll continue to see new variants popping up.”

When Can Kids Get the Vaccine?