Opinion | Moderna’s covid vaccine is a big relief for parents of young children

Placeholder while article actions load

Finally, some good news for parents of young children.

modern announced on Thursday that it has requested authorization from the Food and Drug Administration for its coronavirus vaccine for 6-month to 5-year-olds. It cites new data that its vaccine is safe and effective for the age group.

Specifically, Moderna says two doses reduce symptomatic infection by 51 percent among children 6 months to 2 years old and 37 percent among kids 2 to 5 years old. These results should be a welcome relief for families of the nearly 20 million young children who remain ineligible for vaccination.

As the mother of two children in this age group, I eagerly await the FDA’s decision. If it authorizes the vaccine and the Centers for Disease Control and Prevention subsequently allows it to be given, I will be among the first in line to vaccinate my young children.

That’s because the vaccine’s effectiveness in young children appears comparable to its effectiveness in adults. Moderna conducted its trial with children when omicron was dominant, and we know that the coronavirus vaccines in adults are less effective against omicron than earlier variants. A recent New England Journal of Medicine study found that while omicron was dominant, effectiveness against symptomatic disease after two Pfizer doses was about 65 percent at two to four weeks, dropping to under 9 percent after 25 or more weeks. For adults who received two doses of Moderna, the effectiveness was 75 percent after two to four weeks, dropping to about 15 percent after 25 weeks.

Sign up for The Checkup With Dr. Wen, a newsletter on how to navigate the pandemic and other public health challenges

These data require two important explanations: First, the primary reason to be vaccinated is not to prevent infections, but to reduce the likelihood of severe disease. Numerous studies before and during the omicron surges have found that two doses of the mRNA vaccines continue to protect against severe disease, even as protection against symptomatic illness declined sharply. Among 5- to 11-year-olds who were hospitalized for covid-19, nine out of 10 were unvaccinated.

There were not enough children who became severely ill in the Moderna study to conclude that the vaccine reduces hospitalization in the youngest age group. But given that the protection against symptomatic infection is comparable to adults and that the little kids had a similar antibody response to older individuals, it’s reasonable to extrapolate that the vaccine will probably achieve its most crucial outcome in the younger age group as well.

Second, it has become clear that at least one booster dose is necessary to sustain protection against symptomatic disease. The same New England Journal of Medicine article found that a third Pfizer or Moderna dose restored protection to more than 66 percent after two to four weeks. The CDC recommends one booster dose for everyone 12 and above, and Pfizer just applied to extend the booster to 5- to 11-year-olds.

It appears likely that children under 5 years old will need a third dose to achieve maximum protection, as well. I had previously argued that the FDA was right to delay authorization of Pfizer’s vaccine for children because two doses didn’t prove effective, so regulators needed data on a third dose before approval. Moderna’s vaccine, though, seems different. Whereas Pfizer used a 3-microgram dose for the youngest children (just one-tenth of the company’s adult dose), Moderna went with a 25-microgram dose, or a quarter of its adult dose. Two doses of Moderna’s 25-microgram vaccine achieved a similar level of protection to older age groups. A third dose will probably enhance that protection, but if the first two doses are already effective, then parents should be able to start vaccinating their children while awaiting data on the added protection of the third.

To be sure, the case for vaccinating young children is not as clear-cut as it is for older children and adults. New research estimates that 60 percent of Americans, including 75 percent of children, have already contracted covid-19 and therefore have some degree of immunity to future infections. But vaccination enhances that immunity and can provide more durable protection.

Some will also argue that little kids are unlikely to become severely ill. But the CDC reports that 572 children and infants 4 and younger were hospitalized with covid-19 during the omicron surge. In addition, children are at risk to rare but serious complications associated with covid-19, such as multisystem inflammatory syndrome. Vaccination dramatically reduce the chances of this condition among children. Moreover, it decreases the incidence of long-haul covid in adults, and might well do the same in children.

If a safe vaccine can reduce these risks, then many parents, including me, will eagerly choose that additional protection. Families with young children have waited long enough. The FDA and CDC should review Moderna’s application without delay.

Related Articles

Leave a Reply

Your email address will not be published. Required fields are marked *

Back to top button