February 19, 2021
4 min read
Source / information
Source:
Healio interviews.
Disclosure:
Creech reports serving as investigator for Phase 3 studies for COVID-19 vaccine studies of NIH-funded vaccines Johnson & Johnson and Moderna.
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Although the Biden government has announced that enough COVID-19 vaccine doses will be available in the US by the end of July to vaccinate 300 million people, it is still unclear when large-scale childhood vaccines will be available.
Currently, the Pfizer BioNTech vaccine is the only COVID-19 vaccine available in the United States for a pediatric population and approved for use in people aged 16 and over. Both Pfizer BioNTech and Moderna Messenger RNA (mRNA) vaccines are currently being tested in children ages 12 and up, and other manufacturers are making similar efforts.
Oxford and AstraZeneca announced that they have started enrolling children between the ages of 6 and 17 in a study for their vaccine candidate. A Johnson & Johnson executive told Bloomberg last month that the company is expected to begin enrolling children in studies 4 to 6 weeks later, receiving phase 3 data from studies in adults.
Healio spoke to the editorial board member on infectious diseases in children C. Buddy Creech, MD, MPH, Professor of Pediatrics and Director of the Vanderbilt Vaccine Research Program at Vanderbilt University Medical Center on the pediatric vaccine trial schedule and what it means to open schools.
Healio: Do you think a child vaccine will be available in time for the next school year?
Creech: I think the same model that we had for other companies and other products we’ll see with these newer vaccines. Basically, they state that the vaccine is safe and effective in adults, and once they can determine that the burden of this pandemic is there, we can turn our attention to younger children. There may be slightly different approaches as we now have some effective adult vaccines. But, by and large, this was an adult pandemic, and that’s where the focus was.
Pfizer is down to 12 years, Moderna is down to 12 years, and all companies have pediatric plans that take different approaches. But I think it will likely be the fall school year before we see any of our teens getting vaccinated, especially those with underlying conditions. It would continue to be winter or early spring when I think we would see our youngest children vaccinated because we may not all need to vaccinate because everyone else’s vaccination will make us pass this pandemic by.
Healio: Do you think it is important that children are vaccinated so that schools are open?
Creech: No, but I’ll also say that different scenarios require different answers. My children have been to school in person all year round, so we have a clear sense of what it looks like to do it safely and well. I don’t think that vaccinating students should be a requirement for school openings, especially because their burden of disease is so much lower than that of adults. That being said, one of the best ways to ensure schools stay open is to vaccinate our teachers and children, especially those with underlying illnesses.
Healio: How important is it for teachers and staff to be vaccinated?
Creech: I think they should be prioritized, and in fact they are. Teachers are widely recognized as being in the early stages of vaccination and I think they are currently being vaccinated in most areas. That is certainly the case here in Tennessee. My wife is a primary school teacher and is about to be vaccinated. I also think we are seeing really good effects from risk reduction strategies, which means that this is an important part of going back to school but not a necessary part.
Healio: What about teachers and staff who may be hesitant about vaccines?
Creech: Well, I want to dive in and understand the basis of that hesitation. If that hesitation was because the vaccines were made by the government, I would say that almost all of our vaccines were developed through government funding at some point in their development. If they hesitate because they think it happened too quickly, I would refer to two decades of research on the coronavirus spike protein and two decades of research on mRNA vaccines and adenovirus vectors. I think it’s an unfortunate misunderstanding to say that these vaccines are a year in the making. In reality it was most of 20 years.
When it comes to infertility fear or microchip implantation I would point out that there is a lot of misinformation out there and people are trying to create havoc by making false statements about vaccines. If they have certain medical reasons that put them at risk for a specific adverse event in the vaccine, I would like to understand and be able to make a more individualized recommendation. But many of the reasons we hear people say they hesitate, have no biological basis and can be addressed with simple conversation.
Healio: Is there anything else we haven’t talked about?
Creech: One of the things I want to emphasize is that it is really important that we do these studies on children. If vaccination of adults and older adults is not enough to rid us of this pandemic, we need to know how to introduce this vaccine to children. Do you have more fever? Do you have more arm pain? We also need to make sure we are getting the correct dose and we need to make sure that there are no other unusual reactions to the vaccine that would give us a break. Occasionally, when children are affected by coronavirus, they can develop inflammation very similar to Kawasaki disease. The development of multisystem inflammatory syndrome will be one of the things in the pediatric development programs that we will be very careful about. At the end of the day we all need to be reminded that children are not just small adults, so we need to evaluate them differently.
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