In a café in London this week, two moms had lunch with their babies, who are both below the age of one. They discussed sleepless nights, feeding habits, babysitters—and now, whether it’s safe to vaccinate them.
The Pfizer COVID mRNA vaccine for children under the age of 5 is now being considered by the Food and Drug Administration for rollout in the U.S., and could be available by the end of the month. It would be a major breakthrough and a huge relief to families that have been wanting to protect their babies and toddlers against severe infection from COVID.
But some parents who got the vaccine themselves, and were mortified by the politicization of vaccination as an issue, are grappling with hesitation around vaccinating their young children.
While vaccine hesitancy ranges across nationality, age, education, and political ideology, parents who were eager to self-vaccinate as soon as possible just feel differently about their children 5 years old and younger. Only three in 10 parents of children younger than age 5 say they intend to get their child vaccinated against COVID as soon as shots become available for that age group, according to a survey published Tuesday by the Kaiser Family Foundation.
“I think if it was rolled out in the U.K. and it was recommended to get it, then I would get it,” says Esme, a triple-vaccinated recruiter and mother of a 2-month-old in London told Fortune. “But I don’t think there is enough evidence for babies yet to say you should definitely have it.”
“I am not against it, and I think it would depend on if there were more serious strains of COVID and it was proven it was more risky for babies or very young children,” Tess, an accountant who is also triple-vaxxed and who has a 4-month-old daughter, told Fortune. “That would have to weigh up my decision,” she says.
Parents have been hard hit by the pandemic. While schools went remote and childcare came in the way of jobs, they’ve also had to worry about the health of their children, a concern that became even more acute when the Omicron wave swept through the U.S. and Europe, leading to record numbers of hospitalized unvaccinated children. But even if the solution does come along in the form of a vaccine for kids under the age of 5, it may not be the answer many parents want.
Doctor’s orders
The FDA is meeting on Feb. 15 to decide whether or not it wants to authorize the Pfizer vaccine for kids under the age of five.
The emergency approval is dependent on Pfizer and BioNTech’s submission, which will be made public “no later than two business days before the meeting,” according to the FDA. However, before submitting a request for approval, Pfizer released a statement on Dec. 17, 2021, noting two three-microgram doses of their COVID vaccine—a tenth of what is normally given to adults—did not produce the desired immune response in children ages 2 to 5 and that they were evaluating whether or not a third dose administered two months after the second shot increases efficacy.
Federal regulators pushed Pfizer to submit the request, despite the lack of the immune response developed in children ages 2 to 4, according to the New York Times, as officials found that two doses were still proven to be safe for children.
While the COVID vaccine’s efficacy is still under review, among pediatricians in the U.S., there is consensus that a safe and effective COVID vaccine for young children would be welcome.
“I feel that having the vaccine that is safe and effective for young children will bring remarkable peace of mind for many people around the world, not just parents, but grandparents, but uncles and aunts,” Dr. Wafaa El-Sadr, professor of epidemiology and medicine at Columbia University, told Fortune.
While young children are far less likely to develop severe disease from COVID-19, there has been an upswing of hospitalizations in that group in the U.S. because of Omicron’s high transmissibility and their lack of vaccine protection. The U.K. has also seen an uptick in infant hospitalizations, according to a Isaric/Co-CIN study published by the Scientific Advisory Group for Emergencies.
“If you’re of the mindset that, you know, any death or any hospitalization in a young child is unacceptable, and if we have the supply for this vaccine, why should we deny it to children?” Kathleen M. Neuzil, professor of medicine and pediatrics at the University of Maryland School of Medicine, told Fortune.
Will this quash parent concerns?
If the vaccine proves to be safe for young children and is approved by the FDA, and while Omicron continues to sweep through the world, what is stopping parents from their kids getting jabbed?
A wide array of misinformation on vaccines online has created a robust anti-vax movement in the U.S., and introduced significant vaccine hesitancy. Only around 43% of Americans over 12 have received a booster shot, according to the CDC. And around 65% of Brits have had a booster shot, according to data from the BBC.
But even parents who are pro-vaccine are hesitant to inoculate their children. Anecdotal evidence has circulated online and between parents about kids eligible for the vaccine having rough and unnecessary side effects. Some parents still fear the risk of myocarditis, or inflammation of the heart muscle, which was found to be a side effect of the Moderna mRNA vaccine in boys and young men ages 12 to 39 years old.
For some, the slim risk that their child will get COVID just isn’t a strong enough argument to get a vaccine.
“As far as my child goes, we just don’t know enough about the long-term effects, and I’m not willing to risk it on my child’s future health,” Jodi, a mother who runs a nail salon, tells Fortune. She adds, “The risk just doesn’t outweigh the benefits.”
For many, getting the vaccine will come down to what their doctor advises.
“I am torn,” an engineer and father of a toddler in France, who asked his name be kept anonymous, told Fortune. He is hesitant to make any decision before more data shows up. “I think I would listen to what my doctor tells me,” he says.
His wife, a social worker who was vaccinated and boosted while pregnant, agrees. “At first, no, I would wait to hear about statistics, as [I did] when I was pregnant, and then I would ask for the baby’s doctor’s opinion,” she said.
Individual vs. community benefits
For adults and children over 5 years old, getting vaccinated means not only protecting themselves, but also protecting the people they could infect, particularly vulnerable groups like the elderly and immunocompromised.
With the Omicron variant, though, vaccines significantly reduce the chances of severe infection, but they likely do not limit the transmission or curb the spread of infection. That means that for any new vaccine administered, the benefit would be for the child to elicit a better immune response rather than protecting the community.
“At this point, our strongest reason for vaccinating [children under 5] is really the individual benefit,” says Neuzil.
Sweden, for example, has decided to not vaccinate anyone below the age of 11 because the communal benefit of reducing new cases of COVID is low and children are at low risk of severe disease.
“The vaccines are safe, there are very good vaccines, but we are now focusing on the medical benefits of the individual child, and we don’t see that the benefits are great enough for us to recommend for the whole group,” Britta Björklund from the country’s Public Health Agency told reporters at a press conference on Thursday.
But that could all change if a new variant comes along. The World Health Organization warned that more variants are expected to come after Omicron, and if they are more virulent or severe, it may persuade parents to change their mind.
It’s also important to remember that vaccination doesn’t happen all at once—the strongest protection takes three doses over a period of time.
“To be able to get started on that, would be a real advantage,” said Neuzil. “So even if Omicron is starting to wane, we don’t know what’s gonna come next. We don’t know what the severity of the next variant is gonna be.”
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