On November 2, 2021, the Advisory Committee on Immunization Practices (ACIP) reviewed clinical trial data showing that the Pfizer-BioNTech (“Pfizer”) vaccine is safe and effective in preventing COVID-19 in children aged 5 to 11 years old. They recommended that children in this age group receive a 2-dose series of the Pfizer pediatric vaccine. A December 31, 2021 MMWR reported that as of December 19, more than 8.7 million doses of the Pfizer vaccine had been administered to this age group and serious adverse events were rarely reported. Moreover, the data suggest that vaccination against COVID-19 remains highly protective against hospitalizations and long-term complications, including multisystem inflammatory syndrome in children. On January 5, 2022, ACIP also reviewed safety data in children using three different systems, the Vaccine Safety Datalink, v-safe and the Vaccine Adverse Events Reporting System, as well as efficacy data of the vaccine, who have again shown that this vaccine is safe and effective.
Supplementary doses and booster doses
It is recommended that individuals 5 years of age and older who are moderately or severely immunocompromised receive an additional primary dose of mRNA vaccine 28 days after their second dose, as they may not respond adequately to a two-dose series.
A booster dose is recommended for anyone aged 12 and over given the reassuring data on vaccine safety and emerging evidence that a booster dose significantly increases protection against infection with the Omicron variant. It is recommended that young people aged 12 to 17 receive a single dose of Pfizer vaccine at least 5 months after completing the primary series, and that those aged 18 and older receive a Pfizer or Moderna booster. See COVID-19 Vaccine Supplier Eligibility Summary Table.
Low vaccination rates among children 5-11 years old with wide variation by postal code
Despite the demonstrated safety and efficacy of the Pfizer vaccine in children and the unprecedented increase in COVID-19 cases, vaccination rates remain low among children ages 5-11. In Los Angeles County, only 29% received a first dose compared to 83% of 12 to 17 year olds. Additionally, first dose rates for children ages 5-11 by ZIP code vary widely, from 11% to 95%, with the lowest rates generally being in resource-poor communities that have been disproportionately affected by COVID-19. Booster uptake in 12 to 17 year olds is also low. See the LA County COVID-19 Vaccine Data Dashboard for more details.
Acceptance of vaccines
Parents’ concerns about COVID-19 vaccination include potential unknown long-term health issues, side effects, and the vaccine being too new, as well as not worrying about COVID-19 or to think that the vaccine is not necessary. According to the Kaiser Family Foundation, pediatricians are the most trusted source of information about the COVID-19 vaccine for 77% of parents, but only 37% of parents of children ages 5-11 say they have spoken to the pediatrician about their child from COVID-19. vaccine. Many resources are available to help providers address these concerns during patient conversions (see below).
To better protect children and address inequities in COVID-19 vaccination, we urge providers to take action.