COVID-19 vaccines for kids under 5 are finally here, but most parents aren't jumping in line

Families with small children lined up at 8 a.m. in a sparsely filled but buzzing auditorium, ready and relieved for COVID-19 vaccine appointments for their little ones at Children’s National Hospital’s research campus in Washington.

Seated in red chairs and surrounded by shiny red and white metallic balloons, small children and their parents sat with nurses, who administered the shots in front of an audience of masked spectators, largely press and hospital staff. 

Onlookers cooed and clapped as the kids got their shots, each child receiving a high-five, a sticker and a chance to pet Barney and Sprout, two facility dogs specially trained to help soothe children during their recovery.

Tuesday was the first day COVID-19 vaccines were available to children under 5 following authorization last week when, after many delays, the Food and Drug Administration and the Centers for Disease Control and Prevention determined that the benefits of vaccination for children outweigh the risks. 

Sarah Schaffer DeRoo, a pediatrician at Children’s National, was among the first parents to bring their child for a shot. Her 7-month-old son, Hewitt, sat on his mother’s lap as he got the jab in front of cameras and family.

Although DeRoo was eager to get her son vaccinated, she’s heard a variety of thoughts from parents. 

“There are a number of parents I know who are elated (and) are going to be among the first in line to get their children vaccinated … but there’s a lot of hesitation around the pediatric vaccines,” she said. "And so I consider it my job to do my best to show them what are the benefits versus risks of the vaccine for them.”

Every other age group of Americans has long had access to the vaccines, except babies younger than 6 months old, who can get protection from the parent's vaccination during pregnancy.

In polling data from April, 18% of parents said they would vaccinate their young child right away, while 27% said they definitely wouldn't and 38% said they'd wait and see.

Some parents say the vaccine trials conducted among young children were too small to satisfy their safety concerns, said Grant Paulsen, an infectious disease pediatrician and lead researcher for the children under 5 vaccine trials at Cincinnati Children’s Hospital Medical Center.

Though adult trials included more than 70,000 people for both vaccines, 5,000 children received at least one dose of the Moderna vaccine and 3,000 received Pfizer. Although health experts saw no signs of safety concerns in the clinical trials, they said rare side effects could turn up as more children are vaccinated, just as with other pediatric vaccines.

Because the two vaccines were studied separately, they cannot be compared directly.

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Moderna’s shots are given four weeks apart, meaning a child could have the fully intended protection against infection and severe disease by midsummer. The plan for Pfizer-BioNTech’s vaccine is to give two doses three weeks apart plus a third dose eight weeks later.

Health experts said Moderna may add a third dose to its vaccine regimen for children under 5. It's unclear when the company will have data on that shot. 

"Moderna is actually studying a third dose to their vaccine as well," Dr. William Towner, regional physician director for clinical trials at Kaiser Permanente Southern California. "In the clinical trials, it's positioned six months after the second dose." 

Parents have told experts they're concerned about adding another shot to their child’s pediatric vaccine schedule. In the clinical trials, Paulsen said, children were not recommended to get another vaccine within 14 to 30 days of getting COVID-19 vaccine to ensure accurate results.

"There are certainly other vaccines that are given in multiple doses and so this isn't unique among that," Towner said. "What we don't know currently is if this vaccine can be co-administered with other vaccines." 

The CDC said adults can be co-administered with COVID-19 vaccine and flu vaccine, but the agency has yet to make any recommendations for the youngest tots.

Those studies will happen in coming months, company officials promised the FDA. 

In addition to lingering questions, misinformation plays a small part in vaccine hesitancy among parents, said health experts who have spent nearly two years trying to counter it.

“I get questions about fertility and long-term side effects,” Paulsen said. “There are fewer questions about conspiracies or trackers in the vaccines. … Parents, most of the time, they have reasonable concerns.” 

Although young children have largely been spared the worst of COVID-19, they can become seriously ill, and more than 200 have died from infections, according to data presented by the FDA.

Half of the young children hospitalized with COVID-19 did not have any preexisting conditions before they fell ill, the FDA said. 

Pediatricians worry the "wait and see" approach parents appear to be taking could mean many children won't be protected against COVID-19 in time for the fall, when many experts predict another surge in cases.

Pfizer's COVID-19 vaccine for children 5 to 11 has been authorized in the USA since October, but as of June 8, only 36% received at least one dose, according to the American Academy of Pediatrics. 

"It’s a little challenging to play the timing game with young children in particular, given that we’re looking at a three-dose series for one of the vaccines," said Richard Besser, a pediatrician and president and CEO of the Robert Wood Johnson Foundation. "If you want your child fully protected in the fall ... I wouldn’t wait." 

At Children’s National Hospital, James Damon, 35, and Eunkyoung Kim, 34, brought their children to the research campus to get vaccinated Tuesday. Like many parents, they had taken special care in indoor spaces with their sons, Junsoo, 4, and Sooha, 1, before they could get vaccinated.

“I feel relieved that they're vaccinated," said Damon, an attorney who lives in Washington. "It feels like the pandemic is over for me and for my family, to know that we're all protected and that we're also vaccinated to protect the members of our community and our family members and our friends." 

Contributing: Karen Weintraub

Follow Adrianna Rodriguez on Twitter: @AdriannaUSAT. 

Health and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input.