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CDC advisers give Pfizer COVID-19 vaccine green light for use in young teens

Advisers also determined people can receive other vaccines at the same time as the COVID-19 vaccine

Rochelle Walensky, director of the Centers for Disease Control and Prevention, on April 15.
Rochelle Walensky, director of the Centers for Disease Control and Prevention, on April 15. (Tom Williams/CQ Roll Call)

A Centers for Disease Control and Prevention advisory committee recommended on Wednesday the use of Pfizer’s COVID-19 vaccine for youth who are 12 to 15 years old.

Advisers also determined people can receive other vaccines at the same time as the COVID-19 vaccine.

Once CDC Director Rochelle Walensky signs off on the recommendations, teens can line up for shots, likely as soon as Thursday, opening up the life-saving shot to this age group for the first time. Safety and efficacy data demonstrated the vaccine is 100 percent effective in preventing COVID-19 in young teens. All 14 advisers who voted favored the recommendation. One member abstained due to a conflict of interest.

“This is one more step closer to gaining immunity and bringing the pandemic closer to the end,” said Jose Romero, chair of the Advisory Committee on Immunization Practices.

Also, Kate Woodworth, a CDC official with the National Center on Birth Defects and Developmental Disabilities, said the agency will update its policy on COVID-19 vaccines and other vaccines to indicate they can now be administered on the same day.

The CDC says there’s now enough data on vaccine administration and immunogenicity so that public health officials don’t feel the need to recommend isolating the COVID-19 vaccine from the administration of other vaccines by 14 days on each end as they did before.

The updated recommendation would apply to adults as well as children. This change may help kids catch up on other routine vaccinations.

Molly Howell, a committee liaison representing the Association of Immunization Managers on the committee, said denying coadministration of vaccines this summer could be a missed opportunity to get kids up to date on vaccines before school starts.

“It’s often hard to get adolescents in for multiple visits, and again, we don’t really want to pull them out of activities in which they’re just starting to re-engage,” said Amy Middleman, who represents the Society for Adolescent Health and Medicine as a liaison on the committee.

Some advisers took issue with the recommendation and worried that coadministration of vaccines could lead to unintended vaccine side effects. In response, the committee added a line to the recommendation saying it’s unknown whether reactogenicity is increased with coadministration.

Pfizer vaccine data

Nearly all kids who participated in Pfizer’s COVID-19 vaccine trials reported pain at the local injection site within seven days of vaccination, as well as fatigue and headache. Most symptoms resolved in one to two days. There were no serious adverse events and no deaths, according to information presented to the committee.

The vaccine’s immune response in younger adolescents actually exceeded the immune response in young adults ages 16 to 25, and vaccine efficacy was 100 percent effective, Pfizer representative John Perez told the committee. Megan Wallace, of the CDC’s National Center for Immunization and Respiratory Diseases, said the agency came to the same conclusions and said the certainty for benefits was very high and the certainty for harm was very low.

Over the past two months, the hospitalization rate among teens ages 12 to 17 gradually increased, said Sara Oliver, also of the CDC’s National Center for Immunization and Respiratory Diseases.

Twelve- to 17-year-olds are also at severe risk of contracting the virus. So far, over 1.5 million cases of COVID-19 were reported in this age group along with over 13,000 hospitalizations. Even though the committee was examining whether teens 12 to 15 should get the vaccine, much of the virus trend data they had dealt with teens 12 to 17.

The COVID-19 hospitalization rates of kids in this age group are higher than the hospitalization from another virus known as H1N1 for this age group from 2009 to 2010. Sixty-one percent of hospitalized children had at least one underlying condition, 32 percent were Hispanic and 31 percent were Black.

Unvaccinated adolescents may also indirectly impact others’ health, including vulnerable populations. People living in a household with a child attending in-person school full-time showed an increased risk of reporting a COVID-19-like illness.

Polling shows many parents were more wary of vaccinating their kids than getting vaccinated themselves, and there was a strong anti-vaccination sentiment expressed during the public comment portion of the meeting.

A few members of the public expressed concern that there wasn’t enough data to approve the vaccine for kids and said they were concerned the vaccine could have unintended, long-term side effects for kids. One anti-vaccination advocate even compared society’s ostracizing of people who refuse regular vaccinations to the Nazi’s treatment of the Jews during the Holocaust and screamed, “More people are coming to our side!” Another anti-vaccination advocate began quoting the New Testament to make her argument.

Some adolescents may face barriers in getting the Pfizer COVID-19 vaccine and may face higher risks of contracting the virus, such as teens living in rural areas, those in congregate settings or teens who are incarcerated. Racial and ethnic minorities, those living in poverty and teens who are front-line workers or are children of front-line workers could have a harder time accessing the vaccine in some cases and are more vulnerable to the virus, the advisers said.

But the working group said the availability of the vaccine could help increase overall health equity. They suggested public health officials make sure the vaccine is widely available at pediatricians’ offices, rural health clinics, community health centers, children’s hospitals, pharmacies and school health clinics.

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