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My daughter was just starting to walk when the pandemic started. She is now almost four, and all this time – growing up, going to school – she has not had access to any protection from vaccines against COVID-19.
That is changing this week. The White House has unfolded a plan for vaccination of 19 million children under 5 in the US, but if you’re just leaving the holiday weekend trying to figure out where to find a date, you’re not alone.
Claire Hanan helps immunization managers from all 50 states navigate the release of COVID-19 vaccines from the autumn of 2020 as Executive Director of the Association of Immunization Managers. She told NPR what was going on behind the scenes to bring out this new formula with low-dose Moderna and Pfizer vaccines so that young children could finally be protected.
This interview has been edited for length and clarity.
What is the current release status? Were pediatricians able to order these new injections?
There were two waves of pre-orders. The first wave ended earlier in June, and the provider had to be able to get vaccinated yesterday – on the holiday – so pre-orders for the one-wave wave were small. There were significantly more orders in the second wave than the pre-orders that are starting to be delivered [Wednesday] or Thursday. So I think it will be easy to find vaccines by the end of the week.
The CDC’s consultation meeting, at which vaccine experts reviewed all data, took place over a long weekend on Saturday. You watched it – what did the parents miss?
The Commission was unanimous, very passionate about the benefits of the vaccine for children. I think that if someone has doubts about whether to take it for their child, it should remove any of these doubts.
They reviewed data on illness and hospitalization and deaths. There were no serious side effects [from the vaccine]. This is something they continue to monitor as the vaccine is released, but there is no reason to suspect that there may be, given the millions of doses of the vaccine on a larger scale. [that] are given to adults. The effectiveness is not exactly what it was in adults, but – with two doses and potentially a third dose of Moderna and three doses of Pfizer – the effectiveness against hospitalization and death is very good.
Many parents say, “Well, my child already has COVID.” The data they looked at didn’t seem to be of any use if your child had COVID, as long as it prevented future hospitalization and death while the vaccine did. [protect against that.] So, even if your child has had COVID, I would recommend that you get the vaccine and make sure you get all three doses if it’s Pfizer, both doses if it’s Moderna, and just wait for the booster to come.
How much will this implementation rely on pediatricians compared to pharmacies?
I think this implementation will be much more reliable for pediatricians and family doctors. From what the CDC told us, 70-80% of pediatricians are enrolled in Vaccines for children the program are also saved COVID program. There are a number of challenges for providers, but I think there will be many more vaccines in the children’s health center than we have seen in older children and adults, where pharmacies can play a big role.
[Pharmacies] we can vaccinate for up to three years now while we are in the pandemic, but we were told by the CDC to expect 10% of pharmacies to vaccinate children under five because many of them do not feel comfortable vaccinating younger children, not necessarily to have this connection with the parents, [or] space.
Some pediatricians (including mine) do not plan to order the vaccine or offer it in the office. What are some reasons why pediatricians do not participate?
[With other vaccines], pediatricians usually receive single-dose vials. When a child enters, they take the vial out of the refrigerator and give it away. They do not have to worry about waste.
With COVID, this is a 10-dose vial. So if they give one injection to a child, they have to give nine more injections within 12 hours or they will lose – they have to throw away the rest of the vial. It’s just very, very difficult to make them to order [when they will have to likely] discard unused doses. We just really insisted on suppliers [with the message that] it is better to waste one dose and not lose the opportunity to vaccinate a child.
This is also a new wording, isn’t it? The vials of 5-11 years were different – with an orange label.
Yes, this is a new wording. Pfizer’s new vials are maroon and [the Moderna ones] have a purple label. So now you have something like six different formulations that a pediatrician would wear if he wore both Pfizer and Moderna for all age groups from six months to 18 years. This is another real challenge.
What we see is that suppliers only want to wear one brand or another. They want to reduce their chances of having a storage error or an administrative error because vaccines are so different.
With 5-11 vaccines, suppliers had to order a minimum of 100 doses. Is this the case with these vaccines?
Yes, the minimum order is 100 doses. This is definitely a challenge. It works with a 10-dose vial if you are a provider in a rural area or if you have little practice, if you have only 10 children in your practice in this age group, you know you are potentially opening 10 vials on 10 different days and discarding the other nine doses. every time. And this is where the provider says, “You know what? I’m probably not the right provider to give this vaccine. That’s why we have suppliers, especially small suppliers in rural areas, who say they don’t want to order it.
But health agencies have analyzed orders by zip code. They use local health services as a place where the vaccine will be available in communities. In addition, they set up school clinics or mobile clinics if there are no providers in the area who have ordered a vaccine.
What should you do if your pediatrician does not give vaccines and you want to vaccinate your child under 5 years of age?
Check vaccines.gov. This shows the suppliers [near you] who have a vaccine supply for children under five. You can see, “Okay, okay, this pediatrician is not my pediatrician, but they have supplies and vaccinate.” And you can call them. So I would start with vaccines.gov – you can enter your zip code, you can take a look.
And then I would call the local health department or just go to their website, [or] the State Department of Health website and see and see. They may have [vaccine] clinic in your area. I would also check in my pharmacy. CVS minute clinics and some emergency clinics have the capacity to vaccinate [kids] under 3.
The governor of Florida was making news declaring that the state will not order any vaccines against COVID for this age group? Is the vaccine being delivered to Florida?
What happened in Florida was that the state did not order any doses of it [initial] pre-order. Providers [like family doctors] order a vaccine now and managed to order over the weekend, so deliveries to suppliers are likely to start on Wednesday or Thursday.
So the suppliers order the vaccine, it is delivered to them. Retail pharmacies have been able to pre-order it, so some have it [already].
“[So for parents there,] I think it will be harder and it may be a few more days before there is more vaccine, but it is being sent to Florida. ”