The United States is set to approve Pfizer for children as young as five as India prepares to vaccinate young children against COVID-19

Australia’s COVID-19 vaccination program may be reaching new milestones, but the youngest members of society have still not been offered protection.

That may soon change, as the national medical regulator marks a possible decision on whether to make the Pfizer vaccine available to children of primary school age before the end of the month.

Other countries are moving faster.

American children can be vaccinated before Christmas

In the United States, 28 million children between the ages of five and 11 could begin receiving vaccines within days of federal approval.

Pfizer plans to offer young children smaller doses of the vaccine, which come in orange vials to distinguish them from those given to people 12 years of age and older.

As for adults, the two doses will be at three-week intervals, with GPs and pharmacies expected to play a major role in their administration.

“For the adults, they focused more on large vaccine sites, but for the kids, we really hope to prioritize giving it to doctor’s offices so kids and parents can get to places they are safe to go to,” Washington DC-based pediatrician Dr. Jessica Long said.

More than 1.8 million children in the age group of five to 11 years are estimated to have been diagnosed with COVID-19 across the United States, with nearly 150 deaths.

A young girl is sitting on top of a roller coaster on a playground
Astrid, 6, will be vaccinated when Pfizer is made available to children in the United States. (ABC News: Jade Macmillan)

The clinic where Dr. Long working, has been flooded by parents who want to know when they will be able to book their children in for a shot.

“Children get COVID. We know they do not get it as often or as seriously, but now that the elderly populations have been vaccinated, we see even more and more children coming down with it,” she said.

“And there may be long-term side effects, some of which we are not even aware of yet.”

Musician Sandy Choi wants her children, nine-year-old David and six-year-old Astrid, to receive their shots as soon as possible.

“Hopefully the kids will even be able to get vaccinated before the holidays, it would be such a breath of relief for us,” she said.

“We have family members we haven’t seen since before the pandemic, and we know that if the kids can at least get the first vaccine shot, then there’s a really good chance we can get along.”

Sandy stands between her two children.
Sandy Choi hopes her children can receive at least one shot before Christmas. (ABC News: Jade Macmillan)

Modern vaccine could also be offered

The approval of the Pfizer vaccine for children under the age of 12 still has several obstacles to remove.

A panel advising the US Food and Drug Administration (FDA) voted overwhelmingly in favor of the move, arguing that the benefits outweighed any risks.

The FDA has since approved this recommendation, and the Centers for Disease Control is expected to make its own decision soon.

In the US, Pfizer is not the only company pushing to vaccinate children between the ages of five and 11, and Moderna publishes promising trial results ahead of a formal application.

A main image of Dr.  Long front.  She has long blonde hair and a wide smile.
Jessica Long says that vaccination of children is an important step in controlling COVID-19 – and preventing new variants from developing. (ABC News: Jade Macmillan )

Dr. Long himself has four children and is optimistic that the next phase of the rollout will make a difference.

“The more people who are vaccinated, the less chance of people getting sick, the less chance this virus will mutate into something more powerful, as we have seen with the Delta variant and other situations,” she said.

“So I do not know if it will be the last piece of the puzzle, but it is certainly a really important step.”

Vaccines for younger children

While Pfizer is awaiting the FDA’s decision on the use of its vaccine for children aged five to 11, the company is also testing the drug on those aged between two and five, as well as babies as young as six months.

Pfizer says these results are expected “as soon as the fourth quarter of 2021 or the beginning of the first quarter of 2022”.

A small baby wrapped in a pink blanket is sleeping.
Pfizer aims to submit data on the use of its infant vaccine all the way down to six months early next year. (ABC News: Som Patidar)

In India, some hospitals are already asking parents to register children as young as two for a COVID-19 vaccine.

The locally produced Covaxin shot has been widely used as part of India’s vaccine rollout, which has so far seen 1 billion doses administered into the arms of adults across the country.

Now the vaccine’s manufacturer Bharat Biotech is seeking approval from India’s drug regulator to administer the dose to anyone aged two to 18 years.

As with the U.S. approval process, there are several obstacles that must be cleared before children can begin receiving the shot.

Most recently, the Indian government’s expert committee recommended emergency use of Covaxin for children.

Now the Drug Controller General of India – equivalent to the Australian Therapeutic Goods Administration – is ready to make a decision.

On Monday, the TGA listed Covaxin as a recognized vaccine in Australia “for the purpose of establishing a traveler’s vaccination status” for anyone 12 years of age or older.

In India, Bharat Biotech has submitted data from the Phase 3 trials of the drug in children.

According to local media reports, the data showed that the Covaxin shot produced a similar effect among children as it did in adults – 77.8 percent.

A mother stands wrapped in an orange sari and holds a small child with two standing at her feet.
Children as young as two years old may soon receive COVID-19 vaccines in India. (Reuters: Adnan Abidi)

If the vaccine is approved for children, India’s most vulnerable young people will first have access to the drug.

In southern India, Ankura Hospital is preparing to vaccinate children in its pediatric ward.

“Our hospital is already doing adult vaccinations and preparations for children’s vaccination are underway. We are fully prepared and will start after the government’s nod,” said pediatrician Dr. Suman Kumar.

Dr. Kumar said children with pre-existing heart disease, lung and kidney problems, diabetes, immune deficiency and other serious health complications are “most vulnerable, so vaccination should start with them”.

“We have observed mortality in previous waves, and children aged 16 to 18 are as affected as adults,” he said.

Three young girls stand in a field wearing navy blue uniforms and face masks.
Experts believe that young school children should receive a vaccination after those with health complications and after 16 to 18 years of age. (AP: Anupam Nath)

With more than 1 billion doses administered, India has only fully vaccinated 30 percent of its eligible population, and the number of people receiving the shot every day has slowed down.

Bringing children into the rollout will use more supply.

Dr. Kumar said a “large stockpile” of Covaxin was required before embarking on a mass vaccination of India’s young children.

“They are [scaling] increase their production, but still the government would like to fully vaccinate adults before starting mass vaccination of children, “he said.

India’s Committee of Experts on Vaccines has said that all children from the age of two will be able to access the vaccine from the beginning of 2022.

Adolescents aged 12 to 18 are already eligible for vaccines in a number of countries, including Australia.

India is expected to open its program for this age group soon and they will be able to access a needle-free shot.

Another vaccine developed in India – by the manufacturer Zydus Cadila – is the world’s first DNA vaccine.

It carries the genetic code of the coronavirus peak protein, which the body can then read and generate an immune response.

The vaccine, called ZyCoV-D, is delivered via a jet injector – sometimes called a gene gun – and uses a high-pressure stream of fluid to burst it into the skin’s cells.

Close-up of a jet injector in one arm.
The DNA-based vaccine is administered using a needle-free injection system.(AP: Business Wire)

Vaccination of children worldwide

The Covaxin shot was developed in India and is currently being evaluated by the World Health Organization for inclusion on the list of globally accepted COVID-19 vaccines.

WHO approval would see Bharat Biotech’s Covaxin shot join the Pfizer, Moderna, AstraZeneca, Sinovac, Sinopharm, Johnson and Johnson and Serum Institute vaccines as emergency-approved medicines.

A young boy gets a vaccine.
In El Salvador, children as young as six can be vaccinated against COVID-19. (Reuters: Jose Cabezas )

China recently brought children into its vaccination program, where authorities approved the use of Sinopharm and Sinovac sprays for those aged three to 17 years.

After the vaccines received the domestic approval, foreign governments began giving shots to children in their own countries.

Cambodia uses both Sinovac and Sinopharm’s shots for children six to 11 years old. Regulators in Chile and El Salvador approved Sinovac for children as young as six years old. In Argentina, the authorities approved the Sinopharm vaccine for children as young as three years old.

Cuba has also started vaccinating children as young as two years old, but the country has used local vaccines that are not approved by the WHO or had their experimental data independently reviewed.

ABC / AP

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