Student Well-Being

Children and COVID-19 Vaccinations: What to Know

By Sarah D. Sparks — January 26, 2021 4 min read
Houston Health Department LVN Alicia Meza prepares a dose of COVID-19 vaccine on Jan. 3, 2021, at a Houston Health Department's COVID-19 vaccine clinic in Houston.
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Teachers are already among the first to get the new vaccines against COVID-19 that states are rolling out right now, and under President Joe Biden’s coronavirus relief package, that process would speed up. But school leaders should still plan for the bulk of their student population to be unable to be vaccinated before next fall.

That’s because so far none of the vaccines are considered safe for any but the oldest students, and differences in how children and adults process vaccines mean it may take longer for scientists to develop safe ways to protect them.

While children remain less likely to experience severe symptoms of COVID-19 than older Americans, nearly 2.7 million U.S. children have become infected with the virus since the beginning of the pandemic, according to January data from the American Academy of Pediatrics and the Children’s Hospital Association. Children (defined at different ages in different states) now make up 12.7 percent of all coronavirus cases, and there has been a 16 percent jump in cases among children from Jan. 7 to Jan. 21, the groups report.

Tina Tan, a professor of pediatrics at the Feinberg School of Medicine at Northwestern University and an infectious diseases physician at Lurie Children’s Hospital of Chicago, said even after vaccines are available, though, adults “on a personal level also need to be careful in the community as they go about their business because that’s where all these individuals are picking up the virus and then that increases the risk of bringing it into the classroom setting.”

As school leaders plan for long-term instruction, here’s what they need to know about children and the vaccines.

Are any of the COVID-19 vaccines available for children now?

No. Because those under 18 tend to have less severe symptoms than older people who get infected with the coronavirus, they are generally last on states’ priority lists for receiving doses of vaccines unless they have other medical conditions.
But state schedules aren’t really the point: Moderna’s vaccine is approved only for those 18 and over, while Pfizer-BioNTech’s is approved for those 16 and up. Others from AstraZeneca-University of Oxford, Janssen, and Novavax are still in clinical trials.

Why can’t children use the current vaccines?

The current vaccines do not use a live virus, but genetic material that triggers an immune response. Children’s immune systems operate differently from those of adults; just using smaller dosages isn’t enough to account for those differences.
So far, only Pfizer and Moderna have included children 12 and up in clinical trials for vaccines, and health experts from the Centers for Disease Control and Prevention and Connecticut Children’s Hospital predict these vaccines may be available in late 2021. There are no trials for younger children.

Will unvaccinated children alone make school COVID-19 outbreaks more likely?

Not necessarily. Recent studies in North Carolina, Wisconsin, Sweden, and Norway all found that separate pandemic mitigation measures, such as social distancing, mask-wearing, and hygiene, all significantly forestalled outbreaks in schools.

One Duke University study analyzed 56 North Carolina school districts operating this fall with some 90,000 students and staff. Thirty-five of the districts had at least some in-person teaching over nine weeks, while 21 offered only remote learning; all of them implemented mitigation practices. All told, the districts had about 770 total cases of coronavirus that students or staff caught within the wider community outside of the school during the first nine weeks of the school year. But only five of those districts had one or more cases of secondary infection spread within the schools.

A study of 18 schools in the rural Wood County, Wisc., from the end of August through November 2020, similarly found only 3.7 percent of all COVID-19 cases among the more than 5,500 students and teachers had been contracted at school. While the community infection rate was high during the study period, topping 1,100 cases per 100,000 per week during the worst periods, the infection rate among students and staff in schools with in-person instruction was 37 percent lower than the rate in the community at large. During the 13 weeks of the study, teachers reported more than 92 percent of students and staff wore masks and limited contact between students and adults outside of assigned cohorts.

In Sweden, which never ended in-person schooling, researchers found teachers were not at much higher risk than their peers in other jobs. Teachers’ relative risk of contracting the virus was actually lower than average for those outside the health-care industry, while preschool teachers’ risk was slightly higher. Moreover, while 65 children ages 1 to 16 died from November 2019 to February 2020 (before the pandemic reached the country), 69 children died from March through June 2020, and none of those deaths came from the coronavirus.

Nathaniel Beers, a member of the American Academy of Pediatrics, who helped develop the academy’s COVID-19 guidance for schools, advised school leaders to incorporate planning for adult (and later student) vaccinations into their reopening plans both this spring and for fall 2021.

“School districts need to ensure that teachers are part of the early cohort of adults being offered vaccinations, [so] that we are positioned to be able to move forward more rapidly with a return to in-person instruction for students,” he said, “and then ... they need to be making sure that they have a strong plan in place for how they’re going to respond to individual cases in their schools and being public and transparent about that, so that parents and students all feel confident that the school district is taking into account their own safety.”

A version of this article appeared in the February 03, 2021 edition of Education Week as Children and COVID-19 Vaccinations: What to Know

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