Kern County public health officials and doctors are beginning to prepare for a whole new group of children to be vaccinated against COVID-19.
The FDA has scheduled a meeting Tuesday to consider approving Pfizer's application for emergency authorization of their mRNA vaccine for 5- to 11-year-olds. If approved, a COVID-19 vaccine could be available to young children for the first time in early November.
In Kern County, this means that another 99,526 residents would be eligible for a vaccination, which is spurring preparations.
"Part of the reason we opened our scaled-down version of the Fairgrounds mass vaccination clinic was in preparation for the authorization of the vaccine in the 5-11 age group," Michelle Corson, spokesperson for Kern County Public Health Services, said in an email.
The department is also working to bring a fifth mobile vaccination clinic online to partner with elementary schools to assist with vaccinations in this age group.
If the Pfizer vaccine is approved for younger children, it won't just be a matter of giving out more doses of Pfizer as was the case when it was approved for 12- to 15-year-old children. These pediatric doses are smaller, and so are the needles that administer them and the vials that contain the doses.
That means that doctor's offices and Public Health will have to wait until they receive shipments to begin giving the shots.
Conversations about vaccinations
The conversation about vaccinating children has become even more heated in California since Gov. Gavin Newsom announced that K-12 students would be required to be vaccinated against COVID-19, pending full FDA authorization.
On Monday, there was a protest at the Kern County Superintendent of Schools office in downtown Bakersfield, and some northwest Bakersfield school districts saw attendance drop by a quarter, which was a part of a broader statewide action. Many parents at these protests say that they are worried about the long-term effects of the vaccinations on children.
Andrew Noymer, a public health professor at the University of California at Irvine, said there's no way to know what the long-term effects will be. But all evidence points toward the COVID virus itself creating more problems than the vaccine, which reprograms the immune system to fight COVID.
"All you have left is an immune system with a programmed memory," he said. "With the virus, it could be replicating and sequestering itself in the body."
Dr. Nimisha Amin, a pediatrician at Southwest Pediatrics in Bakersfield, said worrying about the long-term effects of a vaccine is a little like worrying about a Tylenol you took years ago. Any side effects for a vaccine are most likely to show up within two months, she said, not years down the line.
Noymer encourages parents of younger children to vaccinate their children based on data from Pfizer's safety trials. But concerned parents will have a lot more time and data before the state requirement kicks in — he expects it won't take effect until at least January 2023.
"I would remind them that by the time the requirement kicks in, we’ll have much more data because we’ll have data on the kids who are getting it now," he said.
Amin encourages parents to discuss their concerns with doctors who have the proper training and experience.
"As busy as a time as it has been, we do take that extra time to talk," she said. "Nothing replaces talking to a professional face-to-face."
Public Health, for its part, said its message about vaccinations for younger age groups is no different than any other group that has been approved to receive the vaccine.
"We continue to encourage vaccination in all eligible age groups, as it is the most important intervention to end this pandemic," Corson said.
The case for vaccinating children
But this week Amin took to Facebook to make a specific case for children getting vaccinated against COVID because she felt it was urgent to address the misinformation circulating recently.
For instance, she said there is no evidence to address the myth that the vaccine affects fertility. She noted that leading organizations representing OB-GYN specialists endorse getting vaccinated, including the American College of Obstetricians and Gynecologists.
Some parents have not felt the vaccine is urgent for children, since their symptoms tend to be milder.
Amin said that hospitalizations, long COVID, multi-inflammatory syndrome in children (MIS-C) and death, though rare, are still risks for children. Those with long COVID and MIS-C often had no underlying conditions.
Kern County has reported no deaths of children due to COVID, but it has reported 21 cases of MIS-C, which is a serious condition.
In her own pediatric practice, Amin has had a "small handful" of patients who've tested positive for COVID-19 that she has sent to emergency rooms for supplemental oxygen. Some have had fevers that lasted seven to 10 days. More often her patients come in with mild symptoms. Even a runny nose or a stomach ache can mean 10 days out of school and parents taking time off work.
Vaccines greatly reduce the risk of hospitalization, but Amin believes that the fact that students end up missing so much school for even mild issues is spurring many vaccinations.
Kern County's vaccination rate among 12- to 17-year-olds has climbed from 26 percent on Aug. 18 to 40.2 percent now, according to the state COVID dashboard. It lags behind the statewide vaccination rate in that age group of 58.2 percent.
There is one risk of the vaccine that has been noted particularly among young men and teens: myocarditis, inflammation of the heart muscle. The condition is a rare but serious side effect that, if it occurs, more often does so after the second dose. Most of the cases associated with COVID-19 resolve with medical attention after a few days, Amin said.
However, those who contract COVID are at a much higher risk for myocarditis, and they tend to experience more severe cases, including heart failure. It is for this reason that the Advisory Committee on Immunization Practices concluded the benefits outweigh the risks.
Amin said that in her practice, her patients have handled the vaccine well, and none have required a follow-up appointment.
Her final appeal to encourage children to get vaccinated is about the adults in the lives of children. Children can catch COVID and pass it on to an adult whose immune system isn't quite so robust. That can weigh on a child.
"I think it is really important to consider the emotional impact of a child bringing this virus home and then spreading it to a loved one and potentially having that loved one get very sick or dying of the virus," she said.