Infectious Disease

AAP advocates the simultaneous administration of routine vaccinations and COVID-19 vaccines

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Munoz reports that he is the lead researcher studying the Pfizer-BioNTech COVID-19 vaccine in children under the age of 12 at Baylor College of Medicine, and the lead researcher is studying the Moderna COVID-19 vaccine in children under the age of 12. and a principal investigator for a pediatric treatment study for remdesivir.


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The AAP has advocated vaccinating children and adolescents simultaneously with COVID-19 vaccines.

Previously, it was recommended that children and adults not receive any other vaccine within 14 days of receiving a COVID-19 vaccine – a recommendation made with great caution, a CDC scientist said Wednesday during a meeting of the CDC advisory committee Immunization Practices (ACIP).

Source: Adobe Stock

The AAP advocated the simultaneous administration of COVID-19 vaccines and routine immunizations. Source: Adobe

The ACIP unanimously voted to recommend the Pfizer BioNTech vaccine for children ages 12-15. During the meeting, the CDC said that COVID-19 vaccines “can now be administered regardless of the timing” with other vaccines in both children and adults, and the AAP released a policy statement in support of the new guidelines.

Flor M. Munoz

Infectious diseases in children played a role Flor M. Munoz, MD, MSc, FAAP, an Associate Professor of Pediatrics and Infectious Diseases at Baylor College of Medicine who authored the Policy Statement.

Healio: Did the AAP draft the new policy statement supporting vaccination delivery to adolescents at the same time as CDC independent COVID-19 vaccines, or did they know that the CDC would also propose this during Wednesday’s meeting?

Munoz: The process is no different from what normally happens with all kinds of policy statements and discussions about childhood vaccinations. There is a CDC representative at the AAP, so these types of discussions – just like every year with flu shots or new vaccines that become available – are always in line with the CDC. So it is not an independent recommendation, and it is not a recommendation that is blinded. CDC is aware of what the AAP Committee on Infectious Diseases is discussing and vice versa.

Healio: Is there any data that supports the new policy?

Munoz: The policy is really focused on creating vaccination facilities to ensure that there is no further delay in vaccination for that particular age group, 12-15 years old. The data used to address this recommendation are not from the youth group as the COVID-19 vaccine study was clearly not performed concomitantly in this population.

There is some data from adult studies that are ongoing, some not in the US, and others related to specific vaccines. The co-administration considerations largely relate to influenza vaccines as we know that co-administration must be efficient from a practical point of view.

There is some data available for the adult population that has been taken into account and the reality is that the discussion for 12 years and above who is still a pediatric population is still not a population that is is very different immunologically from young adults.

Part of what is also taken into account in making this decision regarding the co-administration data is that other vaccines have been studied in the past for co-administration and co-administration does not raise immunogenicity concerns for the majority of the inactivated vaccines .

For example, we know that if you give a live vaccine like the measles or varicella vaccine, you can have some immune response effects to other vaccines you give shortly afterwards. However, when it comes to co-administering inactivated vaccines or non-live vaccines, this effect has not been observed.

This is also some of the data that has been taken into account, only looking at other past experience of co-administration of non-live vaccines and finding that little or no immunogenicity from knowledge of a disorder of action There are concerns about vaccination reactions.

Certainly one of the reasons for COVID-19 vaccine studies is that the 14 day window of time is around deciding on the COVID-19 vaccine, because in a clinical study you want to make sure that you are not confused by the reactogenicity assessment. So if you are giving other vaccines at the same time, you have no way of knowing which one caused the side effect.

Knowing the safety profile and what reactions to expect with the COVID-19 vaccine was also another piece of data that was taken into account as we know what to expect now and we also know what to do with reactogenicity is to be expected from other vaccines already available such as the flu vaccine or Tdap, which are other vaccines given to teenagers. All of these are very safe vaccines with very few reactions that occur after administration. Again, we now have a clear understanding of the types of side effects that may be associated with each vaccine.

When you consider that we are still in a pandemic, the really important thing is that there is no delay in getting the COVID-19 vaccine for this population and if you have to wait because giving other vaccines will be an obstacle It really is more of a translation into the kind of public health that is about getting access and making sure we don’t miss out on vaccination opportunities, not just for COVID-19 but the other infections as well.

Healio: How should pediatricians go about implementing this new policy? How should they talk about it with patients and their parents?

Munoz: We see enormous enthusiasm from paediatricians. In fact, this was a highly anticipated approval. This week has been wonderful for pediatrics. One of the questions the pediatricians had is exactly this simultaneous use as it would actually be more difficult to have to wait 14 days after the last dose. So what we see is the welcome excitement from pediatricians with the recommendation that they really don’t have to worry about when the vaccines will be given. It gives them more flexibility, it gives them the ability to really make sure the kids are up to date with their vaccines before school.

From an implementation perspective, some children started vaccination yesterday when vaccination recommendations became available and approval became available. I know our facility is already vaccinating.

The implementation is geared towards catching up with everyone with the COVID-19 vaccine. Taking them for a COVID-19 vaccine also gives you the option to have the pediatricians review their vaccination records with the parents and children and provide them with any other vaccines they need or an appointment to get them these vaccines if that is possible.

From a practical point of view, paediatricians were happy with it and really can do more than just COVID-19.

Healio: What about pediatricians whose patients may be seeking a COVID-19 vaccine outside of their practice?

Munoz: It is still possible that some of the vaccines may not be available at all pediatrician offices due to storage requirements, but will certainly be much more available at the clinics and hospitals or distribution centers that may administer them. The coordination of this vaccine administration and the updating of the records in the pediatrician offices will be another logistical element that will be important.

Summertime is usually a time for school athletes, perhaps for some travel advice, summer camps that reopen where the vaccinations are required. There are many options for pediatricians to review vaccinations during this time of year. Everyone now receives a card with their COVID-19 vaccination. I think it will be in the best interests of parents and pediatricians to ensure that the records of this vaccine are on their medical records so that the pediatrician has that information if they lose a card or something.

I think there will be efforts to educate all vaccination centers that vaccinate young children to provide information to parents so that they can communicate or share that information with their pediatrician. I am sure pediatricians are in touch with their families when it comes to vaccinations. Telemedicine and other types of online communication have become widespread.

Healio: How far behind have America’s teens got routine vaccinations?

Munoz: This is an important point. You’re more behind than I thought to be honest. There has been a sharp drop in vaccinations over the past year once all social distancing and closings have taken place. So it was a year of it. It looks like we’ve done a pretty good job with influenza vaccines.

I have to say influenza vaccine intake is not great. It’s not as high as it should be. About two-thirds of children get their flu vaccine each year. Since Thanksgiving last year, it’s been pretty much the same as previous seasons. I think overall post-vacation intake is usually down, and this year we saw a slight decrease in flu vaccine intake without influenza.

However, there is concern among other vaccines that coverage for the MMR vaccine has dropped significantly during the pandemic. There was some increase after vaccination against COVID-19 started. I know the vaccination increased a bit. We’re either approaching prepandemic coverage rate, but we’re not quite there yet.


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