How To Prioritize Pediatric COVID-19 Vaccination

Monica McArthur, MD, PhD, discusses why to-be-authorized COVID-19 vaccine doses for children may not be tiered for patient risk as they were for adults.

As COVID-19 vaccine regulations progress to younger and younger populations—with Pfizer-BioNTech and Moderna each seeking Emergency Use Authorization (EUA) based on data observing mRNA vaccines in patients as young as 5 years—the discussion turns from clinical benefit to patient prioritization.

Just as high-risk adult populations were prioritized for the first authorized vaccines, will a similar plan be put in place for children?

In an interview with Contagion during IDWeek 2021, Monica McArthur, MD, PhD, of the University of Maryland School of Medicine, discussed the progression of pediatric COVID-19 vaccination—a matter which in 2 years has shifted from a non-issue to a pressing priority.

“I think one of the most important things to note is that initially we were thinking that COVID-19 really wasn’t a big issue in the pediatric population,” McArthur said. It was only until a combination of factors including greater adult vaccination rates that pediatric cases began to climb.

McArthrur discussed the strategy of vaccine rollout and administration if and when vaccines become available to younger pediatric populations; the factors which influenced global health agencies to recommend older and high-risk adults receive the first available doses may not apply to children.

“Part of the concern with rollout for high-risk populations was vaccine scarcity, and I don’t think we’re faced with that as much anymore,” McArthur said. “My hope is that as soon as the vaccine becomes available under EUA for children aged 5-11 years old, it’d be available for all children.”

That said, children deemed to be at high risk of COVId-19 severity should still be targeted for safe, appropriate vaccination by direct caregivers, McArthur said.