Keep kids in our vaccine plans

There’s a mantra I often hear when talking with parents these days. It sounds more like a prayer or an invocation than a statement of fact. It goes something like this: At least kids can’t get COVID.

I hate to be the bearer of bad news in a time when bad news seems to be in abundant supply, but this reassuring sentiment is false. More than 1.4 million children in the United States have been infected with COVID-19, with in excess of 6,000 having been hospitalized and more than 120 even dying. Pediatric COVID-19 cases now account for nearly 12% of the total cases in the United States. As we race to deliver safe and effective vaccines, it’s imperative that we also include children in studies, not just adults.

This may sound like an obvious statement. Sadly, it’s not. Talking with parents these last few months, my colleagues and I have sensed a significant discomfort with the idea of vaccination in general. Vaccines are one of the greatest medical and public health achievements of our era, protecting children and adults from many infectious diseases. Yet these days, vaccine delays or refusals are increasingly common. In fact, we’ve seen a decline in parents seeking non-COVID-related vaccines for their children, the result, no doubt, of wishing to avoid coming into a doctor’s office in the middle of a raging pandemic.

Many parents’ concerns seem to go deeper, expressing trepidation that a COVID-19 vaccine developed so quickly may not be safe. They’d prefer to wait and see, they say, before accepting it for themselves, let alone offering it to their children.

Such concerns are understandable. The death toll from this virus in such a short period of time is terribly frightening. Plus, there’s still much more we don’t know about the virus and disease. Vaccines also are not totally risk-free, so the need for safe and effective COVID-19 vaccines is paramount.

But as we think about public health and the health of our children, it’s important to remember three crucial numbers.

The first is five. That’s the number of COVID-19 vaccines that have completed, entered or are about to enter Phase III clinical trials, including Pfizer’s that received FDA emergency use authorization and others on the cusp of receiving it. COVID-19 vaccines are being studied in tens of thousands of people, but none of the trials include very many children, except for one that has only recently expanded its enrollment to teens as young as age 12 years. As we begin to include more children in the current breakthrough COVID-19 vaccine trials, we’ll already have considerable data culled from a very significant diverse population of adults.

The second is 15. That’s the number of independent experts, knowledgeable in vaccine-related fields, on each of two important federal advisory committees: the Vaccines and Related Biological Products Advisory Committee of the FDA and the Advisory Committee on Immunization Practices of the CDC.

The FDA’s committee advises on emergency use authorization by evaluating the clinical data derived from Phase III trials and determining whether they sufficiently meet safety and efficacy benchmarks for a particular vaccine or whether additional studies are required. In turn, the CDC’s committee makes national recommendations that determine how an FDA-licensed or approved vaccine will be used and administered to the public.

The third and final number is 4 million. This is the estimated number of births each year in the United States, which means there are close to 72 million children under 18 years of age. This highlights the critical need for more children to be included in COVID-19 vaccine trials as soon as possible.

The work of coming up with a successful COVID-19 vaccine isn’t just up to the talented scientists toiling in their labs to speed-up discovery. It is really up to us all. We must work collectively to reject any attempts at misinformation pertaining to COVID-19 vaccines and vaccinations in general, insisting instead on learning from only credible and transparent sources. A rant on social media isn’t a sound medical opinion, and a celebrity’s musings aren’t equal to a study published in a peer-reviewed medical journal.

Indeed, children do get COVID and can spread it, so let’s do whatever we can to keep ourselves well informed and our children safe. As we do that, we should also remember that it is incumbent upon us to insist that testing and public health policy both consider the value of including diverse population groups in clinical trials, including children. This isn’t some politically correct talking point — it’s a matter of life and death for all of us.

Bernstein is professor of Pediatrics at Zucker School of Medicine at Hofstra/Northwell and Cohen Children’s Medical Center, a member of the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices, and ex-officio member of the Committee on Infectious Diseases of the American Academy of Pediatrics.