“Before you put [a vaccine] into children, you’re going to want to make sure you have a degree of efficacy and safety that is established in an adult population, particularly an adult, normal population.”

Approved COVID-19 vaccines are most likely headed to the American public in a matter of weeks. Those shots, however, will not be available to children in time for them to return to school next year or for many parents to start their return to work as normal. 

Drugmakers Pfizer and Moderna have both released promising results from their vaccine trials and are awaiting approval from the Food and Drug Administration to begin distributing doses. The first vaccines have not been tested extensively on children under the age of 18, and experts are concerned that an approved vaccine for children will not be available before fall 2021. 

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“Before you put [a vaccine] into children, you’re going to want to make sure you have a degree of efficacy and safety that is established in an adult population, particularly an adult, normal population,” Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Disease, said of the trial process last Sunday on NBC’s Meet the Press.

Andrew T. Pavia, chief of the pediatric infectious diseases division at the University of Utah, is among the immunology experts who called for trials in children to begin earlier, specifically after initial results in adults showed it was safe and effective. 

“We think that there was enough safety data emerging and early efficacy data a month or six weeks ago that the adolescents could have been added earlier,” Pavia told the Washington Post

Because children can have different immune responses to vaccines than adults, experts agree that drugmakers need to implement pediatric trials to determine the efficacy and safety for children. However, trials to test vaccine candidates in children are either still underway or have yet to begin. Fauci noted on Sunday that it could take months before anyone under the age of 18 has access to a COVID-19 vaccine. 

Moderna, whose vaccine candidate’s early data show a 94.5% efficacy rate for adults, is currently awaiting approval for a trial that includes children 12 to 18 years old, according to the Washington Post. Fauci also said on Meet the Press that an expedited testing process for children would “very likely” begin in January 2021.

The delay in a vaccine suitable for children will also delay the overall US recovery from the pandemic, according to experts. Sally Goza, president of the American Association of Pediatrics, wrote a letter to federal leaders in September noting that older children can transmit the virus just as easily as adults, and often have close contact with vulnerable groups. 

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“While the likelihood of spreading the disease may vary among different aged children, we know that children can and do spread the virus to household members, grandparents, teachers, and other children,” Goza wrote. She also noted the effects of the pandemic on schooling and mental health of children. 

“It is counter to the ethical principle of distributive justice to allow children to take on great burdens during this pandemic but not have the opportunity to benefit from a vaccine, or to delay that benefit for an extended period of time, because they have not been included in vaccine trials,” she continued. “We urge the inclusion of children in vaccine trials as we move forward in the development of a [COVID-19] vaccine.”

Children are integral to the country’s recovery. Without a vaccine approved for children, schools will largely remain closed, delaying parents’ return—and disproportionately working mothers—to the workforce. 

Since the start of pandemic-related school closures, more than 1 million parents have been pushed out of the workforce. This trend is especially difficult for low-wage workers who are forced to choose between a paycheck and child care. For the United States to see any meaningful recovery, children will need to have a vaccine.

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