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Children Under 12 Could Be A Step Closer To A COVID-19 Vaccine Shot


Kids under 12 could be one step closer to a COVID-19 vaccine shot. Pfizer says it'll put in the formal request for emergency authorization for kids 5 to 11 soon, and the FDA could make its decision in just a few weeks. Now, this comes as the delta variant significantly increased hospitalizations of children. Joining us to get some perspective on all this is Dr. Sarah Ash Combs. She's a pediatric emergency physician at Children's National Hospital in Washington, D.C. Good morning, Doctor.

SARAH ASH COMBS: Good morning. Thanks for having me.

MARTINEZ: All right. Now, help us understand how the development and authorization of the COVID vaccine for kids under 12 might be different from older teens and adults.

COMBS: Absolutely. So one thing we know and always say in pediatrics is that kids aren't just little adults. So we do need to look at them separately, which, again, is why this has taken a little bit longer and we've had to look at them as a separate group. One of the things we know is that they've actually come up with a smaller dose for children in this age group. That's no surprise to those of us who practice clinically in pediatrics. Pretty much any medication that you give to an adult, you have to adjust for a child based on their weight.

So what's come through the trials - and they've done all the correct phases they need to, you know, down through the Phase 2 and 3 trials - is that we're going to be giving these young children, if it's approved, a 10-microgram dose as opposed to the 30, which would be the full adult dose.

MARTINEZ: What about immune response for kids that age?

COMBS: So what they've shown is that there's been a really robust, favorable immune response. So the great thing about children is that they are ready to ramp up their immune systems at any given time. They have super active immune systems. They're young. And so they can just go and produce antibodies very well, which is why they need the slightly lower dose that achieves the balance between a good immune response but also a favorable safety profile.

MARTINEZ: OK. Now, the American Academy of Pediatrics president recently testified to Congress that COVID cases in children have increased exponentially, with, quote, "over a million new cases between August 5 and September 16." Doctor, how much of an increase are you seeing at Children's National Hospital? How sick are kids getting?

COMBS: So we've definitely seen an uptick. We - back in what was considered the first wave - that would be around late 2020, going into 2021 - our peak hospitalization numbers for COVID-19 at Children's National Hospital were 18. The peak we've had in the past couple weeks within September has been 23. And currently, our data, as of September 28, is that we have 14 children hospitalized with COVID-19. And again, those numbers might seem relatively low when you think in absolute numbers, but you've got to put those in perspective and think that, well, we're seeing higher numbers now with the delta variant than the first wave. And children - you know, we really don't want children to be coming into the hospital for anything, let alone for respiratory viruses, you know, let alone during a pandemic. These children really can get very sick. They can need help with breathing. They can need to come to our intensive care unit.

MARTINEZ: So based on what you've seen in your young patients, Doctor, how urgent is it to get kids vaccinated?

COMBS: Yes. It's absolutely urgent. You know, we know that these young children are getting sick. We know they've been harder hit. You alluded to the American Academy of Pediatrics, and they are our governing body, and we look to them for national data. We know that what we're seeing at Children's National Hospital here in Washington, D.C., is symptomatic of what's happening across the country, that children are just making up more and more of a share of cases of COVID as the weeks go by. And actually, over the past two weeks, we've had almost half-a-million new childhood cases nationally. So we know delta has hit children hard. We know that we need to get them vaccinated. And that's why this is so important. And those of us who work in this health care field, who are on the front lines helping children with COVID, are really excited and anxiously awaiting what is to come.

MARTINEZ: Can the pandemic ever truly, really end without vaccinating children?

COMBS: We don't think so, to be perfectly honest. You know, you've got to look at how big a share of the population children make up. And you talk about herd immunity; we're just not going to get there without vaccinating these young people from a herd immunity perspective and also from a transmissibility perspective. We know that a lot of people will cite, well, maybe kids don't get that sick from COVID, which, A, isn't necessarily true, but, B, we know that children are very good at transmitting viruses to each other and to others. So they're there as vectors, and we really need to have them in the immunization pool to move forward, to see a way out through this pandemic.

MARTINEZ: I know that some parents who are vaccinated against COVID have expressed hesitancy in getting their kids vaccinated, even if the FDA approves - or authorizes, I should say, the Pfizer vaccine. It's like, you want to be 100% sure when it comes to your kids, Doctor. I mean, how much of a hurdle do you think that could be?

COMBS: So I think hurdle is the right word. So it's not a brick wall. It's not a stopping point. And it's something that we'll have to overcome. What we, in pediatrics and emergency pediatrics, would say is we are often also parents. I have a child. We would vaccinate our own children. We understand those concerns, but this did go through the appropriate phases. We do know what we're doing. It's safe. It's effective. And we want our kids to get back to their usual way of life, and this is the way to do it.

MARTINEZ: Dr. Sarah Ash Combs is an attending physician in the pediatric emergency room at Children's National Hospital in Washington, D.C. Doctor, thank you.
