US approves Pfizer and Moderna vaccines for youngest children

• FDA approves Pfizer and Moderna Covid-19 vaccines for use in youngest children.
• The CDC must still recommend the vaccines before they are put into use in the United States.
• Moderna’s decision to go with a higher dose is associated with higher levels of fevers in reaction.

The US Food and Drug Administration granted emergency approval Friday for the use of Pfizer and Moderna Covid-19 vaccines in the youngest children, the age group most countries have yet to immunize.

The agency, whose approval is considered the global gold standard, approved Moderna’s two-dose vaccine for children aged six months to five years, and Pfizer’s shots for children aged six months to four years.

“Today is a day of huge relief for parents and families across America,” President Joe Biden said in a statement, adding that vaccinating young children will help “our nation continue to move forward safely.”

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FDA chief Rober Califf similarly hailed the decision, saying “vaccines for younger children will provide protection from the most severe outcomes of Covid-19, such as hospitalization and death.”

Pfizer said it plans to submit requests for authorization to other regulators around the world, including the European Medicines Agency in early July.

“Parents in the US now have the option to vaccinate their children under 5 years of age, and we are working to ensure that other countries worldwide will follow,” said Ugur Sahin, CEO and co-founder of Germany’s BioNTech, which developed the vaccine together with Pfizer.

The Centers for Disease Control and Prevention (CDC) must now also recommend the vaccines before they are put into use in the United States — a final green light that will be given after a meeting of an advisory committee of experts that is expected to be held shortly.

But the government has said that as soon as the FDA decision was made, 10 million doses could immediately be sent around the country, followed by millions more in subsequent weeks.

Both vaccines are based on messenger RNA, which delivers genetic code for the coronavirus spike protein to human cells that then grow it on their surface, training the immune system to be ready. The technology is now considered the leading Covid vaccination platform.

The vaccines were tested in trials of thousands of children. They were found to cause similar levels of mild side effects as in older age groups and triggered similar levels of antibodies.

Efficacy against infection was higher for Pfizer, with the company placing it at 80 percent, compared to Moderna’s estimates of 51 percent for children aged six-months to two years old and 37 percent for those aged two to five years.

But the Pfizer figure is based on very few cases and is thus considered preliminary. It also takes three doses to achieve its protection, with the third shot given eight weeks after the second, which is given three weeks after the first.

Moderna’s vaccine should provide strong protection against severe disease after two doses, given four weeks apart, and the company is studying adding a booster that would raise efficacy levels against mild disease.

However, Moderna’s decision to go with a higher dose is associated with higher levels of fevers in reaction to the vaccine compared to Pfizer.

“We are thrilled that the FDA has granted Emergency Use Authorization of Moderna’s Covid-19 vaccine for children and adolescents, particularly for our vulnerable, youngest children,” said Moderna CEO Stephane Bancel.

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“Children need to live highly social lives to develop and flourish,” Bancel added. “With this authorization, caregivers for young children ages 6 months through 5 years of age finally have a way to safeguard against Covid risks in classroom and daycare settings.”

According to the FDA, the United States, which has 20 million children aged four and under, has recorded 480 Covid deaths in that age group during the pandemic, far more than even a bad flu season.

There had been 45,000 hospitalizations in that group as of May 2022, with nearly a quarter requiring intensive care.