COVID vaccines for children under the age of 5 are still not available, even as the country lifts some of its final masking restrictions, so what should parents know before they travel and when could vaccinations be authorized?
Dr. Vivek Cherian, an internal medicine physician in Elk Grove, the decision of whether to travel with unvaccinated children following the lifting of the mandate "really depends on your level of risk tolerance."
COVID vaccines for children under the age of 5 took a major step forward last month as many parents anxiously await approval for the only age group not yet eligible for vaccination, but little has been heard since.
With cases of the omicron subvariant BA.2 on the rise across the U.S. and restrictions largely lifted in most settings, parents of children still not eligible for vaccination are wondering when their time might come.
The nation’s 18 million children under 5 are the only age group not yet eligible for vaccination.
Some have argued the decision to lift masking requirements for public transit was premature given that not everyone is eligible for vaccination.
"We don’t know when children under 5 can be vaccinated," Cherian said. "That could be for the foreseeable future. It’s not going to be a year from now. Reasonably, at most, we’re one or two months away."
Currently, Pfizer's COVID vaccine has been the only one approved for emergency use in the US for children between the ages of 5 and 17.
Pfizer currently offers kid-size doses for school-age children and full-strength shots for those 12 and older. The company is testing even smaller doses for children under 5 but had to add a third shot to its study when two didn’t prove strong enough. Those results were expected by early April, though no announcements have been made so far.
Moderna announced last month that in the coming weeks it would ask regulators in the U.S. and Europe to authorize two small-dose shots for youngsters under 6 — a development that could pave the way for the littlest kids to be vaccinated by summer if regulators agree. But as of Thursday, no such request has been filed.
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The company also is seeking to have larger doses cleared for older children and teens in the U.S.
Once Moderna and Pfizer submit the full data from their trials, the FDA will have to determine if youngsters are as protected against severe illness as adults.
If the FDA eventually authorizes vaccinations for little kids from either company, there still would be another hurdle. The Centers for Disease Control and Prevention recommends who should get them — and Goodman said there may be debate about shots for higher-risk children or everyone under 5.
Vaccinating the littlest “has been somewhat of a moving target over the last couple of months,” Dr. Bill Muller of Northwestern University, who is helping study Moderna's pediatric doses, said in an interview before the company released its findings. “There’s still, I think, a lingering urgency to try to get that done as soon as possible.”
While COVID-19 generally isn’t as dangerous to youngsters as to adults, some do become severely ill.
The CDC says about 400 children younger than 5 have died from COVID-19 since the pandemic’s start.
The omicron variant hit children especially hard, with those under 5 hospitalized at higher rates than at the peak of the previous delta surge.
For parents looking to keep their child safe while traveling, the CDC and some health experts continue to recommend masking on public transportation.
Masks still give some protection from COVID-19, but they work better if others wear them too, experts say.
"One-way masking or just masking your high-risk (populations) certainly will reduce the risk for those individuals, but it is safer for everyone if everyone's wearing a mask, and there are some places where that's still a good idea," said Dr. Emily Landon, an infectious disease expert at UChicago Medicine.
High-quality masks work in two ways, according to Carl Bergstrom, a University of Washington evolutionary biologist who studies emerging infectious diseases. First, they protect the wearer by limiting the number of infectious particles inhaled, and they protect others by limiting particles exhaled if the wearer is infected.
As for travel, experts say, aside from driving yourself, air travel is the safest form of public transportation when it comes to masking.
"When you’re actually onboard the plane, the doors are closed, air is going through the HEPA filters, you’re actually quite safe on the plane," Cherian said. "It’s more of the process of getting to the plane, going through the TSA checkpoint, traveling through the airport, that’s really where the concern is."
