We're All Waiting For A COVID-19 Vaccine. For Kids, The Wait May Be Much Longer.

Experts say it is unlikely that a COVID-19 vaccine will be available for children while one is available for adults. (Photo: Sasiistock via Getty Images)
COVID-19 cases are rising again in the US as experts warn of a "third peak" that could be particularly devastating as much of the country winters indoors.
Even if the case numbers start to drop, there is no real chance life will return to anything near normal until a COVID-19 vaccine is available. And until a vaccine is available for children, there is little chance that families will find themselves back into working routines.
Unfortunately, experts seem to think that it is unlikely that a vaccine against COVID-19 in children will be available once one (or more) becomes available for adults. Some predict we won't get a vaccine for children until next fall.
This is not a simple prediction to hear as a parent. Dealing with this elongated timeline - as theoretical as it may be - can influence the decisions parents are making as they navigate the pandemic with their children.
HuffPost parents reached out to some experts to talk a little more about children and a possible COVID-19 vaccine. Here are a few things to keep in mind:
COVID-19 vaccine studies have so far focused solely on adults.
Vaccine manufacturers have worked hard to come up with a response to COVID-19, but no children have been involved as of this week. On Wednesday, CNN reported that Pfizer plans to immediately include teens in its current experimental vaccine trials, and that the FDA has also given it permission to include children 12 and older in those efforts. So far, it is the only vaccine study in the US that children are participating in.
It is not necessarily uncommon for potential vaccines to be tested in adults first. For one, healthcare workers and certain groups of older adults who are more susceptible to serious illnesses from COVID-19 are likely to be prioritized when a vaccine is available. Traditionally, the process of developing a vaccine usually involves testing in larger and larger groups of adults, followed by older children and younger children. And this process often takes several decades.
However, nothing is typical about the speed and global scale of development of a COVID-19 vaccine. Given the surge in COVID-19 cases in children (nearly 700,000 children have tested positive for the virus in the US since the pandemic began), some researchers argue that there is an urgent need to ensure that children are included in studies.
If there were tests on adults that showed it was safe and effective, we wouldn't just be saying, "OK, now you can just open the doors and give this to kids too."
Dr. Yvonne Maldonado, epidemiologist and infectious disease specialist
In September, a group of doctors wrote a comment arguing that "clinical trials remain neutral on children," which also affects children's ability to return to school and daycare. "An approved COVID-19 vaccine for children could have far-reaching positive effects on health and educational equity," they write.
Dr. Priya Soni, a pediatric infectious disease specialist at Cedars-Sinai Medical Center in Los Angeles, told HuffPost that excluding children from vaccine trials could undermine overall prevention efforts. "Children could likely remain a great reservoir for infection," she argued. "This, in turn, would undermine all of our other efforts to contain the pandemic."
For parents, the fact that studies so far have focused primarily on adults is probably most important, as experts like Soni “believe with confidence” that a vaccine is not ready for children while one is ready for adults.
"The hope is that vaccine developers have enough data to start registering in children by the end of 2020," she said. "But even if that changes, it is hard to imagine that a globally effective vaccine would be available simultaneously for adults, children and other vulnerable populations."
Children are not mini-adults and their immune systems are very different.
Clinical trials in children are imperative as children are not just small adults, explained Dr. Yvonne Maldonado, epidemiologist and infectious disease specialist at Stanford Medicine, chair of the American Academy of Pediatrics' Infectious Diseases Committee.
“Your immune system is very different from that of adults. The immune system continues to develop, especially in children under 5, ”said Maldonado. “There are studies that have shown that children react differently to vaccines. Younger children in some cases react very differently than older children - in some cases better and in some cases worse. Younger children “develop” many of their basic biological responses in ways that older children and adults do not.
In addition, for reasons not yet understood, children seem to react differently to COVID-19 than adults.
"We have to do very rigorous safety studies in children before we can endorse a vaccine in children," Maldonado said. "If there were tests on adults that showed it was safe and effective, we wouldn't just say, 'OK, now you can just open the doors and give this to kids too. "
Some children have a rare inflammatory response to COVID-19 - which complicates things.
For months, doctors have been following a condition known as childhood multisystem inflammatory syndrome, or MIS-C. It appears to be a rare inflammatory reaction in children infected with COVID-19 that develops weeks after this initial infection and that can make them extremely sick.
MIS-C received significant media attention when it was first released, but has largely fallen from the spotlight, partly because it is so rare.
However, for doctors and vaccine manufacturers, this was the number one priority - and this is one reason they advocated that research be carried out slowly and extremely carefully.
"It's the first thing most of us pediatricians thought of when we heard about this syndrome," said Maldonado. "We don't really know what it is ... the underlying immune mechanism is important to understand as we don't want to see a vaccine that could increase this response."
Layer protection measures are still the best way to prevent spread.
At this point, too, nobody really knows when an adult or child vaccine will be available. Therefore, our best ways to prevent the spread of COVID-19 remain the same: keep social distance, wash hands, and wear masks.
And there has been some good news lately when it comes to kids and the virus. This week, the researchers published the first major study looking at the spread of COVID-19 in daycare centers that stayed open throughout the pandemic, and found that children were not at great risk to the staff who are constantly watching them . And at this point, with school districts returning to face-to-face learning across much of the country, it doesn't look like K-12 schools are a big driver of the virus.
Even so, the experts who advocate increased focus on developing COVID-19 vaccines for children say parents should understand that things won't really change until a vaccine becomes available for children - and could, too be a way out.
"We need to make childhood vaccines a priority if we have any hope of returning to normal," argued Soni.
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This article originally appeared on HuffPost and has been updated.

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