Finally, Covid-19 vaccines for children under 5 years old will reach little arms and legs this week. Since the US Centers for Disease Control and Prevention has recommended two options for this age group, one from Pfizer/BioNTech and one from Moderna, parents and caregivers may be wondering which is right for them. your son.
Both use an mRNA platform and both are considered safe and well tolerated. Pediatricians CNN spoke with across the country suggest either is a good option.
“I think both are very effective with very good side effect profiles and I wouldn’t hesitate to give them to my children,” said Dr. Nina Alfieri, a pediatrician at Ann & Robert H. Lurie Children’s Hospital of Chicago. “I think both are very good options.”
Both appear to create protective antibodies in young children as they do in young adults. There are only subtle differences and one may be more suitable for some children than the other.
Moderna’s Covid-19 vaccine is now licensed for children ages 6 months to 5 years. Pfizer is for children ages 6 months to 4 years.
Pfizer’s vaccine was previously licensed for children up to 5 years old. Moderna’s vaccine for people ages 6 to 17 was recently licensed by the US Food and Drug Administration, and CDC vaccine advisers will vote this week on whether to recommend it.
A child who gets the Moderna vaccine won’t have to go to the doctor or pharmacy as often, and will get protection a little faster than the Pfizer vaccine.
The Moderna series is completed with two doses of 25 micrograms administered one month apart. Children with compromised immune systems would receive a third injection. The Moderna injection for young children is a quarter of the size that adults receive.
With Pfizer, it takes three shots to complete the series. The company initially tested two doses, but data from the trial showed that after the second dose, the vaccine did not generate enough of an immune response. The three-dose vaccine licensed last week is one-tenth the size of Pfizer’s adult dose.
With Pfizer, the first two injections are given three weeks apart. The third can be administered at least eight weeks after the second. In total, it can take almost three months for the child to have the complete series.
In the future, scientists may want children to get boosters with either company’s vaccine.
Children were slightly more likely to have a fever with the Moderna vaccine; it happened with about a quarter of trial participants, versus less than 10% with Pfizer. Most of the fevers were mild. Less than 1% of all trial participants had a fever reaching 104 degrees.
“That was weird, but I feel like if we’re not honest with parents, when these things come out, it’s going to be concerning,” said Dr. Grant Paulsen, the site’s principal investigator for the Pfizer and Moderna Covid-19 vaccine. clinical trials for children ages 6 months to 11 years at Cincinnati Children’s.
“Most kids will most likely do fine and have really minimal problems,” he said. “Most are not going to have major side effects.”
Moderna said that other fever-causing illnesses were in circulation during the trial, and that may have caused some of those fevers, as 10.6% of children in the trial’s placebo group who did not receive the vaccine reported fever.
Dr. Claudia Hoyen, a pediatric infectious disease specialist at UH Rainbow Babies Hospitals in Cleveland, said she understands why parents hate to see their children have a fever, but they need to be reassured that a fever doesn’t cause any kind of permanent or long lasting. long-term problems and should resolve quickly on their own or in response to over-the-counter medications such as Tylenol or Motrin.
“I think if you continue keep that in mind and realize that, yes, it’s scary, but it can be manageable.” Hoyen said. “People should work with their pediatrician. I think a lot of the kids with the first dose may or may not have a fever, but people should work with their pediatrician if they do and come up with a good plan and that will be the best thing to do. It should be resolved quickly.”
Safety data from Moderna and Pfizer, reviewed by the FDA and CDC, found that potential side effects were mostly mild and short-lived.
Side effects of both include pain at the injection site and sometimes swelling or redness.
For systemic or whole-body symptoms, the most common was fatigue or drowsiness. Some children had fussiness or irritability, loss of appetite, headache, abdominal pain or discomfort, enlarged lymph nodes, mild diarrhea, or vomiting. But they all got better quickly.
“It is very similar to side effects that we have seen in older children or in adults. About 24 hours some kids, you know, they don’t feel as good, they feel tired, they don’t have the same appetite. But thankfully, there haven’t been any serious side effects from these vaccines,” Dr. Ashish Jha, the White House’s Covid-19 response coordinator, told CBS on Monday.
The scientists did not observe any serious or rare side effects in the trials. They were on the lookout for any signs that the children were developing problems with myocarditis, inflammation of the heart muscle, because there were a handful of cases among older children and adults. But myocarditis was not identified in trials in young children.
Both vaccines were tested when the Omicron variant was the dominant strain of coronavirus. Studies show that regardless of age or dose level, this particular variant was more successful in evading the protection offered by either company’s vaccine.
The Omicron variant was tricky for this age group in general. Without access to a vaccine, hospitalization rates among children 5 and younger were five times higher during Omicron’s peak in the winter, compared to when the Delta variant was the dominant strain last summer, according to a report. March from the CDC.
Moderna was estimated to have 36.8% efficacy against symptomatic disease in children 2 to 5 years of age and 50.6% protection against symptomatic disease in children 6 to 23 months of age.
For the Pfizer vaccine, there have only been 10 cases of covid in the vaccine and placebo group in the trial; it is too small a number to estimate the efficacy of the vaccine. However, the main efficacy data from the preliminary findings is “encouraging,” according to the company. And the FDA said the immune response to the vaccine at 6 to 23 months of age and 2 to 4 years of age was comparable to the immune response of older participants, but more research is needed.
Get whatever vaccine is available, experts said.
“I don’t think it’s clear that one is better than the other. They are different,” Paulsen said. “It’s a lot that parents prefer. Balancing those differences and honestly what’s available and what your pediatrician has or what the local hospital has.”
Doctors also suggest looking online or calling to find out what the local site offers. Not all places will offer both shots. Some immunization clinics may not offer immunizations for young children or may have restrictions on the ages they serve. CVS stores that have MinuteClinics, for example, will vaccinate this new age group, but only if the child is 18 months or older.
Vaccines.gov can be helpful. The website provides information on the clinics listed by category.