NC pediatricians to give COVID-19 vaccine to toddlers

By Anne Blythe, Rose Hoban and Taylor Knopf

Christoph Diasio, a Southern Pines pediatrician and president of the North Carolina Pediatric Society, was thrilled on Tuesday as COVID-19 vaccines for children as young as 6 months old were being distributed across the state.

The Centers for Disease Control and Prevention opened the door for such distribution on Saturday when the federal agency endorsed a recommendation from its Advisory Committee on Immunization Practices that access to COVID vaccines be expanded to include children from 6 months to 5 years old.

That has led to a pounding on pediatricians’ doors by some parents and caregivers who have waited anxiously to have their young ones protected from a virus that has wreaked havoc on the world for nearly two and a half years. Other parents are taking a wait-and-see approach or not planning to get their children vaccinated at all.

“We are thrilled and excited,” Diasio said of pediatricians gearing up to vaccinate children in their offices and clinics. “This is better than Christmas and Hanukkah, and all other religious holidays, all wrapped up together. This is an answered prayer. We have been waiting for this a long time.”   

On June 17, a day before the CDC issued its recommendation, the Food and Drug Administration authorized emergency use of the Moderna and Pfizer vaccines for children as young as 6 months old.

The Moderna vaccine is administered in two doses for children.  Pfizer developed a three-dose vaccine for children younger than 5 after the company realized that a two-dose vaccine they were developing failed to produce a sufficient level of antibodies or protect children as the Omicron variant began to spread.

Ready for that shot

Kreth Ball-Johnson, the mother of a 3 year old and a child not yet 6 months old in Raleigh, has been eagerly awaiting the news. Her older child got COVID in February.

“He had a fever for maybe three days, then he seemed much better,” Ball-Johnson said.

Ball-Johnson said she had no qualms about getting her 3 year old vaccinated and plans to get her younger child vaccinated when she can. Her family has curbed their activity during the pandemic and she is ready to do more without having to worry about them getting sick. She plans to go to her pediatrician when she can get an appointment.

For those who are not as enthusiastic as Ball-Johnson about getting their children inoculated, Diasio tries to reason with them. COVID, he explains, “is a top five killer of children in America.”

Across the country, 1,235 children under the age of 15 have died from COVID-19 infections and 485 of those deaths were children younger than 4 years old, according to the CDC.

“We usually think children matter in America and we need to hold on to that,” Diasio said.

Though his youngest child is 17, Diasio said, if he had children newly eligible for a COVID vaccine, he wouldn’t hesitate.

“We know enough now to say it’s safe and effective,” Diasio added. “Waiting any longer to be protected against what’s been a bad disease doesn’t sound like a good plan to me.”

Lingering hesitancy

The percentage of children younger than 18 who are eligible to be vaccinated who have received their shots has not topped 50 percent, according to the state Department of Health and Human Services COVID vaccine dashboard. Among those who are from 12 to 17 years old, 384,911 children, or 48 percent, have had at least one dose. Only 27 percent of children ages 5 to 11, or 241,501 in all, have had at least one vaccine dose. 

Children aren’t considered fully immunized until they’ve had that second or third dose, however.

A Kaiser Family Foundation COVID-19 Vaccine Monitor showed that national polling from April found that only 18 percent of the parents contacted planned to get their children younger than 5 vaccinated right away. Thirty-eight percent said they would take a “wait-and-see” approach. Eleven percent would get their young children inoculated only if required to do so for school, according to the poll, and 27 percent definitely would not vaccinate their child.

“Many parents and families have been eagerly awaiting a vaccine to protect our youngest North Carolinians,” Kody Kinsley, secretary of the state Department of Health and Human Services, said over the weekend after the CDC announcement. “These vaccines are the best way to protect children from COVID-19 — they are safe, effective and free.” 

Many parents and caregivers have questions. The NC Health News team has some answers.

Do you really need to get your child vaccinated if you or they have had COVID?

The CDC recommends the COVID-19 vaccine for everyone 6 months and older. The dosage and number of doses in the COVID-19 vaccine series varies based on the child’s age. 

“Emerging evidence indicates that people can get added protection by getting vaccinated after they have been infected with the virus that causes COVID-19. For children who have been infected, their next dose can be delayed 3 months from when symptoms started or, if they did not have symptoms, when they received a positive test,” according to the CDC.

Studies conducted by the CDC and published last year found that for people who had already had a COVID-19 infection, they were twice as likely to be reinfected with the virus than those who were fully vaccinated after contracting COVID. 

Which vaccine is more effective? How are they different? 

The Pfizer vaccine for children 6 months to 4 years old is given in three doses, while the Moderna vaccine consists of two shots.

Although both the Moderna and the Pfizer vaccines use the same mRNA technology to generate an immune response, the two vaccines are different because they have different amounts of the mRNA in the vaccines, they have slightly different ingredients and different delivery systems.

For children under 5, the Moderna vaccine which has 25 micrograms of mRNA material, is a two-dose series, with four weeks between the two doses. According to the FDA, the vaccine was about 50 percent effective for infants and toddlers after the second shot. The vaccine had a lower effectiveness of only about 39 percent for preschool-aged children than it had for older children or for adults. 

Children who are immuno-compromised can receive a third Moderna dose. 

The Pfizer vaccine, which has 3 micrograms of the active mRNA ingredient, is a three-dose series, with a three week interval between the first two shots and a third dose administered at least eight weeks after the second dose for children aged 6 months through 4 years.

The Pfizer series of shots had better effectiveness for children under 5, but the trade off for parents is the logistics of getting their children in for that third shot. 

“It’s very complicated to decide what the right thing to do is for an individual child,” Diasio said. “That’s why you should consult with a pediatrician.”

How long before COVID protection kicks in?