Children likely won’t see coronavirus vaccine until late 2021: experts
While pharmaceutical companies and governments around the world are in a total sprint to develop an adult coronavirus vaccine, the race to identify one that is safe and effective for children is far behind, which means the most young American may not be vaccinated until the end of next year. health experts told ABC News.
Despite recent evidence that children can play a greater role in the community spread of COVID-19, experts believe the timeline is appropriate because a vaccine must first be tested in adults to make sure it is safe and effective before being tested in children.
“We wouldn’t start injecting five-year-olds until we found out what this vaccine did in adults,” said Dr. William Schaffner, professor of preventive medicine and infectious diseases at the School of Medicine. Vanderbilt University in Nashville.
“Children are not little adults, they have very different immune systems and you may need to have a completely different type of vaccine for children,” said Dr. Anita McElroy, pediatrician infectious disease specialist at the medical center. from the University of Pittsburgh. “And we’re so at this point so far behind the power curve, we’re at the very beginning of any kind of COVID vaccine. [so] that to think that we could just take one that works in adults and put it in children and assume that it will work well is actually a stupid thing to do.
Dr John Brownstein, epidemiologist, Boston Children’s Hospital and ABC News contributor, said there is simply “a lot of things we need to understand” from dosing to learning about safety studies, “so it takes time before you can start to reach out to a larger population of children. “
Yet in a letter to federal health officials this week, the American Academy of Pediatrics called for the inclusion of children in research on potential COVID-19 vaccines, saying that “beyond the direct impact of the infection, children have been greatly affected by the pandemic.
“Children need to be included in vaccine trials to better understand potential immune responses and / or unique safety concerns,” wrote Dr. Sally Goza, AAP chair.
Dr Steven Joffe, professor of medical ethics and health policy at the University of Pennsylvania, said that currently, “none of the major trials in the United States are enrolling children.” The exception is Pfizer, which recently announced it would expand its trials, but only to recruit 16 and 17-year-olds.
Three vaccine groups told ABC News they plan to schedule pediatric trials once the adult vaccine is rolled out. Dr Fauci, the country’s foremost expert on infectious diseases, said in a interview with WTOP by mid-September, adults in the high-risk category could be vaccinated in December or early in the year.
Johnson & Johnson, one of the groups that entered the advanced stage trial testing its adult coronavirus vaccine, plans to include studies evaluating children, but will only progress after analyzing adult data, according to a company spokesperson.
Moderna, a Massachusetts-based biotechnology company, hopes to start trials in children by the end of the year.
“Moderna shares the urgency associated with evaluating COVID-19 vaccine candidates in children,” a company spokesperson said in a statement. “Now that Moderna has sufficient safety data in adults, we intend to begin pediatric trials by the end of this year, subject to regulatory approval.”
Likewise, a spokesperson for Inovio Pharmaceuticals, a biotech company, told ABC News that “it is generally industry standard to start trials in the adult population and then schedule pediatric trials once. security established ”.
Some other leading pharmaceutical companies in the race for an adult vaccine did not respond to ABC News’ request for comment on their efforts with children.
Brownstein said another complication is the recruitment process for clinical trials for children, which is more difficult because parents or guardians must consent to participate in studies.
“The reality is that the trials for children haven’t started yet,” Brownstein said. “It will be in the coming year and so it will be at least a year before we start seeing COVID vaccines in our children.”
Brownstein stressed that clinical trials for children must focus on “diverse populations” and said efforts “must take into account clear disparities in health outcomes with respect to COVID-19” – so as not to repeat what already been a challenge when it comes to adult trials.
In his letter, Goza noted that more than two-thirds of the more than 100 children who have died after being infected with COVID-19 were black or Latino.
This delayed rollout of a pediatric vaccine means parents around the world are brimming with uncertainty about what the next few years might look like, especially for schools.
Although fewer children have been sick with COVID-19 compared to adults, the CDC notes that some children can get seriously ill from COVID-19. They could require intensive care, hospitalizations and in rare cases, they could die.
According to data from the American Academy of Pediatrics and the Children’s Hospital Association, more than 624,000 children have tested positive for COVID-19 since the start of the pandemic.
“We are now over 100 child deaths from COVID-19 in the past seven months. That’s about 15 deaths in the United States each month, ”said Dr. Evan Anderson, professor of medicine and pediatrics at Emory University School of Medicine and pediatric infectious disease specialist at Children’s Healthcare in Atlanta. “It is very important that we begin these clinical trials in children now in order to provide the essential answers that will be needed to advance a vaccine or vaccines towards licensing that can prevent hospitalizations and pediatric deaths.”
Beyond concerns for the health of children themselves, a vaccine for children could be an effective weapon in the ongoing fight to stem the spread of the virus, experts have said.
On Tuesday, the American Academy of Pediatrics and the Children’s Hospital Association released a study that showed the number of children infected with COVID-19 increased from April to September. According to the study, in April, children made up about 2.2% of all reported cases in the United States, but by September that number had risen to 10%.
“Although children do not play the same role in transmission with this virus as they do in influenza, they do play a role in transmission,” said Dr Sean O’Leary, vice chair of the AAP Committee on Infectious Diseases . “We certainly know that children can catch it and spread it. And so I think there is certainly an urgency at all levels for children to receive a safe and effective vaccine.
Anderson said he believed that if “efforts were made to start serious pediatric vaccine studies now on advanced COVID-19 vaccines, we could have a licensed vaccine by next school year.”
Dr Anna Durbin, professor at the John Hopkins Bloomberg School of Public Health, predicts that if all goes perfectly, the United States could have a vaccine ready for children by June 2021. But Durbin warned another reason why it might be more difficult to conduct vaccine studies. for children than for adults: A lower incidence of symptomatic COVID-19 in children means that trials may need to be even larger than those of adults to show that the vaccine works.
“This is essential because without advancing a vaccine, we can anticipate ongoing school closings, epidemics and hospitalizations and even deaths from COVID-19 in children,” Anderson said.
Dr Sallie Permar, pediatric immunologist at Duke University School of Medicine, said a vaccine would help schools “operate without having all of the complexities that come with trying to run a school in the midst of a pandemic.” .
When rolling out a coronavirus vaccine for children, Linda Mendonca, president of the National Association of School Nurses, said she hoped school clinics would receive them first.
“Parents trust school nurses and by providing a vaccine in school clinics, it removes some of those barriers for families,” Mendonca told ABC News. “The vaccine is important for everyone, but when you plan to bring children to school, it should be considered a priority.”
But for now, Brownstein has said it will likely be some time before this vaccine arrives, however urgent the need may be.
“Children deserve the same level of priority,” he said. “I mean, clearly we want to focus on those who are going to have the most severe effects of the virus, but the kids are still critical and most of all we are trying to keep the kids in school and bring them back to life. normal, having a vaccine is so important in getting back to normal. “
According to Schaffner of Vanderbilt, for now, the burden of protecting children from the coronavirus will not rest on a vaccine, but on the behavior of adults.
“If the adults in the community accepted the vaccine, we can immunize the teachers, all the staff, all the parents, everyone in this community, which will immediately reduce the risk to the children,” he said. “It will be a great advantage.”
ABC News Sony Salzman and Ramie Fathy contributed to this report.