COVID-19 booster approved for Michigan children ages 5 to 11

Every Michigander who has had a COVID vaccine, including children as young as 5, now can get a COVID booster.

The U.S. Food and Drug Administration Tuesday extended its emergency use authorization for the Pfizer-BioNTech vaccine, authorizing a single booster dose for children 5- to 11-years old.

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• November: CDC approves COVID vaccine for kids 5 to 11, shots available immediately

The announcement likely won’t trigger a rush to pharmacies and pediatricians’ offices. Michigan parents have been hesitant to get younger children vaccinated. Less than half of 12- to 15-year-olds in Michigan have received their first round of COVID shots, authorized more than a year ago; about 1 in 4 of the younger age group have received COVID vaccines, authorized in November, according to state data. 

“It’s going to be challenging” to convince parents to get boosters for their children, said Dr. Eric McGrath, a founding member of Wayne Pediatrics in Detroit. 

“There has been so much vaccine hesitation in the pediatric realm, and really with adults too. People may look at it as just another add-it-the-list recommendation,” he said.

Still left out altogether from COVID vaccinations are children under 5 years old, even though “a lot of those parents want to get those kids vaccinated,” McGrath said.

Both Moderna and Pfizer are working on vaccines for these youngest children, but the FDA likely won’t decide on authorizing those products until this summer, Dr. Paul Offit, an FDA adviser and director of the Vaccine Education Center at Children's Hospital of Philadelphia, said in an interview with the American Medical Association this week.

If all goes well, Offit said, “you would think by no later than (the) beginning of July, … these vaccines would be available for children less than six years of age.”

A first Booster shot can be given beginning five months after the initial two-dose series.

Certainly, children have been less susceptible to severe COVID, and cases statewide remain low overall — though on a steady, slow rise. The state lists 1,082 adults hospitalized with COVID, and just 40 children as of Monday. It’s not clear how many of those patients are hospitalized for another reason and incidentally are infected with COVID.

The CDC has estimated that 3 in 4 children have had a previous COVID-19 infection, though many were asymptomatic.

But new cases have inched up in the general population in recent weeks, both nationally and in Michigan. 

Additionally, health officials worry about waning immunity from the first doses. Adults 50 and older already are approved for a second booster, essentially a fourth shot for those who opted for one of the initial 2-shot regimens. 

And the FDA in January authorized a booster for children 12 through 15 years old. 

McGrath, the Detroit pediatrician, said his 11-year-old son had his two COVID vaccine doses, but recently contracted COVID. He was not yet authorized to receive a booster. 

Even if children aren’t sick enough to be hospitalized, they can be miserable — with a sore throat, body aches, ear pain, and fever like his son, said McGrath, an infectious disease specialist. 

McGrath said he’s also helped treat children with “some pretty bad cases of MIS-C,” referring to pediatric patients who are otherwise healthy, but get COVID and develop an inflammation in the heart, lungs, kidneys and other organs known as Multisystem inflammatory syndrome in children (MIS-C).

For a detailed listing of which COVID vaccines are available for each age group, visit this CDC page.

There are concerns that current COVID vaccines are less effective in children, especially against omicron and other variants. In March, the U.S. Centers for Disease Control and Prevention reported that the two-dose Pfizer vaccine reduced the risk of Omicron infection by 31 percent among children ages 5 to 11 and by 59 percent among persons aged 12–15 years. In contrast, the Pfizer and Moderna vaccines were considered 95 percent and 94 percent effective, respectively, at preventing COVID-19 with symptoms among adults when they were initially released late in 2020.

The CDC must sign off on Tuesday’s decision by the FDA. Its vaccine advisors are scheduled to meet Thursday.

The FDA said it based its decision to recommend a booster for young children on data in a subset of 67 children in an ongoing, randomized placebo-controlled trial that also guided the agency’s October decision to authorize first doses for 5- to 11-year olds. Those who received a booster dose 7 to 9 months after completing a two-dose primary series showed an increased antibody level. 

The FDA’s decision Tuesday bypassed its usual discussion by the FDA’s Vaccines and Related Biological Products Advisory Committee and the public release of data that usually accompanies a VRBAC meeting. The FDA, according to its announcement, “concluded that the request did not raise questions that would benefit from additional discussion by committee members.”/p>

The agency said it would “make available on its web site relevant documents.”

University of Michigan’s Dr. Arnold Monto, who chairs the committee, told Bridge by email Tuesday that he has no concerns about the FDA’s decision. He noted that the COVID vaccine — without a booster — “does not prevent omicron very well.”