How are the Pfizer and Moderna vaccines different for young children?

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How are the Pfizer and Moderna vaccines different for young children?

Both use an mRNA platform and are considered safe and well-tolerated. Pediatricians whom CNN spoke to across the country suggest either is a good option.

“I think they’re both very effective with very good side effect profiles and I wouldn’t hesitate to give them to my children,” said Dr. Nina Alfieri, pediatrician at Ann & Robert H. Lurie Children’s Hospital of Chicago. “I think both are really good options.”

Both appear to produce protective antibodies in both young children and young adults. There are only subtle differences and for some children one may suit better than the other.

Moderna’s Covid-19 vaccine is now approved for children aged 6 months to 5 years. Pfizer’s is for children aged 6 months to 4 years.

Pfizer’s vaccine was previously approved for children as young as 5 years old. Moderna’s vaccine for people ages 6 to 17 was recently approved by the U.S. Food and Drug Administration, and the CDC’s vaccine advisors will vote this week on whether to recommend it.

dose size and schedule

A child who gets the Moderna vaccine doesn’t need to go to the doctor or pharmacy as often, and they get protection a little quicker than the Pfizer vaccine.

The Moderna range is complete with two 25 mcg doses given a month apart. Children with weakened immune systems would get a third shot. The Moderna intake for small children is a quarter of the size that adults receive.

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At Pfizer, it takes three shots to complete the series. The company initially tried two doses, but trial data showed that the vaccine failed to elicit an adequate immune response after the second dose. The three-dose vaccine approved last week is one-tenth the size of Pfizer’s adult dose.

At Pfizer, the first two shots are fired three weeks apart. The third can be given no earlier than eight weeks after the second. In total, it can take almost three months for the child to have the complete series.

On the other hand, scientists may want children to receive booster shots of either company’s vaccine.

Fever

Children were slightly more prone to fever with the Moderna vaccine; it happened to about a quarter of the study participants, compared to less than 10% at Pfizer. Most fevers were mild. Less than 1% of all participants in the study had a fever that reached 104 degrees.

“It’s been rare, but I have a feeling that if we’re not being honest with the parents, that’s going to be worrying when these things come out,” said Dr. Grant Paulsen, the principal investigator for the site for the Pfizer and Moderna Covid-19 vaccine clinical trials for children ages 6 months to 11 years at the Cincinnati Children’s.
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“Chances are that most kids will just do well and have minimal problems,” he said. “The majority will have no major side effects.”

Moderna said other illnesses that cause fevers were circulating during the study, and this may have led to some of those fevers, since 10.6% of the children in the study’s placebo group who did not receive the vaccine died of reported fever.

dr Claudia Hoyen, a pediatric infectious disease specialist at UH Rainbow Babies Hospitals in Cleveland, said she understands why parents hate it when their child gets a fever, but they should have peace of mind that the fever doesn’t and shouldn’t cause permanent damage or long-term problems resolve quickly on its own or in response to over-the-counter medications such as Tylenol or Motrin.

“I think if you stay keeping that in mind and realizing that it’s scary, but it can be managed. said Hoyen. “People should work with their pediatrician. I think a lot of the kids on the first dose may or may not get a fever but people should work with their pediatrician if they do and develop a good plan and that will be the best thing to do. It should resolve itself quickly.”

General side effects

Moderna and Pfizer’s safety data, reviewed by the FDA and CDC, found that potential side effects were mostly mild and short-lived.

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Side effects for both most commonly included pain at the injection site, and sometimes swelling or redness.

The most common systemic or body-wide symptoms were fatigue or drowsiness. Some children experienced irritability or restlessness, loss of appetite, headache, abdominal pain or discomfort, enlarged lymph nodes, mild diarrhea, or vomiting. But everyone got better quickly.

“It’s very similar to side effects that we’ve seen in older children or adults. For about 24 hours, some kids just don’t feel so good, they feel tired, they don’t have the same appetite. But fortunately there have been no serious side effects from these vaccines,” Dr. Ashish Jha, coordinator of the White House’s Covid-19 response, said Monday on CBS.

The scientists did not see any serious or rare side effects in the studies. They closely monitored signs that children were developing problems with myocarditis, an inflammation of the heart muscle, as there were a handful of cases in older children and adults. However, no myocarditis was detected in the studies in young children.

effectiveness of the vaccine

Both vaccines were tested when the Omicron variant was the dominant strain of coronavirus. Studies show that this particular variant was better at bypassing the protection offered by both companies’ vaccines, regardless of age or dose.

The Omicron variant was generally difficult for this age group. Without access to a vaccine, hospitalization rates among children under 5 during the winter peak of Omicron were five times higher than last summer, when the delta variant was the dominant strain, according to a March CDC report.

Moderna was estimated to be 36.8% effective in protecting against symptomatic disease in 2-5 year olds and 50.6% effective in protecting against symptomatic disease in 6-23 month olds.

For the Pfizer vaccine, there were only 10 Covid cases in the vaccinated and placebo groups in the study — too small a number to gauge the effectiveness of the vaccine. However, the top-line efficacy data from the preliminary results are “encouraging,” according to the company. And the FDA said the immune response to the vaccine at ages 6 to 23 months and ages 2 to 4 years was comparable to the immune responses of the older participants, but more research is needed.

Conclusion: get vaccinated

Get the available vaccine, the experts said.

“I don’t think it’s clear that one is better than the other. They’re different,” Paulsen said. “It’s very much what the parents prefer. Balancing those differences and frankly what is available and what your pediatrician or local hospital has.”

Doctors also suggest searching online or calling to find out what the local website is offering. Not every place offers both recordings. Also, some immunization clinics may not offer vaccines for young children or may have age restrictions. CVS stores that have MinuteClinics, for example, will vaccinate this new age group, but only if the child is 18 months or older.

Vaccines.gov may be helpful. The website provides some information about clinics organized by categories.
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