Biden: Children Could Begin Receiving COVID-19 Vaccinations This Spring

Speaking to reporters on Monday, January 25, President Biden said older children could potentially start receiving COVID-19 vaccinations in the spring. Both Pfizer and Moderna are on track to make that a reality.

The two companies both received emergency use authorization for their vaccines from Food and Drug Administration (FDA) in December; Pfizer for those age 16 and older, Moderna for those age 18 and older. Moderna began clinical trials in children as young as 12 a few weeks ago. Pfizer has completed enrolling children ages 12 to 15, and will begin clinical trials soon.

“Once they have some safety data on older children, we can expect the companies to enroll even younger children in additional clinical trials,” James Campbell, MD, a professor of pediatrics and a pediatric infectious disease specialist at the University of Maryland School of Medicine, tells Verywell.

Campbell says clinical trials generally follow a process of “age de-escalation.” After a treatment is proven safe and effective in adults, researchers can move on to older children, and incorporate younger children while monitoring things like dosage and side effects.

Several pediatric trials are actively enrolling children now, which is an accomplishment in and of itself.

“It’s frequently harder to enroll children because parents worry about putting their kids at risk, Courtney Gidengil, MD, a senior physician policy researcher at the RAND Corporation, tells Verywell. “It’s a big decision for parents to make.” 

Experts Are Optimistic About the Timeline

Campbell, who helped create the structure for pediatric vaccine clinical trials for the National Institutes of Health, says he does think we could see authorization for children as young as 12 this spring. He thinks kids as young as 5—and perhaps even younger—may be authorized to receive a COVID-19 vaccine by the time school starts in the fall.

Campbell believes the vaccines will be effective in children. “There’s no underlying reason to think that children won’t respond as adults do and make high levels of neutralizing antibodies that keep the virus from [infecting them] and spreading," he says. "But with vaccines, we don’t extrapolate adult data, we specifically test in children.”

The flu shot is a good example. Child-specific research showed younger kids need an extra dose to prime their immune systems. According to Gidengil, children under age 9 get two doses of the flu vaccine the first time they receive it, rather than the single dose most people receive annually.

Unfortunately, it's unknown whether the vaccines will be widely available for kids even if they’re authorized, considering the shortages the country is facing now. The American Academy of Pediatrics (AAP) expressed its frustration regarding the pace of vaccine distribution even before President Biden’s inauguration last week.

“Pediatricians across the country are frustrated at the uneven and haphazard distribution of COVID-19 vaccines,” said Lee Savio Beers, MD, FAAP, president of the AAP, in a statement. “While we look forward to working with the Biden-Harris Administration on this and other health challenges that impact children over the next four years, this urgent problem must be addressed now."

Monitoring Vaccine Safety in Kids

Investigators will be especially on the lookout for any signs that the vaccine can cause multisystem inflammatory syndrome in children (MIS-C), Gidengil says. With MIS-C, organs including the lungs, eyes, skin, kidneys, and brain can become inflamed a few weeks after a child has COVID-19. A few hundred children in the U.S. have had the syndrome, though all have recovered. 

“We also need to be sure there are no safety problems, and that anything we do know about we, can alert parents to in advance,” Campbell says. For example, some adults get a fever for a day or two after the vaccine. High fevers can cause febrile seizures in children. “They’re not dangerous, but they are scary for parents, so we need to know if that’s a possibility,” Campbell says.

Upcoming Pediatric Clinical Trials

At least three more companies—Johnson & Johnson, Novavax, and AstraZeneca—are poised to submit data to the FDA for authorization of their COVID-19 vaccines in the next few months. They are expected to conduct clinical trials in children after they get the nod for adult use, according to data presented at a CDC vaccine advisory committee meeting on Wednesday. Sanofi’s adult clinical trials are expected later in 2021, followed by pediatric trials.

So far, Johnson & Johnson is the only vaccine that requires only one shot, which is easier on anyone, but especially kids, Campbell says.

The company is optimistic about the safety of the vaccine in children. A Johnson & Johnson spokesperson tells Verywell that the vaccine platform being used for the COVID-19 vaccine "was used in the development of several of our vaccines…including our European Commission-approved Ebola vaccine and investigational RSV (respiratory syncytial virus) vaccine. Clinical trials for these two vaccine regimens included children (ages 1 year or above for Ebola and 12-24 months for RSV). No significant safety issues have been identified."

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.