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An overview of the COVID-19 pediatric vaccine program - The U.S. experience vaccinating children ages 6 months
Kevin Chatham-Stephens1, Rosalind J Carter2, Chris Duggar3
1Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, CDC, 4770 Buford Highway NE, Chamblee, GA 30341-3717, United States.
Insights
COVID-19 vaccines significantly reduce severe illness and death in children. The U.S. pediatric vaccine program aimed for broad access, but coverage remains lower in younger children, highlighting implementation challenges.
Area of Science:
- Pediatric Infectious Diseases
- Public Health Policy
- Vaccinology
Background:
- COVID-19 vaccination is recommended for children to prevent illness, severe outcomes like MIS-C, and death.
- Vaccine recommendations expanded progressively to include children aged 6 months and older.
- Despite efforts, pediatric COVID-19 vaccine uptake lags behind adult rates and varies by age group.
Purpose of the Study:
- To document the planning and execution of the U.S. COVID-19 pediatric vaccination program.
- To identify successes and challenges in pediatric vaccine distribution and access.
- To inform future pediatric vaccination campaign strategies.
Main Methods:
- The study describes the multi-agency collaboration for vaccine distribution following age-based recommendations.
- It reviews strategies implemented to maximize equitable access, including pharmacy-based vaccination.
- Data on vaccination coverage rates by age group as of May 2023 are presented.
Main Results:
- COVID-19 vaccination coverage as of May 10, 2023: 61.8% (12-17 yrs), 32.9% (5-11 yrs), 5.5% (6 mos-4 yrs).
- Successful expansion of access through pharmacies beyond traditional pediatric providers.
- Challenges included managing multi-dose vials and concerns about vaccine wastage.
Conclusions:
- The U.S. COVID-19 pediatric vaccine program achieved broad distribution but faced lower-than-expected coverage, particularly in younger children.
- Pharmacy access was a key success in extending reach.
- Lessons learned are crucial for optimizing future pediatric immunization efforts, both routine and pandemic-related.
Abstract:
COVID-19 vaccination decreases risk for COVID-19 illness and severe disease in children, including multisystem inflammatory syndrome (MIS-C) and death. On December 13, 2020, CDC recommended COVID-19 vaccination for persons ages ≥16 years, with expansion on May 12, 2021, to adolescents ages 12-15 years; to children ages 5-11 years on November 2, 2021; and to children ages 6 months-4 years on June 18, 2022. Following each age-specific recommendation, the U.S. government collaborated with state and local governments, vaccine manufacturers, and numerous other public and private entities, to ensure rapid, broad, and equitable COVID-19 vaccine distribution to strategic locations across the country to maximize access. However, vaccination coverage among children has been lower than among adults and lower among younger children than adolescents. As of May 10, 2023, COVID-19 primary series vaccination coverage was 61.8% among U.S. children ages 12-17 years, 32.9% among those ages 5-11 years, and 5.5% among those ages 6 months-4 years. This manuscript describes the planning and implementation of the U.S. COVID-19 pediatric vaccine program, including successes (e.g., the availability of pharmacy vaccination to extend access beyond more traditional pediatric vaccine providers) and challenges (e.g., multi-dose vaccine vials instead of single-dose vials, leading to concerns about wastage) to provide a historical record of the program and to help inform planning and implementation of future routine or pandemic-related pediatric vaccination campaigns.
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