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Will the CDC follow the FDA and approve Pfizer's vaccine for kids ages 5-11?

NOEL KING, HOST:

We have a staggering new number on COVID-19 this morning. The coronavirus has killed 5 million people around the world. This week in the U.S., the focus is on kids. CDC advisers will meet tomorrow to give their recommendations on whether kids ages 5 to 11 should get the vaccine. Now, the CDC's green light would be the last step in a long process, and if that light is indeed green, kids could start getting the vaccine in the next few days. NPR's Allison Aubrey is with us. Good morning, Allison.

ALLISON AUBREY, BYLINE: Good morning, Noel.

KING: Are pediatricians ready to vaccinate kids en masse?

AUBREY: Pediatricians have been preparing for this for months, but there are lots of logistics. Remember; the Pfizer vaccine authorized for 5- to 11-year-olds is a different formulation, a lower dose, and this means distributing and shipping a new product to thousands of pediatricians, as well as pharmacies. I spoke to Dr. Nicole Baldwin, a pediatrician in Cincinnati, about what this week could look like after the ACIP - which is the vaccine advisory committee - meets tomorrow.

NICOLE BALDWIN: We were able to order doses last week, and then once the ACIP and the CDC give their official recommendations as to who can get it, then we are able to administer it. So right now we're anticipating, hopefully, being able to start vaccinating those kids ages 5 to 11 starting sometime in the second week in November.

AUBREY: Now, her practice is scrambling to staff up clinics and deal with the logistics of administering this new vaccine to lots of kiddos. Every state is distributing vaccines differently. In Maryland, five pediatricians sent a message yesterday that they may not receive the vaccine for a few weeks, so they recommend taking kids to a pharmacy, such as CVS, which may have it sooner. So the rollout is going to vary a bit depending on where you live.

KING: Much as it did with adults, OK. We know, Allison, from poll data that many parents haven't made their minds up about whether they're going to vaccinate their kids. What advice are pediatricians giving now?

AUBREY: You know, pediatricians point out that more than 650 kids have died from COVID. It's been the eighth-highest killer of kids over the past year. And thousands of kids have ended up in the hospital. Amid the delta surge, hospitalizations among kids increased fivefold. But 90% of 12- to 17-year-olds hospitalized were unvaccinated. So vaccinated kids were protected against serious illness. Dr. Nicole Baldwin says there is a strong case to be made for getting kids the vaccine as soon as it's available, not just to protect the child, Noel, but also to make holiday gatherings safer.

BALDWIN: We do know that vaccines do reduce transmission. So it stands to reason that if we're getting these kids vaccinated now before they go hug grandma and grandpa at Christmas, that can offer additional protection to our more vulnerable population.

AUBREY: So it's beneficial to family and also to help minimize disruptions at school and to learning.

KING: It is worth noting, though, that one of the big reasons parents say that they're not sure they want to vaccinate their kids is because they're worried about potential risks, right?

AUBREY: Yes. Yeah, the risk that's been discussed the most is myocarditis, which is inflammation of the heart muscle. Now, this condition typically develops after a viral infection, though in rare cases it can result from a reaction to the vaccine. It can cause a rapid or irregular heart rhythm. But here's what's reassuring. In the rare cases it has been documented in adolescent boys and young men after a COVID vaccine, most get better quickly. I spoke to David Kimberlin. He's a pediatrician at the University of Alabama at Birmingham.

DAVID KIMBERLIN: The likelihood of having myocarditis from the infection itself, getting COVID, is higher than the likelihood of getting myocarditis from the vaccine. And when it does occur with the vaccine, you know, when people are hospitalized, they're in for a couple of days, they get treated with Advil, they go home.

AUBREY: He says, usually, there are no long-term complications. There's also a link between myocarditis and puberty hormones, which may explain why it's been seen in adolescents. So the risk among younger children, 5- to 11-year-olds, is likely even lower.

KING: Oh, that's interesting. A question that I know a lot of parents have - if my kid has already had COVID, should they still get the vaccine?

AUBREY: You know, the advice from pediatricians is, yes. Dr. Kimberlin says there is some immunity following a COVID infection, but it just may not be enough.

KIMBERLIN: It won't last as long, and it won't be as strong as the immunity that's generated by getting the vaccine. And so the idea of waiting because a person had COVID in the past is not really, in my judgment, a sound kind of approach. So my suggestion is to try to get the strongest immunity you can, and that's with the vaccine.

AUBREY: Now, some of the most serious cases of COVID have occurred in children who had no underlying conditions, meaning they were otherwise healthy. So Dr. Kimberlin says this virus is very unpredictable in kids. I will point out that, so far, it is just the Pfizer vaccine authorized for children. Over the weekend, Moderna said that the FDA will take more time to evaluate its vaccine for adolescents. Last week, the company reported positive data from its trial in 6- to 11-year-olds and will submit that data to the FDA. You know, the American Academy of Pediatrics knows that parents have questions about all of this, so they say pediatricians are standing by to talk with families and to administer the vaccine to children as soon as possible.

KING: OK. Before we let you go, just a quick question about adults and booster shots - will more people be eligible for boosters soon beyond people who are 65 and up and have certain conditions?

AUBREY: You know, the CDC is tracking in real time whether immunity seems to be waning in younger age groups. And the agency has already added to the list of conditions that can put people at higher risk, which makes them eligible for a booster now. This list includes people with depression and other mood disorders, smokers and former smokers and people with substance use disorders. So that is potentially millions of more people now eligible for a booster shot.

KING: Wow. NPR's Allison Aubrey. Thank you, Allison.

AUBREY: Thank you, Noel. Transcript provided by NPR, Copyright NPR.