FDA Advisers Review Pfizer, Moderna Covid-19 Vaccines in Young Children

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A positive recommendation would likely lead soon to expanding the U.S. Covid-19 vaccination campaign to the 19.6 million children ranging in age from 6 months to under 5 years old, one of the last groups of people in the U.S. waiting for shots.

Moderna’s two-dose vaccine is up for the Food and Drug Administration’s authorization in children 6 months to 5 years, while Pfizer’s three-dose shot is under review for children 6 months to 4 years.

FDA staff have reviewed data from the companies’ clinical trials, finding the vaccines were generally safe and effective.

The Vaccines and Related Biological Products Advisory Committee includes physicians, infectious-disease scientists and other health experts. The panel meets regularly to consider vaccines and medicines under FDA review.

After a daylong meeting, the committee is scheduled to vote on whether the FDA should authorize the Pfizer-BioNTech and Moderna shots for young children.

The FDA doesn’t have to follow the panel’s recommendation but usually does.

Should the panel sign off, an FDA authorization is expected to come within days.

The FDA, which regulates medical products, must authorize the vaccines before they can be used outside trials. After the FDA’s action, the Centers for Disease Control and Prevention, which offers guidance to doctors, pharmacies and vaccination sites, would set the policy for the youngsters to get the shots.

Nearly 20 million children would likely soon become eligible for a Covid-19 vaccine if the FDA panel gives a positive recommendation.



Photo:

Daniel Lozada for The Wall Street Journal

Many states and vaccination sites wait for the CDC’s signoff before rolling out shots. Vaccinations could begin as early as June 21, according to the Biden administration.

Children are generally at lower risk of developing severe Covid-19, though hospitalizations increased during the Omicron wave last winter. Health authorities have encouraged vaccinations of children eligible to get the shots to protect not only the children, but also adults.

Peter Marks,

who heads the FDA’s vaccines division, opened up the meeting saying the Omicron surge during the winter resulted in hospitalized children at a rate worse than even a terrible influenza season, and it was important that people “don’t become numb” to pediatric Covid-19 deaths, even if they occur less frequently than in older people.

“Each child lost essentially fractures a family,” he said.

While some parents of children under 5 years are eagerly waiting for shots for their young children, surveys suggest most parents are less enthusiastic.

About 18% of parents surveyed said they wanted to get their child vaccinated right away, while 38% say they plan to wait and see, according to a Kaiser Family Foundation poll conducted in April.

About 27% of parents don’t plan to vaccinate their child at all, and 11% will do so only if they are required, according to the survey.

Pfizer’s request for authorization is based on a 4,526-child study testing three doses of either a vaccine or placebo, with all third doses coming between February and April, when the Omicron variant was prevalent in the U.S.

The study found the vaccine was about 80% effective in preventing symptomatic Covid-19 among the children.

For the youngest children, side effects included irritability and drowsiness. Side effects in children 2 to 4 years old included pain at the injection site and fatigue, according to the FDA.

Pfizer settled on a dose of 3 micrograms—one-tenth the dose that people 12 years and older receive—in part because research found the lower dose to be more tolerable in youngsters and could help with adherence, said

Bill Gruber,

Pfizer’s senior vice president of vaccine clinical research and development, during a presentation.

Children under 5 in the U.S. aren’t yet eligible for a Covid-19 vaccine after efforts to get the shots to market have hit setbacks. WSJ’s Peter Loftus explains what we know about the vaccines and when they might become available. Photo composite: Todd Johnson

“A third dose is required also for the 6 months to less than 5 years of age group to ensure a more robust protection against Covid-19 due to Omicron,” Dr. Gruber said.

In February, the FDA delayed its review of Pfizer’s vaccine for young children, since two doses of its vaccine weren’t effective against Omicron. The delay allowed Pfizer to study a third dose.

The FDA’s review of Moderna’s vaccine was based on studies testing two doses of either the shot or a placebo in more than 6,300 young children.

Agency staff said Moderna’s two-dose vaccine was 37% effective for 2- to 5-year-olds and 51% effective for children 6 to 23 months, in a study conducted when the Omicron variant was predominant.

The FDA said children 6 months to 11 years old had lower rates of side effects than adolescents and young adults, with the exception of fever, which was reported more frequently in the younger age groups.

While the studies of the Pfizer-BioNTech and Moderna vaccines didn’t identify any cases of heart-inflammation conditions including myocarditis, the FDA panel is expected to discuss the issue.

The FDA has identified an elevated risk of the conditions in certain people, particularly males 12 to 17 years old.

The first two Pfizer doses are given three weeks apart, followed by a third dose at least eight weeks later. The two Moderna doses are given four weeks apart.

Moderna said it was studying boosters for its young vaccine recipients and that they would probably be needed. “I think all of us agree that these children are going to need a third dose at some point in time,” said Jacqueline Miller, Moderna’s senior vice president of infectious diseases.

Write to Jared S. Hopkins at [email protected] and Liz Essley Whyte at [email protected]

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