State health officials are about to open a new front in the running battle against COVID-19 — vaccinating children 12 to 15 years old.
Three things make this stage of the fight different:
• For more than a year, we’ve been told the risk of children becoming infected is much lower than for adults, making the need to vaccinate them less acute.
• Because of a planned ramping down of the state’s fixed vaccine clinic sites, the delivery of shots to children whose parents want them to get it will be different from every rollout in New Hampshire thus far.
• Experts like Dr. Anthony Fauci believe giving the vaccine to all eligible and available children could be the key to reaching the level of herd immunity needed to snuff out the pandemic once and for all.
Meanwhile, once the federal government gives the go-ahead, there could be more resistance to vaccinating the younger and healthier. At least one local advocate believes the entire exercise may not be worth the risk.
All this leaves Gov. Chris Sununu and his public health team with a stressful new to-do list just as the battle against COVID-19 among adults seems to be turning their way. New cases, hospitalizations and average daily deaths are all trending down.
“We’ve got to game-plan on this even before the feds give us the go-ahead so we can deliver the shots to these kids whose parents want them to have it,” Sununu said.
Although the 12-to-15 group contains about 60,000 adolescents, Sununu said it’s safe to estimate that the demand for the shots will probably be no more than half that total.
Laura Condon of Bedford, who served as director of advocacy for the National Vaccine Information Center, said younger healthy people, including adolescents, should not get the shot.
“Any honest medical risk/benefit analysis will show that young people are at a very, very, very low risk of serious illness from this virus and their development of robust natural immunity is key to ending the pandemic,” Condon posted on her Facebook Page late last week.
“And because their risk of serious illness is so low, the risk of injury and death from the COVID vaccines is unreasonably high and presents an unethical recommendation to vaccinate them.”
The NVIC is considered one of the most powerful groups in the country opposed to vaccinating children.
As expected, Pfizer and its German partner, BioNTech, are ahead of the two other U.S.-available vaccines, Moderna and Johnson & Johnson, in getting federal approval for vaccines for this younger group.
New Hampshire last month offered the Pfizer vaccine to all 16- and 17-year-olds.
Moderna and the J&J vaccine currently are available only for those 18 and older.
In April, Pfizer asked federal officials for emergency approval of vaccines for the 12-to-15 age group. The final approvals could come soon.
When and where
“Our best guess is mid-May,” said Dr. Benjamin Chan, the state’s epidemiologist. “It’s not a promise, but it looks like right now it could happen around then.”
Like nearly everything to do with the COVID-19 vaccine, all of this is going down ahead of schedule.
Last winter, Pfizer officials had said shots for the 12-to-15 group could be ready by this fall, in time for the next school year.
While the Food and Drug Administration and Centers for Disease Control will call the shots on dosing, the 2,260 younger adolescents in the Pfizer study received the two-shot variety with the same intensity as the adult vaccine.
The study found this younger group produced more antibodies than those 16 to 25 in an earlier study.
The mid-May time frame is pivotal for New Hampshire.
The state already has announced that after Memorial Day, first-dose shots will no longer be given at the state’s fixed vaccine sites, including Southern New Hampshire University in Hooksett and the malls in Nashua, Concord, Salem and Newington.
Those sites will be kept open for second-dose shots for those already in the Vaccine and Immunization Network Interface (VINI).
“If we hustle, we can get a lot of them vaccinated at our fixed sites by Memorial Day,” Sununu said.
The governor said he plans to put the call out for public schools to open clinics for willing adolescents, just as they did for teachers and staff in March and April.
What’s tricky is this group doesn’t fit neatly in a school building.
“We’re talking about kids who could be both in middle and high school,” Sununu said. “Clearly there are more in the middle school, but clinics for both could help.”
It will be up to parents to decide whether their children should get the shot if it becomes available.
“This is a personal choice, period,” Sununu said.
No NH deaths under 20
An estimated 3.5 million COVID-19 infections have occurred in American children, according to the American Academy of Pediatrics (AAP). This represents 13.5% of U.S. cases.
But children’s risk of dying from COVID-19 is very low — under 0.03%.
In New Hampshire, 6,055 children through age 9 have contracted the virus — about 5.3% of all cases.
Those between ages 11 and 19 account for 12.2% of all infections.
Only eight people under 20 have been hospitalized with the virus in New Hampshire since the pandemic began, and none have died.
In one respect, this development comes at an opportune time. The state is continuing to receive 50,000 doses of the vaccine each week, though demand clearly has peaked.
There’s little doubt New Hampshire will have the shots to give if the feds and parents give the OK.
“We are slowing down. I don’t like referring to it as hitting a wall, because we’re victims of our own success,” Sununu said.
“Things will slow down as eventually more people are getting it. This is why we are messaging over the border, if you live in Methuen, Tewksbury or Haverhill (Mass.) and shop here, come on up and get your shot here as well.”
New Hampshire has a long tradition of libertarian freedom with vaccines.
Last year, it became the last state in the country to implement a vaccine registry listing those who have received traditional vaccinations. COVID-19 is not included, because it is only available through an emergency authorization.
Anyone can opt out of the registry.
NH 10th for child vaccines
Many states have copied New Hampshire’s child immunization program. This was the first state to purchase a massive volume of other vaccines at cost, thanks to private health insurers bankrolling the up-front expense.
According to Expert Insurance, New Hampshire has the 10th-best child immunization rate in the country at 79.8%. Massachusetts leads the nation with an 85.9% rate of children having received the top seven series of vaccines.
Montana is lowest in the nation, at 64%.
With children making up about 22% of the U.S. population, reaching herd immunity — where 70% to 90% of all citizens are vaccinated against COVID-19 — without giving shots to children is unlikely.
That is why all three major vaccine makers are pushing to gain approval to offer the shots to all children over 6 months old at different dosing levels, starting at a third of the adult dose.
Last week, Fauci said all school children should have access to the vaccine by early 2022.
“Vaccines for under 12? We hear maybe this summer for all three makers right now, though Pfizer is the leading contender,” Sununu said.
“One thing at a time.”