Young Children Are Lining Up for Next Wave of Covid Vaccines

Many parents have been anxiously waiting for the moment their 5- to 11-year-olds could be inoculated. That day has arrived.,

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In Houston, Texas Children’s Hospital braced on Wednesday for nearly 30,000 pediatric Covid-19 vaccine appointments, a rush that officials said had been booked in just five days. Nationally, Walgreens and CVS pharmacies opened appointment lines for millions of miniature doses. And amid a deluge of demand from parents desperate to get their children at least partially inoculated by Thanksgiving, Dr. Eric Ball realized he would have to skip some of his friend’s daughter’s bat mitzvah.

“Yeah,” the Orange County, Calif., pediatrician said, laughing. “Looks like I’ll be vaccinating kids in my suit this Saturday.”

With the blessing of federal authorities — and just in time for yet another stressful holiday season — health care providers mobilized nationally this week for a fresh wave of inoculations, this time featuring smaller shots in smaller arms.

Late Tuesday, the Centers for Disease Control and Prevention recommended the Pfizer-BioNTech coronavirus vaccine for children aged 5 through 11. The decision was in line with the Food and Drug Administration, which on Friday authorized emergency use of the pediatric dose for the roughly 28 million children in that age group.

Polls indicate that roughly a third of U.S. parents plan to leave their elementary-school-age children unvaccinated. But the latest vaccine announcement came as a relief not only to millions of families exhausted by the pandemic, but to public health officials who said it might help prevent a repeat of the terrifying surge of disease that swept the country last winter.

Although the infection rate in the United States plummeted for weeks as the reach of the contagious Delta variant ebbed, federal officials have warned that another spike is still possible. Absent vaccination, they say, younger children are vulnerable to hospitalization and, in the most rare cases, death from Covid-19, and they can transmit the virus to people of all age groups.

The Biden administration has enlisted 20,000 pediatricians, family doctors and pharmacies to administer the shots and shipped 15 million doses. About five million of them are allocated to pharmacies in the federal program that have been key to the adult vaccination rollout. The other 10 million are allocated to states.

Children’s Hospital Los Angeles was set to begin administering its first batch of pediatric vaccines on Wednesday morning, according to a hospital spokesman. Dr. Zoey Goore, a Kaiser Permanente pediatrician in Roseville, Calif., said her practice near Sacramento planned to start inoculating younger children next week, and had received its first shipment of vaccines on Tuesday: “Our pharmacists took a picture and sent it to everyone.”

In California, which has some 3.5 million children between 5 and 11 — nearly a tenth of the state’s population — the authorization of pediatric vaccines was met with an almost giddy sense of celebration. Dr. Richard Pan, a Sacramento pediatrician and state senator who in recent years has led a push to tighten the state’s vaccine regulations, said he had kept abreast of the C.D.C.’s endorsement on Tuesday by following colleagues on Twitter who were posting about the deliberations of scientific advisers to the agency.

“It’s like the release of a new iPhone,” Dr. Pan joked, predicting that “these first few weeks are going to be all about managing a crush of demand from early adopters.” After that, he said, appointments were likely to level off in the way they have for older age groups.

The state has planned an extensive rollout that includes school sites, community groups, pharmacists and health care providers. The Los Angeles Unified School District, the nation’s second-largest K-12 system, announced that it would deploy mobile vaccination teams for younger students on Monday and begin inoculating elementary school children at school-based clinics on Nov. 16. The district, which was among the first in the nation to use its campuses to distribute vaccinations, serves some 600,000 students, including hundreds of thousands in its elementary grades.

Other states were similarly relying on schools. In Anne Arundel County, Md., vaccination programs already in place for upper grade levels will soon expand to include at least 20 elementary schools, officials said. And Maine’s top health official, Dr. Nirav Shah, said he has asked every school district in the state to either host a clinic or partner with a hospital or Fire Department to offer the vaccine to children. “No one gets away with a simple ‘No,'” he said.

CVS and Walgreens pharmacies also were set to begin administering about one million shots apiece this week, according to company officials. Rina Shah, the head of pharmacy operations at Walgreens, said appointments could be scheduled at stores beginning Wednesday, with the first doses given to children on Saturday.

Roughly 3,000 Walgreens locations, some selected using a C.D.C. index of “social vulnerability” that emphasizes at-risk communities, will offer the service in the coming weeks, she said. Walgreens also will let children use its photo booths for free after their vaccinations, she added, so they can show off their fresh inoculations to their friends.

Jermaine Monroe, co-chair of a Covid 19 task force for Texas Children’s Hospital in Houston, said the intensity of demand became apparent on Friday. That is when, anticipating the C.D.C.’s action, the hospital first began booking appointments for these pediatric doses for the two-week period beginning this Saturday.

What to Know About Covid-19 Booster Shots

The F.D.A. has authorized booster shots for millions of recipients of the Pfizer-BioNTech, Moderna and Johnson & Johnson vaccines. Pfizer and Moderna recipients who are eligible for a booster include people 65 and older, and younger adults at high risk of severe Covid-19 because of medical conditions or where they work. Eligible Pfizer and Moderna recipients can get a booster at least six months after their second dose. All Johnson & Johnson recipients will be eligible for a second shot at least two months after the first.

Yes. The F.D.A. has updated its authorizations to allow medical providers to boost people with a different vaccine than the one they initially received, a strategy known as “mix and match.” Whether you received Moderna, Johnson & Johnson or Pfizer-BioNTech, you may receive a booster of any other vaccine. Regulators have not recommended any one vaccine over another as a booster. They have also remained silent on whether it is preferable to stick with the same vaccine when possible.

The C.D.C. has said the conditions that qualify a person for a booster shot include: hypertension and heart disease; diabetes or obesity; cancer or blood disorders; weakened immune system; chronic lung, kidney or liver disease; dementia and certain disabilities. Pregnant women and current and former smokers are also eligible.

The F.D.A. authorized boosters for workers whose jobs put them at high risk of exposure to potentially infectious people. The C.D.C. says that group includes: emergency medical workers; education workers; food and agriculture workers; manufacturing workers; corrections workers; U.S. Postal Service workers; public transit workers; grocery store workers.

Yes. The C.D.C. says the Covid vaccine may be administered without regard to the timing of other vaccines, and many pharmacy sites are allowing people to schedule a flu shot at the same time as a booster dose.

“We were averaging 120 appointments per minute,” he said. The bulk of slots were snapped up within 24 hours. As of Tuesday morning, 28,698 children had been booked for shots.

Texas Children’s main hospital, its two community hospitals and a variety of other sites are now planning to administer about 2,000 pediatric shots a day, officials said. So far, Mr. Monroe said, the interest has been at least double what the hospital system saw after the Pfizer-BioNTech vaccine became available to adolescents.

He attributed that to greater comfort with the vaccine, fear that the Delta variant posed a bigger threat to younger children, the approaching holidays and the hospital’s effort to educate parents at town halls and other venues about the vaccine’s benefits.

Not all states were as upbeat about the rollout’s prospects.

In Arkansas, only a little more than 40 percent of adolescents ages 12 to 15 have been fully vaccinated, said Dr. Jose Romero, the state’s top health official. And he said that while he knew that pediatricians were “very anxious to have it in their offices,” he hoped the uptake among younger children would be stronger than what the state had seen with older ones.

Dr. Lisa Gwynn, the president of the Florida chapter of the American Academy of Pediatrics, who runs a mobile vaccination program for the University of Miami health system, said the state’s rollout might be “a little bumpy,” as it was for adolescents.

“Unfortunately,” she said, “our state doesn’t have a very well-oiled machine.”

Some logistics have improved, she said: Pediatricians are now able to order 300 shots at a time, rather than the previous and less flexible minimum of 1,100. But having sufficient refrigeration and staff to administer the vaccines remains a concern, she said, especially for smaller offices.

Dr. Robin Straus said she had only one doctor on duty at a time at her small Bay Harbor Islands, Fla., practice, and had been directing families to local children’s hospitals for vaccinations.

She registered with the local office of the Florida Department of Health to receive a shipment of doses for younger children, she said, but her office is short-staffed, she does not allow patients in the waiting room because of Covid protocols and she does not want to keep children and their parents waiting outside for long periods.

“Right now, we’re telling our patients we’re working on it,” she said.

Noah Weiland, Patricia Mazzei and Jacey Fortin contributed reporting.

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