Vaccinating children five to 11: when will they be eligible for Pfizer, and is it safe? | Vaccines and immunisation
Australian children may soon be eligible for the Pfizer Covid-19 vaccine, after the Therapeutic Goods Administration granted provisional approval for its use in children aged five to 11 from 10 January.
The federal health minister, Greg Hunt, said on Sunday that provisional approval was “about keeping our kids safe, keeping our families safe, keeping all Australians safe”.
An independent recommendation from the Australian Technical Advisory Group on Immunisation for use of the vaccine in the age group – which includes 2.3 million Australian children – is likely to follow.
How does the Pfizer vaccine differ for children?
The Pfizer vaccine will be given to children aged five to 11 in two injections at least three weeks apart. Each jab will contain 10 micrograms of the Covid vaccine, one third of the dose given to those aged 12 and older.
To avoid mix-ups, the vaccine in 5 to 11-year-olds will be dispensed from vials with orange caps, instead of the purple or grey used in other age groups.
Dr Vinod Balasubramaniam, a virologist at Monash University Malaysia, said in a statement to the Australian Science Media Centre: “The formula of the vaccine also varies slightly from the formula for adults. Pfizer’s vaccine for kids can be stored up to 10 weeks in a fridge, making it easier to administer.
“The needle used to administer the vaccine will also be smaller.”
Are other countries vaccinating children against Covid?
Many countries are already vaccinating younger children. In the US, the Food and Drug Administration authorised Pfizer’s Covid vaccine for use in 5 to 11-year-olds at the end of October. More than 1.2 million American children have been fully vaccinated with two doses of the Pfizer vaccine, and 4.7 million have received their first dose, according to the Centers for Disease Control and Prevention (CDC).
Last month, authorities in Israel and Canada also authorised the Pfizer vaccine for use in children aged 5 to 11, while the European Medicines Agency recommended that the Pfizer vaccine be approved for the same age group.
China, Cambodia and Chile have been vaccinating children with Sinovac for months. Cuba is immunising children aged two to 10 with locally developed Covid vaccines, while India’s Covaxin vaccine has been approved for people aged two to 18.
Is the Pfizer vaccine safe in children?
Clinical trials of the Pfizer vaccine in more than 2,000 children aged five to 11 showed it was “safe, well tolerated and showed robust neutralising antibody responses”, Pfizer reported in September.
Sanjaya Senanayake, an infectious diseases specialist and associate professor at the Australian National University, said while published data from the US rollout in children was not yet available, anecdotally there had been no reports of serious adverse effects. “There aren’t any … alarm bells or red flags,” Senanayake said.
Dr Nusrat Homaira, a paediatric respiratory epidemiologist at the University of New South Wales, said there have been no reports to date of myocarditis associated with the Pfizer vaccine in 5 to 11-year-olds. “That’s very good news. It seems that it’s relatively safe in that population,” she said.
Rare cases of myocarditis have previously been reported in older age groups – in adolescents and young adults – after receiving mRNA vaccines. However, Israeli research has found the risk of developing myocarditis was significantly higher in people who had contracted Covid-19 than for those who received the vaccine.
In September, data published by the CDC showed that for people aged 16 and younger, those who got Covid had 37 times the risk for developing myocarditis than those who were not infected.
The timing of Australia’s vaccination program in children would allow for experts to review published results from rollouts internationally, Senanayake said, adding that any side effects would likely become apparent within six weeks of vaccinations commencing. “If we start on January 10 in Australia we will be very well placed.”
What are the risks of Covid in kids?
“Overall, the data we have so far suggests that Covid, thankfully, is a milder disease in children,” Homaira said. However, some children have been hospitalised, admitted to intensive care, put on ventilators, and in rare cases died from the disease.
Children transmit Covid-19 and can also develop long Covid, although the exact risk of the latter is still unclear.
“The other aspect of Covid that seems to be unique to kids is multisystem inflammatory syndrome, which occurs in around one in 3,000 children [following Covid infection],” Senanayake said.
The condition, also known as paediatric inflammatory multisystem syndrome, commonly results in fevers and gastrointestinal symptoms, and in serious cases can lead to organ failure.
Emerging data from South Africa on the Omicron variant suggested more children under 18 were getting infected and presenting to hospitals, Homaira said, emphasising that direct comparison between countries is difficult due to differences in health systems, vaccination coverage and background infection rates. “These are very early days,” she said.
“At this point it is suggested that Omicron is much more transmissible,” Homaira said. “Whether it’s severe or not, that we still don’t know.”
“Given Omicron … we are now in a stage where we should be rolling out the vaccine for the paediatric population.”
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