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COVID-19

California plans ambitious effort to vaccinate young children

A nurse administers the COVID-19 vaccine to a student at San Pedro Senior High School on May 24 in Los Angeles.  (Carolyn Cole)
By Luke Money and</p><p>Rong-Gong Lin II Los Angeles Times

LOS ANGELES – California health officials said Wednesday that they are prepared to pull out all the stops to vaccinate children ages 5 to 11 against COVID-19 as the country draws closer to authorizing eligibility for that age group.

While there are still a number of federal and state hoops to jump through, officials said they are preparing to offer doses to the roughly 3.5 million children in the age group statewide as soon as the end of next week, as the critical holiday season approaches.

“The more vaccinations we get into the arms of eligible Californians, the more we stop the spread and shrink the pool of people vulnerable to COVID-19. This will get us closer to ending the pandemic,” said state epidemiologist Dr. Erica Pan. “Our youngest children have remained vulnerable to the highly contagious virus as older Californians have received their vaccine. Now the time is coming to protect them.”

Though the early part of the vaccination rollout was marred by scarce supplies and long lines, officials said they expect to have ample doses and capacity to handle increased demand.

Pan, who is a pediatric infectious disease specialist and a parent, said California will have more than 1.2 million doses available in the first week after younger children become eligible.

By comparison, an average of only about 77,000 doses have been doled out daily over the past week.

And while California already has a network of thousands of vaccination sites, officials said they are looking to work with schools to establish more on-campus locations – not just for any newly eligible children but for parents who might be looking for a convenient site to receive their own shots.

On Tuesday, a Food and Drug Administration advisory panel voted to endorse kid-sized doses of the Pfizer-BioNTech vaccine.

The benefits of preventing COVID-19 in that age group outweighed any potential risks, such as myocarditis – an inflammation of the heart – that’s been rare in teens and young adults, the panel said.

In fact, a clinical trial for children ages 5 to 11 found no reports of myocarditis post-vaccination, according to data presented to the FDA. Monitoring will continue as to whether rare reports of myocarditis will end up emerging.

Some experts have expressed optimism that the lower dosage for children ages 5 to 11 will reduce the chances of side effects like myocarditis. The dose for these children, 10 micrograms, is one-third what is given to ages 12 and older.

The FDA is expected to make its own decision in the coming days. Should that agency sign off, the matter will next go to an advisory committee for the U.S. Centers for Disease Control and Prevention for review.

The advisory committee plans to meet on Nov. 2 and 3. After the panel makes a recommendation, the matter will go to CDC Director Dr. Rochelle Walensky, who will issue a final clinical recommendation on who should get the vaccine.

In California, shots won’t start going into youngsters’ arms until the completion of additional review by the Western States Scientific Safety Review Workgroup, a coalition of public health experts from California, Nevada, Oregon and Washington. That review might take an additional day to complete.

Even so, it’s possible children ages 5 to 11 will be able to get their first dose of the Pfizer-BioNTech vaccine by the latter part of next week.

“These young heroes want to fully participate in life again. With holiday gatherings and festivities approaching, vaccine authorization could not come at a better time,” Pan said.

As with those age 12 and older, the vaccine for this younger age group will be administered in two parts, with the second dose recommended by the manufacturer to be given three weeks after the first.

The Pfizer-BioNTech shot has been fully approved for those who are at least 16 years old and is authorized for use in children between the ages of 12 and 15 on an emergency basis.

Health officials have long maintained that immunizing children is critical to finally bringing the COVID-19 pandemic to its knees.

Vaccinating youngsters, officials say, not only will help prevent them from being stricken by the disease. It will keep them from unwittingly spreading it to other, more vulnerable residents – or from incubating potentially dangerous coronavirus mutations.

“Fully vaccinated children will be better protected at schools, youth activities, holiday gatherings and celebrations, and homes,” Los Angeles County Public Health Director Barbara Ferrer said in a statement.

Once the CDC issues final approval, the county will use its network of providers to vaccinate younger children, she said.

The potential new front of the inoculation campaign comes as California is still combating vestiges of the latest coronavirus surge, fueled by the highly infectious delta variant.

At the peak of the wave, California was confirming an average of nearly 15,000 new daily infections and more than 8,300 COVID-19 patients were hospitalized statewide.

While both those metrics have declined substantially in recent months, they remain stubbornly elevated. Over the last week, the state has reported an average of 5,560 new coronavirus cases per day – down only about 5% from two weeks ago, according to data compiled by the Los Angeles Times.

The number of COVID patients hospitalized, 3,827 as of Tuesday, is largely flat from two weeks ago and has increased slightly in the past week.

On average, more than 100 Californians are still dying from COVID-19 each day.

However, officials continue to stress that it’s unvaccinated residents who are continuing to bear the brunt of the pandemic. Unvaccinated Californians are roughly 6.6 times more likely to be infected, 12 times more likely to wind up hospitalized and 18 times more likely to die than their vaccinated counterparts, according to Dr. Mark Ghaly, the state’s health and human services secretary.

“We enter into these next many weeks confident in the state of play with vaccines and their ultimate protection of so many, but cautious and vigilant with our guard up,” he said.

While children are, on the whole, far less likely than adults to suffer the worst health impacts of COVID-19, the disease is not harmless for youngsters.

According to the Kaiser Family Foundation, in August and September, COVID-19 became the seventh-leading cause of death among the youngest children, ages 1 to 4; the sixth-leading cause of death among those ages 5 to 14; and the fourth-leading cause of death among those ages 15 to 24.

The chance of dying from COVID-19 among children can be small yet still rank as a leading cause of death, because children don’t die very often, said Dr. Monica Gandhi, a University of California, San Francisco infectious diseases expert.

But during the latest coronavirus surge, she said, “kids got a lot of cases, and there were more hospitalizations in children than we have ever seen before” in places across the country with low rates of adult vaccination.

Nationwide, 763 children under the age of 18 have died from COVID-19, according to the CDC.

In California, 37 children have died from COVID-19, according to the state Department of Public Health.

“It’s kind of like: What if you had a vaccine that was totally safe,” Gandhi said, and a child “would never get cancer?”

As of mid-October, more than 6 million children in the U.S. had been infected with the coronavirus since the pandemic began, with 1 million of those cases recorded in just the last six weeks.

“There have been more than 35 pediatric deaths (from COVID-19) in California alone, and this is more deaths than we see with flu in a very bad flu season,” Pan said. “There simply is not an acceptable number of child deaths when such an effective and safe prevention are available.”