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Looking for clarity on vaccines for young


A Moderna COVID-19 vaccine trial in Commack, N.Y., last year.

By David Leonhardt


Why hasn’t the Food and Drug Administration approved a COVID-19 vaccine for children younger than 5? Government officials have given two conflicting answers in recent days — one that places responsibility on vaccine manufacturers, another that casts the lack of approval as a deliberate federal policy.


It’s the latest instance of what has been a recurring problem during the pandemic. Public health officials have sent confusing messages about COVID-19 policy. They have done so on masks, tests, adult vaccines and basic COVID-19 statistics.


Sometimes, the confusion has been intentional: Officials haven’t trusted Americans with the truth. Other times, the confusion has been an accidental byproduct of a public health bureaucracy in which no one person has responsibility for delivering clear messages to the public.


The situation has bred frustration among many Americans — such as parents who are desperate to vaccinate their young children. These parents listen to the public statements of government officials and the news coverage but fail to find comprehensible answers.


“I feel like the goal posts have been moving,” Rachel Perera, the mother of an 8-month-old in Los Angeles, told The New York Times. Dr. Jessica Snowden of Arkansas Children’s Hospital said: “I hear from lots of parents every day, asking, ‘Do you know, do you know? When’s it going to be approved?’” said Sen. Patty Murray, D-Wash., describing parents. “They’re frustrated, they are confused, and I am too, and they really do deserve some clarity on this.”


The confusion has become one more factor contributing to Americans’ distrust of major institutions like the government, the media and the medical system. People think they are not getting straight answers, and they’re right about that.


When FDA officials have spoken publicly about the lack of a vaccine for young children, they have put the onus on Moderna and Pfizer, the vaccine makers. The officials have suggested that the companies have not completed their portion of the regulatory process.


During a Senate hearing this past week, Dr. Peter Marks — the FDA official who oversees vaccine approval — declined to give a direct answer about why the agency had not authorized the vaccine for young children. But he did say this: “Just remember that we can’t actually finish our reviews until we actually have complete applications.”


An announcement Thursday from Moderna seemed consistent with his suggestion. The company said that it would finish submitting data from its research trials by May 9 and that it hoped the FDA would then approve the vaccine for young children.


Together, Moderna’s announcement and Marks’ comment seem to suggest that the FDA is eager to approve a vaccine for young children as soon as possible. Other evidence indicates the opposite.


Dr. Anthony Fauci, a top Biden administration COVID-19 adviser, suggested on CNN that the FDA would not approve a Moderna vaccine for young children until it could simultaneously approve one from Pfizer. Approving two vaccines at different times, he said, could “confuse people.”


This planned delay raises two big questions. One, why does the government think Americans are incapable of handling different approval dates? Two, why is the government telling us conflicting stories — one in which the FDA is deliberately delaying approval and another in which the agency is merely waiting for Moderna and Pfizer to submit the necessary information?


I posed these questions to Biden administration officials Thursday, and the answers were fascinating. Although the officials did not want to be identified, they offered a much clearer answer than I have heard them give in public.


At the moment, the FDA is indeed waiting for more data from Moderna and Pfizer. And the agency would prefer to make decisions about the two vaccines at the same time, partly to allow parents to decide which vaccine is best for their young child.


“If the stars align, we would like that to happen,” an administration official told me. “However, we are not going to put ourselves in a situation where we sit on data.” If one company’s timetable is only a few days or weeks before the other’s, the FDA will wait to act on both at once. If the gap is longer, the agency will act on either Moderna or Pfizer without waiting for the other.


“We don’t want to delay anything unnecessarily,” the official said.


I told him that his answer was the clearest one I had yet heard from the administration and asked why officials were not providing the same clarity in public. He said he hoped that soon it would.


For now, the FDA has been speaking in bureaucratic jargon and leaving people confused. “The messaging,” Dr. Jennifer Lighter, who specializes in pediatric infectious diseases at New York University, told me, “has been so poor.”


Public health officials in this country are often uncomfortable trying to convey the full truth. They worry that people will misunderstand the details and behave dangerously. Instead, the officials provide only partial truths and hope that Americans won’t notice. The strategy hasn’t been very successful.

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