SPRING PRICKIN' — When I showed my 3 year old my Covid booster-shot bandage a couple of weeks ago, he asked me, "Why is it on your arm?" He's used to getting vaccinations in the thigh and then plied with treats afterward. When it comes to getting a Covid shot to defend against the prospect of an Omicron surge, my two toddlers will have to wait until next spring for their chance at immunity and, perhaps as important, the accompanying Paw Patrol stickers. During our big family Thanksgiving feast, my kids were the only ones who had yet to receive a Covid shot. Everyone else was well above 5 years old. Toddlers and babies are the biggest pool of unvaccinated people in the country, said Philip Landrigan, a pediatrician and epidemiologist at Boston College and a former CDC official. Because their risks are generally lower and the potential for side effects greater, younger kids have only just started participating in clinical trials for Covid vaccines. Companies aren't expected to submit their trial data to the FDA until early next year. After an agency review, an approval could come next March or April. Moderna and Pfizer are currently testing their mRNA vaccines in kids between 6 months and 4 years old. Infants generally have some level of protection from antibodies they receive in the womb of a vaccinated parent, but the age cutoffs are somewhat arbitrary, said C. Buddy Creech, director of the Vanderbilt Vaccine Research Program and a professor of pediatric infectious disease at Vanderbilt University Medical Center. Moderna is testing about a quarter of its adult dose, and Pfizer is testing about a tenth of its adult dose. Kids tend to produce a better immune response than adults do, meaning they should require a much smaller dose to get the same vaccine benefits, said Creech, who is conducting one of Moderna's pediatric trials. Initially, younger children are expected to be on the same dosing schedule as everyone else — two doses a few weeks apart — but that might change over time. Canada has recommended that children who are 5 to 11 get their doses eight weeks apart. Covid shots are unlikely to be a part of a regular doctor's visit alongside other routine childhood vaccines. Because researchers are trying to isolate side effects, they are testing Covid shots outside the normal vaccine schedule — at least two weeks before or after they get another shot. Most of the side effects so far have been mild: fever, fussiness or soreness. Trials are watching closely for signs of myocarditis or heart inflammation, but that should be less of an issue in younger kids, Creech said. Covid risks in the vast majority of young kids are very, very small, Creech said. It might be because they have low levels of an enzyme that helps the virus infect the body, but also in general they have fewer risk factors like obesity. Still, he added, the case for vaccinating kids without health risks is becoming more urgent with the potential for Omicron or another variant to plow through the U.S. in search of people to infect. Unvaccinated children can contribute to greater Covid spread. Since the start of the pandemic, 224 kids between the ages of zero and 4 have died from Covid, according to the CDC. Among others, there are concerns about longer-term symptoms. And, as parents of preschoolers and school-age children know, a positive Covid test triggers a disruptive quarantine. "We are in an arms race with this virus," Creech said. "We need to provide as much immunity as possible so when the virus finds its way into a community, it cannot get a foothold." Welcome to POLITICO Nightly. Reach out with news, tips and ideas at nightly@politico.com. Or contact tonight's author at rrayasam@politico.com, or on Twitter at @RenuRayasam.
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