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CDC advisors recommend booster shots for children ages 5 to 11

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The Centers for Disease Control and Prevention recommended Thursday that children ages 5 to 11 receive a third dose of the Pfizer-BioNTech coronavirus vaccine to boost their immunity as cases and hospitalizations tick up in many pockets in the United States.

CDC director Rochelle Walensky highlighted the recommendation on Thursday night, and she also encouraged parents of children in the age group who have not yet been vaccinated to get their first shot soon.

“Vaccination with a primary series among this age group has lagged behind other age groups, making them vulnerable to serious illness,” Walensky said. “With over 18 million doses administered in this age group, we know that these vaccines are safe, and we must continue to increase the number of children who are protected.”

Walensky also announced that the CDC strengthens its recommendation that people over the age of 50 should receive a new booster dose – a fourth injection in most cases – to be reviewed for their coronavirus vaccinations. Earlier, the agency said older adults could get a booster. Immunocompromised people 12 years and older should also get an extra booster, she added.

“With increasing cases, it is important that all people have the protection they need,” Walensky added.

CDC advisers voted 11-1, with one member abstaining, recommending that 5-to-11-year-olds should receive a third dose of the Pfizer vaccine at least five months after completing the first two-shot series. Children in the age group that is moderate to severely weakened immune system had already been allowed to receive a primary series of three doses; those particularly vulnerable can now receive a fourth booster dose. Qualified children can get a booster immediately.

The guidance comes for a cohort for whom the protection of the two-shot regime has been disappointing. Real-world studies have shown that vaccine efficacy declined rapidly in children aged 5 to 11 years, even though it held up against severe outcomes. Data provided by Pfizer and BioNTech have shown that a booster strengthens children’s immune system, especially against the omicron variant.

The counselors discussed whether the CDC offers guidance that children “can” get a third dose, or whether they “should” get the booster. Most favored to say “should”, partly to comply with the recommendations for adolescents and adults.

“What we really need to do is be consistent and be as clear and simple as possible,” said Beth Bell, a clinical professor at the University of Washington’s School of Public Health.

Others supported recommending the booster because the data show that a three-dose vaccine is likely to provide stronger protection than a two-dose regimen.

“I’m concerned that ‘may’ does not portray the urgency of vaccines,” said Katherine A. Poehling, a professor of pediatrics and epidemiology at the Wake Forest School of Medicine.

Helen Keipp Talbot, an associate professor of medicine at Vanderbilt University, stressed that immunocompromised children should be given a fourth shot to boost immunity, but said the focus should be on getting more otherwise healthy children vaccinated with the primary series.

“Very few have received their first two doses, and I think it’s incredibly important for us to focus on before we start increasing them,” Talbot said.

Vaccine intake among children aged 5 to 11 is low, and it is unclear how many parents will embrace booster shots for their children. Less than 30 percent of children ages 5 to 11 have been fully vaccinated, and about 36 percent have had at least one dose, according to data published by the CDC.

Detection of the vaccine against the coronavirus

The Food and Drug Administration on Monday approved a third dose for children ages 5 to 11. The Pfizer vaccine is the only one approved for children in that age group, although the FDA is considering approving other pediatric vaccines in the future.

In a statement issued Tuesday, FDA Commissioner Robert M. Califf said that while covid-19 has been less severe in children than adults, “the omicron wave has seen more children get sick from the disease and be hospitalized, and children can also experience longer-term effects, even after initial mild illness. “Califf said the booster was authorized to provide extra protection for children.

The country’s largest association of doctors supported the new booster guidelines for children and expressed concern that so few children have been vaccinated, partly due to the belief that children do not get as sick from the virus as adults.

“The Omicron variant led to change that should change this calculation,” Gerald E. Harmon, president of the American Medical Association, said in a statement. “According to [CDC]the highly transmissible variant not only sent more children to the hospital and the intensive care unit than previous waves, but children who were unvaccinated were twice as likely to be hospitalized as those who were vaccinated. “

Other counselors supported recommending the booster to all children in this age group to simplify the CDC’s advice and protect immunocompromised and otherwise vulnerable children who may be exposed to healthy children in school or other settings.

“It’s confusing when we say ‘can’,” said Camille Nelson Kotton, an associate professor of medicine at Harvard Medical School who treats transplant patients. “I am very surprised to find that the vast majority of immunocompromised patients are out of date with their vaccines and are vulnerable to significant, including life-threatening, infections. I believe that a “should” recommendation will help to provide the necessary clarity. “

While children have generally suffered milder illness than adults, some are at risk for severe covid-19. Since the approval of vaccines for children in November, there have been 2.9 million cases of coronavirus, 6,700 hospitalizations, 739 cases of multisystem inflammatory syndrome in children (MIS-C) and 95 deaths among children aged 5 to 11, according to data presented Thursday. The vast majority of the hospitalized children – 90 percent – were unvaccinated. And 93 percent of the children who developed MIS-C were unvaccinated.

Federal health data released in April showed that by the end of February, 3 out of 4 children in the United States had contracted the coronavirus at least once since the pandemic began.

CDC counselors reviewed data that showed the potential of the booster shot to prevent infection and the likelihood that the third dose may reduce the risk of post-covid conditions such as MIS-C, which children ages 5-11 are most likely to experience under to data presented Thursday. Two studies of the coronavirus in adolescents found that vaccinated individuals were less likely to experience post-covid conditions and were less likely to have symptoms 12 to 20 weeks after infection, compared with unvaccinated individuals.

In a clinical study looking at the safety of the booster dose, no serious adverse reactions were reported among participants, including no deaths or cases of anaphylaxis after the third shot. The most common symptoms after the shot were all mild and included pain, redness and swelling at the injection site and fatigue.

Children aged 5 to 11 are the last age group to have access to a booster. The CDC recommended boosters for children ages 12 to 17 in January and for all adults in November. The agency allowed people 65 and older to get a new booster dose – a fourth shot in most cases – although it stopped recommending the extra booster for the older adults. The country’s youngest child under the age of 5 has not yet authorized the vaccine.

Counselors’ guidance comes amid concerns about declining immunity to vaccines and previous infections, just as a highly transmissible subvariant of omicron called BA.2 is rapidly becoming dominant in the United States. The nation reached 1 million coronavirus deaths this week.

“There are too many who do not have the necessary protection as we are facing another increase in cases and hospitalizations,” CDC Director Rochelle Walensky said during Thursday’s meeting. “We know that immunity diminishes over time, and we must do everything we can to protect those who are vulnerable.”

New infections were approaching 100,000 this week across the country, raising concerns that the nation may see a new increase as people plan to gather for Memorial Day weekend. Biden officials, who have appealed to Congress to approve more covid emergency funding, warned earlier this month of a possible summer rise across the south and an autumn rise that could infect 100 million people.

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