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Politics & Policy

Could We Really Be Vaccinating First-Graders by Autumn?

A healthcare worker receives a dose of the Moderna vaccine in San Diego, Calif., December 22, 2020. (Bing Guan/Reuters)

This seems like a dramatically under-discussed development:

Children as young as first graders may be able to get the coronavirus vaccine by the time school starts in September, presuming trials are successful in those age groups, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said in an interview with ProPublica.

“We’re in the process of starting clinical trials in what we call age de-escalation, where you do a clinical trial with people 16 to 12, then 12 to 9, then 9 to 6,” Fauci said. When asked what was the youngest age group that might be authorized for the vaccine by September, he said, “I would think by the time we get to school opening, we likely will be able to get people who come into the first grade.”

Testing the vaccine on teenagers actually started in the middle of last year; Pfizer’s Phase 3 clinical trial “began in late July 2020, recruiting participants aged 12 and over, and completed enrollment of 46,331 participants in January 2021.” Pfizer stated that 2,259 participants were ages twelve to 15, and 754 participants were age 16 or 17. Moderna started its trial of those ages twelve to 17 in December. In November, Johnson and Johnson’s Dr. Jerry Sadoff said the company intended to test its vaccine on children “as soon as possible.”

COVID-19 represents a much smaller and milder threat to children and teenagers, which is not the same as saying it represents no threat to children and teenagers. According to the most recent set of figures from the CDC, of the first 21 million confirmed cases in the U.S., 2.4 million were under age 18 — in other words, kids and teenagers made up 11 percent of diagnosed cases. Of the first 362,950 confirmed COVID-19 deaths, 325 were under age 18.

Then there’s the “multisystem inflammatory syndrome in children” (MIS-C), which the CDC characterizes as “a rare but serious condition associated with COVID-19.” It adds that “MIS-C is a new syndrome, and many questions remain about why some children and adolescents develop it after a COVID-19 illness or contact with someone with COVID-19, while others do not.” As of February 8, the CDC says the country has suffered 2,060 cases of MIS-C and 30 deaths.

In the not-too-distant future — late spring? summer? — every American adult who wants a coronavirus vaccine will have access to one. A majority of our adult population will be protected against the worst-case scenarios, and people will be able to resume much of life as normal — parties, getting on planes, attending sporting events and concerts, going in to bars and restaurants at or close to full capacity.

But kids won’t be vaccinated, and while the risk to them is much smaller, people will wonder . . . how safe is it to allow a child to resume normal activities? Should kids still wear masks? Even if a child is unlikely to have a serious health problem because of SARS-CoV-2, could a child unknowingly spread it to someone who’s unvaccinated? (In the coming months, we’re going to have a big debate about how much vaccinated people should worry about those who make the choice to remain unvaccinated.)

A few teachers’ unions didn’t merely demand that teachers be vaccinated before returning to classrooms; they wanted students vaccinated as well, which was akin to demanding the entire 2020–2021 school year be virtual, because no vaccine is approved for use on children yet. Until recently, that threshold of vaccinating children seemed extremely far off, but now vaccinating kids against COVID-19 might be a reality by the time school begins again this fall. Those unions will need to find some other way to move the goalposts.

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