CDC endorses Pfizer boosters for children ages 12 and older
By Roni Caryn Rabin
The Centers for Disease Control and Prevention earlier this week endorsed booster shots of the Pfizer coronavirus vaccine for children ages 12 to 17, citing rising infections in teens and young adults and a troubling increase in pediatric hospitalizations.
As the contagious omicron variant spreads through the country, public health officials have seized on extra vaccine doses as a first line of defense. Pfizer boosters are now authorized for any American older than 12 who is five months past his or her second dose of the vaccine.
An advisory committee recommended the changes after a meeting Wednesday. They were endorsed by Dr. Rochelle Walensky, the CDC director, on Wednesday night. Adolescents ages 12 to 15 may begin to receive boosters immediately. Adolescents ages 16 and older were already permitted to receive booster shots, but on Wednesday the CDC panel strengthened the recommendation.
The advisory panel followed a similar move earlier this week by the Food and Drug Administration, which authorized Pfizer boosters for adolescents and shortened the recommended time interval between the initial vaccine regimen and the booster.
The FDA also endorsed “an additional primary dose” of the Pfizer vaccine for moderately or severely immunocompromised children ages 5 to 11, to be given 28 days after their second shots.
Studies suggest that vaccine side effects are minimal in children, although there is lingering concern about a link to myocarditis, a rare inflammation of the heart muscle that occurs more frequently in young men, after vaccination.
In Israel, which started administering boosters to adolescents ages 12 to 15 in June and rigorously tracks side effects, the Health Ministry identified two cases of myocarditis among some 41,600 adolescents in this age group who received the booster.
Both children were hospitalized briefly and have fully recovered, said Dr. Sharon Alroy-Preis, an Israeli health official who addressed the committee.
The booster dramatically reduced infection rates among children ages 12 to 15, Alroy-Preis said. Although most infected youngsters generally did not experience severe COVID-19 that required hospitalization, two children — one boy and one girl — have died, she said.
But while much of the committee’s discussion focused on the risks of the vaccine and its side effects, Dr. Camille Kotton, an associate professor at Harvard Medical School who specializes in transplant and immunocompromised patients, said the focus should be on the disease itself, which is having a devastating effect on vulnerable and immunocompromised patients.
“This is an important thing to think about — the risk of myocarditis from the disease itself,” Kotton said.
Although omicron is generally perceived as causing less severe disease, she said, she now sees numerous patients on life support. Some have died.
“It’s a horrible state of affairs,” Kotton said. “The highly infectious nature of omicron is such that patients who have been incredibly careful the last two years have been getting infected with awful outcomes.”
Dr. Katherine Poehling, director of pediatric population health at Wake Forest School of Medicine in Winston-Salem, North Carolina, expressed similar sentiments.
“There are children waiting in the emergency department 18 hours and longer to get into the hospital because we’re so full,” she said. “We have parents asking us can their children get a booster dose, like older children.”
But several committee members said they were increasingly disturbed that only a minority of younger children are getting vaccinated at all, and said it is critical to increase the rates and adhere to other prevention strategies, like masking.
“We can’t put all of the burden on the people who are willing to get vaccinated,” said Lynn Bahta, a committee member who is a registered nurse with the Minnesota Department of Health. “When we have only half our adolescents vaccinated, that adds more burden as well. I am so concerned that the burden of disease prevention is all falling on the vaccinated and them getting the boosters.”
More than 70% of people 12 and older in the United States are fully vaccinated, according to the CDC. Children younger than 5 are still not eligible for vaccination.
Americans 18 and older who received Moderna’s vaccine can get a booster of any available coronavirus vaccine six months after the second shot. Those who received Johnson & Johnson’s single-shot vaccine may get a booster dose of any available vaccine two months after their first shot.
The Pfizer and Moderna vaccines are both strongly preferred over the Johnson & Johnson vaccine, the CDC has said. Only the Pfizer vaccine is authorized for children ages 5 to 11; boosters are not yet recommended for this group.