With Pfizer-BioNTech’s announcement on Monday that its coronavirus vaccine had been shown to be safe and effective in low doses in children ages 5 to 11, a question looms: How many parents will have it given to their children?
If authorized by the Food and Drug Administration, the vaccine could be a game changer for millions of American families and could help bolster the U.S. response to the highly contagious Delta variant. There are about 28 million children of ages 5 to 11 in the United States, far more than the 17 million of ages 12 to 15 who became eligible for Pfizer’s vaccine in May.
But it remains to be seen how much of the younger group will be vaccinated. Uptake among older children has lagged, and polling indicates reservations among a significant number of parents.
Lorena Tule-Romain was up early Monday morning, getting ready to ferry her 7-year-old son to school in Dallas, when she turned on the television and heard the news.
“I was like, ‘Oh my gosh, this is exciting,’” said Ms. Tule-Romain, 32, who said she felt a surge of hope and relief. She has spent months in limbo, declining birthday party invitations, holding off registering her son for orchestra in school and even canceling a trip to see her son’s grandparents in Atlanta.
Ms. Tule-Romain will be among those eagerly waiting to learn whether federal officials authorize the vaccine for the younger group, a step that is expected to come first on an emergency-use basis, perhaps as soon as around Halloween.
However the F.D.A. rules, Michelle Goebel, 36, of Carlsbad, Calif., said she was nowhere near ready to vaccinate her children, who are 8, 6 and 3, against Covid-19.
Though Ms. Goebel said she had been vaccinated herself, she expressed worry about the risks for her children, in part because of the relatively small size of children’s trials and the lack of long-term safety data so far. She said the potential risk from a new vaccine seemed to her to outweigh the benefit, because young children have been far less likely than adults to become seriously sick.
Only about 40 percent of children ages 12 to 15 have been fully vaccinated so far, compared with 66 percent of adults, according to federal data. Polling indicates that parental openness to vaccination decreases with a child’s age.
About 20 percent of parents of 12- to 17-year-olds said they definitely did not plan to get their child vaccinated, according to polling by the Kaiser Family Foundation published last month. The “definitely not” group grew to about 25 percent in parents of children ages 5 to 11, and 30 percent among parents of under-5s.
René LaBerge, 53, of Katy, Texas, said she planned to vaccinate her 11-year-old son when he became eligible. “But I’m not impatient. I want them to do the work,” she said.
She said she had heard about some rare, but serious, side effects in children, and she was eager for federal officials to thoroughly review the data.
Understand Vaccine and Mask Mandates in the U.S.
- Vaccine rules. On Aug. 23, the Food and Drug Administration granted full approval to Pfizer-BioNTech’s coronavirus vaccine for people 16 and up, paving the way for an increase in mandates in both the public and private sectors. Private companies have been increasingly mandating vaccines for employees. Such mandates are legally allowed and have been upheld in court challenges.
- Mask rules. The Centers for Disease Control and Prevention in July recommended that all Americans, regardless of vaccination status, wear masks in indoor public places within areas experiencing outbreaks, a reversal of the guidance it offered in May. See where the C.D.C. guidance would apply, and where states have instituted their own mask policies. The battle over masks has become contentious in some states, with some local leaders defying state bans.
- College and universities. More than 400 colleges and universities are requiring students to be vaccinated against Covid-19. Almost all are in states that voted for President Biden.
- Schools. Both California and New York City have introduced vaccine mandates for education staff. A survey released in August found that many American parents of school-age children are opposed to mandated vaccines for students, but were more supportive of mask mandates for students, teachers and staff members who do not have their shots.
- Hospitals and medical centers. Many hospitals and major health systems are requiring employees to get a Covid-19 vaccine, citing rising caseloads fueled by the Delta variant and stubbornly low vaccination rates in their communities, even within their work force.
- New York City. Proof of vaccination is required of workers and customers for indoor dining, gyms, performances and other indoor situations, although enforcement does not begin until Sept. 13. Teachers and other education workers in the city’s vast school system will need to have at least one vaccine dose by Sept. 27, without the option of weekly testing. City hospital workers must also get a vaccine or be subjected to weekly testing. Similar rules are in place for New York State employees.
- At the federal level. The Pentagon announced that it would seek to make coronavirus vaccinations mandatory for the country’s 1.3 million active-duty troops “no later” than the middle of September. President Biden announced that all civilian federal employees would have to be vaccinated against the coronavirus or submit to regular testing, social distancing, mask requirements and restrictions on most travel.
“I don’t want my son to take something that is unsafe,” she said, but added, “I believe Covid is dangerous. There aren’t any good easy answers here.”
Among the side effects scientists have been studying is myocarditis, an inflammation of the heart. In rare cases, the vaccine has led to myocarditis in young people. But a large Israeli study, based on electronic health records of two million people aged 16 and older, also found that Covid was far more likely to cause these heart problems.
The Pfizer trial results were greeted enthusiastically by many school administrators and teachers’ organizations, but are unlikely to lead to immediate policy changes.
“This is one huge step toward beating Covid and returning to normalcy. I don’t think it changes the conversation around vaccine requirements for kids,” said Randi Weingarten, president of the American Federation of Teachers, a national union.
Ms. Weingarten predicted that there would not be widespread student vaccine mandates until the 2022-2023 school year. She noted that parents and educators were still awaiting full F.D.A. approval of vaccines for children aged 12 to 15, and that mandates for adults did not come until months after the shots first became available.
A significant barrier to child vaccination, she said, were widespread conspiracy theories about the shots affecting fertility.
“When people have these conversations prematurely about requirements, it adds to the distrust,” she said.