The federal government on Wednesday took a final step toward making the Pfizer-BioNTech coronavirus vaccine available to adolescents in the United States, removing an obstacle to school reopenings and cheering millions of families weary of pandemic restrictions.
An advisory committee to the Centers for Disease Control and Prevention voted to recommend the vaccine for use in children ages 12 to 15. The C.D.C. director, Dr. Rochelle Walensky, is expected to review the recommendations and approve them later on Wednesday.
“Approving Covid-19 vaccines for children 12 to 15 years of age is an important step in removing barriers for vaccinating children of all ages,” said Dr. Yvonne Maldonado, who represents the American Academy of Pediatrics on the federal Advisory Committee on Immunization Practices.
Many parents are eagerly anticipating the availability of vaccines for children, at least in part to speed their return to schools. Roughly one-third of eighth graders, usually 13 or 14 years old, are still learning fully remotely.
Vaccinations of adolescents have already begun in a few states, like Maine. Others plan to offer the vaccine as early as Thursday. There are nearly 17 million 12- to 15-year-olds in the United States, accounting for 5.3 percent of the population.
Nearly all states now have a glut of vaccine doses that could be quickly redirected to adolescents. The dose used to immunize adults is also safe and effective for these adolescents, clinical trials have shown.
“Sometimes we lose the importance of children and adolescents in the midst of pandemic — there’s such a focus on older adults in particular,” said Dr. Grace Lee, a member of the committee and professor of pediatrics at Stanford University.
While children’s risk of severe illness is low compared with that of adults, the coronavirus has infected more than 1.5 million children and sent more than 13,000 to hospitals, more than are hospitalized for flu in an average year, according to data collected by the C.D.C.
“It is currently one of the top 10 causes of death in children since the pandemic began,” Dr. Maldonado noted.
Young children are thought to spread the virus less often than adults do, but their ability to transmit increases with age. Teenagers, particularly those in high school, may transmit the virus as readily as adults. Children aged 12 to 17 years represent an increasing proportion of Covid cases in the country.
Vaccinating children should increase the level of immunity in the U.S. population, helping to bring down the number of cases.
“Every person with Covid-19 provides the virus with an opportunity to spread and continue to mutate and further expose our communities,” said Dr. Bill Gruber, a senior vice president at Pfizer. “The decisions from health authorities this week bring us one step closer to protecting adolescents and achieving herd protection.”
Pfizer announced in March that the vaccine seemed to be at least as effective in 12- to 15-year-olds as it has been in older teenagers and adults. Apart from a slight increase in the frequency of fevers, the shots also seemed to have comparable, mostly negligible side effects.
The company plans to continue monitoring trial participants for two years after the second dose to assess the vaccine’s long-term safety and efficacy.
The Food and Drug Administration reviewed the clinical data and on Monday authorized the Pfizer vaccine for use in these children, capping weeks of anticipation from parents and children about a swifter return to normalcy.
“While it’s true that children are generally spared from severe disease, the fact that they’ve been unable to be vaccinated has caused major disruptions in their lives that have real developmental consequences,” said Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security. “Vaccination of this age cohort will allow these children to more fully return to their normal lives.”
President Biden promised last week to be “ready to move immediately” after authorization of the vaccine for 12- to 15-year-olds. Pediatricians, family doctors, schools and about 20,000 pharmacies nationwide are expected to offer the vaccine for free to these children.
But some experts have expressed ethical concerns about vaccinating children who are at low risk from the virus, even as health care workers and older adults in many countries remain in danger.
“Thinking purely as a parent, if I had teenagers, I’d probably be happy to vaccinate my children,” said Jennifer Nuzzo, an epidemiologist at the Johns Hopkins Center for Health Security.
But, she added, “I greatly worry about a situation where the few countries in the world that have had enough vaccines to protect their adults now continue to hoard those vaccines to use in low-risk kids.”
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School reopenings have sputtered across the nation, as parents, teachers, unions and school boards have worried about outbreaks. Research shows that children are mostly spared severe disease and are not significant drivers of coronavirus spread, as they are for influenza.
“Clearly this flawed risk perception will divert vaccination priorities away from what would be the optimal strategic use of the vaccines globally,” Dr. Adalja said.
The committee also recommended administering the Covid-19 vaccine along with other important vaccines that teenagers may have missed over the year. The agency had encouraged waiting two weeks before and after immunization against Covid-19 before receiving other vaccines.
The most important hurdle may be parental hesitancy. More than 40 percent of parents of adolescents said they would not get their children vaccinated or would do so only if required by a school, according to a recent survey by the Kaiser Family Foundation.
Some of those parents may change their minds, as other children safely receive vaccines and resume in-person schooling, or rejoin team sports like football and basketball that involve close contact, the researchers suggested.
Others may wait until they must comply with school requirements. Public schools in all 50 states require certain vaccines, but officials may not be able to enforce compliance until the Pfizer-BioNTech vaccine gains the F.D.A.’s full approval.
The vaccine has emergency authorization now. Pfizer has applied to the F.D.A. for full approval, but that process is expected to take several months. Even after approval, students may still opt out by citing medical reasons or religious beliefs.
State and local leaders will need to make particular efforts to reach children in low-income families or in communities of color. Black and Hispanic adults have among the lowest rates of vaccination: As of May 3, just 25 percent of Black people and 27 percent of Hispanic people had been inoculated, compared with 39 percent of white people.
Making the vaccine accessible to these communities will require easier transportation and storage of doses. The Pfizer-BioNTech vaccine can be stored for only five days in standard refrigerators. The companies are planning to ship smaller packs for use in doctors’ offices, and are developing a formulation that can be refrigerated for up to 10 weeks.
Pfizer and BioNTech plan in September to submit requests for authorization of the vaccine in children ages 2 to 11.
