It’s interesting to get people vaccinated at the rates we have – over 150,000 doses were given in Utah last week, and that number is expected to increase. On April 1, all Utah adults are eligible to enroll, but for some the decision is not as easy.
Children, pregnant women and those who have had COVID-19 may have different challenges. I want to explain why this is and what science says about vaccination options for these groups.
Vaccines for children
Adolescents over the age of 16 can receive the Pfizer vaccine, but not Moderna or Johnson & Johnson. For those under 16, we are still waiting for clinical trials.
As with all COVID-19s and children, it is important not to think of children as a single group, but of several age groups. In many ways, adolescents who have gone through puberty appear to have similar results – albeit better than – to other young adults, while children younger than them appear to have additional protective abilities that make symptomatic infection less likely.
So, for months, these companies have been testing their coronavirus vaccines in teenagers. The Modern “TeenCove” study, launched in December, aims to study the impact of the vaccine on approximately 3,000 children aged 12 to 18 years. The Pfizer vaccine was initially tested at the age of 16 and over, and the company fully enrolled a study in children aged 12 to 15 in January.
Biologists are very confident that the vaccine will work essentially in these adolescents as well as in the elderly, but of course we need to study it to make sure. The results of these studies are to be published “in the middle of 2021.” It seems that researchers are trying to draw conclusions before the 2021-22 school year, so June or July is a relatively safe bet.
And now we study the vaccine in younger children as well. Moderna announced on Tuesday a phase 2/3 study to test the vaccine in two different age groups: from six months to two years and from two years to 12 years. Researchers will test the vaccine on 6,750 children and experiment with different doses to see which is most effective. On the younger set, they will give quarter, half and full size doses, and on the older set they will try both half and full doses. Pfizer has not yet begun a similar study, but says it plans to do so this month.
When will we get the results of these studies? “Just looking at the deadlines, it’s probably more likely by the end of 2021 to early 2022 for younger children, but maybe it will go a little faster than that,” said Robert Frenck, director of the Vaccine Research Center at Hospitals. Cincinnati children and principal investigator for Pfizer’s research, Bloomberg said.
The Johnson & Johnson vaccine is interesting when it comes to children, not only because of the simplicity of a dose, but also because it uses an older vaccination technology. This means that vaccines of this type have already been used in young children, including Ebola and RSV. While Johnson & Johnson has not yet begun a study on the under-12s, it intends to do so.
Vaccines for pregnant women
Centers for Disease Control and Prevention do not directly recommend that pregnant mothers be vaccinated, but they do not say they should not either. These federal officials say it is a “personal choice.” This is because the vaccines were not initially tested in pregnant women, but all the signs so far have been positive.
Vaccination studies for Pfizer, Moderna, and Johnson & Johnson generally excluded pregnant women, but a few slipped – women who did not know they were pregnant or became pregnant after the trial began. A total of 18 pregnant women were vaccinated “accidentally” as part of these studies and none had any side effects.
More recently, the CDC followed 30,000 pregnant women who chose to be vaccinated, including 1,800 who agreed to provide detailed descriptions of their results. As reported by Harvard Medical School, “To date, pregnant women appear to have the same side effects of the vaccine as people who are not pregnant. No miscarriages, stillbirths or premature births related to vaccines have been reported. ”
More invasive tests have also been performed on animals pregnant with coronavirus vaccines. Again, no red flags were raised.
In particular, the vaccine itself does not appear – either the mRNA particles from Pfizer / Moderna vaccines or the modified Johnson & Johnson vaccine virus – end up in the placenta. They are swept away by the body relatively quickly.
What seems to happen, however, is that after the body develops antibodies in response to the vaccine, these antibodies are shared with the baby. A Massachusetts General Hospital study that tested 10 blood from the umbilical cord of newborns after vaccinating their mothers found antibodies in all 10. A similar study in Israel found the same thing, but with 20 pairs of women / newborns. born.
This is not a huge surprise, but it happens with most vaccines. But, in essence, it is the best case: newborns were actually at a relatively high risk for COVID-19 and it seems that vaccination of the mother can give those children antibodies without exposing them to the vaccine injection itself .
Meanwhile, Pfizer has an ongoing trial with 4,000 expectant mothers, with the first participants being dosed about a month ago. After completing the process in a few months, I expect the CDC to start fully.
Vaccines for those previously infected with COVID-19
At this time, in Utah, those who have been infected with COVID-19 for the past 90 days are asked to wait to be vaccinated. The reason is simple: you already have antibodies and are currently strong, so save the dose for someone else.
That being said, the Utah decree is a suggestion – if you really want to get vaccinated despite being infected for the past 90 days, you can. It’s a kind of selfish move, but for sure.
Interestingly, studies show that those who have already been infected tend to have a stronger immune response to the first dose than those who have not already had COVID-19.
And, in fact, there are now several studies showing that a single dose should be enough for complete protection for those who have already had the disease. These studies show a 100x to 1000x increase in antibody levels after the first dose, but no real change in antibodies after the second dose.
Makes sense. For “naive” individuals COVID-19 – people who have not been infected – the first dose teaches the body about the virus, and the second teaches the body that the virus is a constant threat. For those who have already been infected, the first dose acts as that lesson. A second dose is just exaggerated: “Welp, here’s this virus for the third time this year.”
So those who have already had coronavirus should definitely be vaccinated in the end, but maybe not several times. However, the current CDC and Utah protocol is to give these people both doses, although the scientists who worked on the above studies have asked the CDC to change this. It takes a long time for the CDC to change its mind, which is reasonable, though reasonable, but some other countries have already given up a single blow.
If I had been infected before, my approach would be “wait and see”. If I had given positive results in the last 90 days, I would wait for my dose so that someone at higher risk could take it. If it was more than that, I would receive the first dose as soon as possible, then use the next 21-28 days to follow the CDC page for changes to their protocol.
Andy Larsen is a data columnist. He is also one of the Utah Jazz rhythm writers at The Salt Lake Tribune. You can reach him at [email protected].