DHSS Insights: Covid-19 vaccines could soon be available for 12- to 15-year-olds

April 23, 2021 – The U.S. Food and Drug Administration (FDA) will soon decide whether to authorize the Pfizer Covid-19 vaccine for children ages 12–15. When it does, communities across Alaska have enough doses to start vaccinating children in this age group immediately, said Dr. Lisa Rabinowitz, staff physician with the Alaska Department of Health and Social Services.

Covid-19 vaccines for all ages are free. If families have health insurance, it may be billed to pay for administering the shot, but that cost won’t be passed along to families – with or without insurance.

Next week, Alaska’s health department will hold a free online webinar about this pending release of Covid-19 vaccines to youth. Families and health care providers can join this Question-and-Answer webinar at 6 p.m., Wednesday, April 28, 2021. There’s no need to register in advance.

Pfizer recently submitted results to the FDA from its clinical trials of the Covid-19 vaccine in 12- to 15-year-olds. Moderna may soon submit similar results for its vaccine, said Coleman Cutchins, Alaska’s lead clinical pharmacist focusing on COVID-19 testing and vaccination. The Pfizer and Moderna vaccines both require two doses, spaced apart. Once the FDA rules these vaccines are safe and effective for 12- to 15-year-olds, Cutchins and Alaska’s public health doctors said they would encourage families to consider vaccinating children as soon as they’re eligible.

Providing the Covid-19 vaccine to younger Alaskans will return a lot of hope to children, Cutchins said. Dr. Michelle Laufer, a pediatrician in Anchorage, said teenagers visiting her office tell her they have felt lonely, sad and depressed. Some have struggled at school, finding learning to be much harder this year.

Getting vaccinated can help kids feel like kids again, Laufer said. Vaccinated children will be able to safely hang out with other vaccinated kids. They can safely rejoin extracurricular activities like bands, musical or theater groups, and camps that have had to change how they met during the past year, if they met at all. They can feel safer going to school. If vaccinated children get exposed to someone who has Covid-19 on their soccer team or in their classroom, they no longer need to quarantine for two weeks and miss other opportunities. By participating in the vaccine effort, kids are empowered to be part of the solution to a problem which has upended their childhoods, Laufer said.

“I think it’s the way our kids get back to the most normal life as soon as possible,” said Cutchins, a parent of two teenagers in the age group that could have an authorized vaccine soon.

Covid-19 vaccines soon to be available to at least 40,000 Alaska children

To date, more than 200 million doses of Pfizer and Moderna Covid-19 vaccines have been given nationwide without long-term serious side effects, Cutchins said. These vaccines could soon be available to at least 40,000 Alaska youth — the number of children enrolled in seventh through tenth grades at public schools in Alaska. In recent weeks, the number of Covid-19 infections has been climbing among Alaskans ages 19 and younger, making them one of the top two age groups getting infected, Cutchins said.

To date, almost 50% of eligible Alaska residents have received at least one dose of the Covid-19 vaccines. Providing the vaccines to 12- to 15-year-olds will make it possible for more Alaskans to be vaccinated, Rabinowitz said. This will increase the number of immunized Alaskans and help the state get closer to herd immunity — which means protection against the Covid-19 virus for communities as a whole.

Cutchins, Rabinowitz, Laufer and other Alaska public health leaders answer related questions below.

Protect yourself. Protect your family. Appointments available at covidvax.alaska.gov.

Will children ages 12 to 15 receive the same size doses as adults in a two-shot series?

Once the FDA approves emergency use of the two-dose Covid-19 vaccines for children ages 12–15, the vaccine will be no different than the vaccines given to adults. The dose is the same, as well as the timing of the two-dose series. There are 21 days between doses of the Pfizer vaccine, and 28 days between doses of the Moderna vaccine. Like vaccinated adults, children will be considered fully vaccinated two weeks after the second dose of the vaccine, Rabinowitz said.

Cutchins said many vaccines that children and adults receive are given at the same doses, regardless of a person’s age or body size. The annual flu vaccine is one example, he said.

Dr. Elizabeth Ohlsen, staff physician with the health department, said the goal is to determine and then use the smallest amount of vaccine you can give someone to help their immune system create a good picture of the virus so the body can recognize and fight the virus if it gets exposed later. Using the smallest effective dose of vaccine for individuals will maximize the whole supply of available vaccines to protect more people worldwide, she said. 

How has this vaccine been studied in children ages 12–15?

Vaccine manufacturers and the federal government have been conducting separate studies of Covid-19 vaccines in adults and children.

“Children are considered a protected population by the FDA,” Cutchins said. That’s why the studies need to be separate from the initial trials among adults.

Pfizer has completed all levels of required clinicals trials that involved 12- to 15-year-old children and submitted its results to request emergency use of the vaccine in this age group, Cutchins said. Moderna is expected to take a similar action soon, he said. The next step for the Pfizer vaccine involves the FDA meeting to review the results of the Pfizer clinical trials to determine that using the vaccine in this age group is safe and effective. The FDA requires follow-up for all drugs and vaccines after they are approved. The FDA will continue studying Covid-19 vaccines for years to look for longer-term immunity and safety in children.

Rabinowitz said Pfizer’s clinical trial included 2,260 children ages 12–15: 1,131 of them received the Covid-19 vaccine and 1,129 received what’s called a placebo, or a shot that didn’t contain the vaccine. During the trial period, 18 children in the placebo group ended up getting Covid-19 infection. None of the vaccinated children did, Rabinowitz said.

Early results showed the Pfizer vaccine caused children’s bodies to create a robust number of antibodies to fight the Covid-19, should they be exposed to the virus in the future.

“We saw great protection from the immune system,” Rabinowitz said.

Ohlsen likes to think of antibodies like Velcro. After giving a child a vaccine, scientists check to see if the child’s body has created enough antibodies that can stick like Velcro around the invading virus, defending the rest of the body against it. A good immune response means the body responded to the vaccine by making a large number of antibodies that can stick all around the virus and stop it before it can cause infection, Ohlsen said.

Families can learn more about the Covid-19 vaccines on the American Academy of Pediatrics website.

Any vaccine Alaska receives will be authorized by the FDA through a 4-phase process.

What side effects can 12- to 15-year-old children expect after getting the vaccine?

Ohlsen said the most common side effects from the two-dose Covid-19 vaccines were not serious. Similar side effects were reported among 12- to 15-year-olds and the previously tested group of 16- to 25-year-olds. The two most common symptoms were feeling tired and having pain in the arm where the child received the vaccine. Other common symptoms included headaches, muscle aches and chills.

These symptoms go away on their own within a few days and typically do not require treatment, Ohlsen said. After getting the vaccine, some children with symptoms may feel better after taking acetaminophen or a similar over-the-counter medication.

Side effects from the vaccine are usually mild.
Side effects typically only last a few days and resolve on their own.

Can children get the Covid-19 vaccines at their pediatricians’ offices, as well as other locations?

Alaska’s Vaccine Task Force is working to increase the number of pediatricians’ and doctors’ office that will be able to provide the vaccine to children, Rabinowitz said. Parents will be able to use the Covid-19 vaccines webpage to schedule vaccine appointments for their children. Alaskans can schedule an appointment by visiting the website for vaccine scheduling or calling (907) 646-3322, which can answer calls on weekdays and weekends.

Vaccine appointment

Children may be due for vaccines to prevent other diseases, such as tetanus or meningitis. How should parents plan to schedule these vaccines along with the Covid-19 vaccine in the coming months?

When children are eligible for a Covid-19 vaccine, Alaska public health doctors recommended that families prioritize it even if they are due for other vaccinations. In most circumstances, children should get the COVID-19 vaccine first and then get other vaccines they may need at least two weeks later. That allows doctors and families to watch for any serious reactions after children receive vaccines and know which vaccine may be connected to those reactions, Ohlsen said.

Serious reactions after a vaccine are very rare, Ohlsen said. The FDA recommends scheduling a Covid-19 vaccine two weeks before or after other vaccines only as a precautionary measure.

This year has been challenging for families in many ways, including scheduling visits to the doctor. Some children may need to get up-to-date on other vaccinations. Doctors’ offices and public health clinics across the state are ready to give those vaccinations to help protect children against many diseases that can be prevented. Parents can check with their child’s health care provider to see if the child needs any other immunizations.

When will Covid-19 vaccines be available for children younger than age 12?

Cutchins said vaccine manufacturers have not completed enrollment for clinical trials among children younger than age 12. Once those trials are completed, the FDA will need to review the results to ensure the vaccine is safe and effective for younger children. The best estimate right now is that children younger than 12 may be eligible to receive the Covid-19 vaccines sometime between late fall 2021 and early 2022.

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