States are moving quickly to vaccinate teens with Pfizer’s Covid-19 shot before the summer, with one moving ahead of a key advisory panel.
Health officials across the country say they’re rolling out in-school vaccination clinics as soon as Thursday to take advantage of the recent clearance of Pfizer’s Covid vaccine for children as young as 12. They’re hoping to reach adolescents before the end of the school year to boost their state vaccination rates.
“States are ready and able to vaccinate adolescents,” Marcus Plescia, chief medical officer at the Association of State and Territorial Officials, told reporters Tuesday.
Plans for inoculating the new cohort differ from state to state as officials grapple with consent requirements for children 12 to 15 years of age.
Some states, like Georgia, say they’re vaccinating kids 12 and older “as of today,” according to a state health department spokeswoman. Texas providers are holding off until Wednesday’s CDC vaccine advisory meeting. The head of California’s pharmacist association also advised pharmacists to wait.
These different plans by states come less than 12 hours after the Food and Drug Administration announced an expansion of the emergency use authorization for Pfizer-BioNTech vaccine to include children 12 years and older.
“This is a big step for our country as vaccinating a younger population can bring us closer to a sense of normalcy and to ending this pandemic,” Peter Marks, director of the FDA’s center that regulates vaccines, told a Senate health panel Tuesday.
Immunity for Waiting
States are free to vaccinate kids immediately if they want because the FDA authorized Pfizer’s vaccine Monday, Kalie Richardson, a lawyer at Hyman Phelps & McNamara who advises clients on pharmacy regulatory requirements, said. Pharmacists are already allowed to administer Covid-19 shots to kids age three and up due to a federal rule released last fall.
But pharmacists get liability immunity under federal law if they wait to get the blessing of the vaccine advisory board, which is a big draw for states to hold off kid Covid vaccinations until later in the week, Richardson said.
Even before the pandemic, state pharmacy boards relied heavily on guidance from the CDC’s Advisory Committee on Immunization Practices to shape when and how pharmacists could vaccinate children, so waiting for ACIP’s recommendation this time around is standard practice.
The CDC advisers will meet Wednesday to offer recommendations on how to use that vaccine. The White House has said more than 15,000 local pharmacies will be ready to administer shots once the FDA greenlights use of Pfizer’s vaccine in teenagers, and it’s working to allow more doctors offices to offer shots.
Leaders at the FDA said children 12 and up could start getting inoculated as early as Thursday, following the ACIP meeting.
In Texas, health officials have reached out to more than 3,000 pediatric health-care providers in hopes of enrolling them in the state’s Covid-19 vaccination program, making them eligible to get doses of the vaccines, Douglas Loveday, a spokesman for the Texas Department of State Health Services, said.
The state has told providers to hold off on vaccinating kids 12 to 15 until after the CDC advisory board makes recommendations for administering the shot to children, Loveday said.
In Georgia, the state’s department of health isn’t waiting for the CDC, spokeswoman Nancy Nydam said. The state is vaccinating children as young as 12 starting Tuesday, she said.
In New York, the state’s clinical task force will meet after the CDC makes its recommendations, Gov. Andrew Cuomo (D) said in a statement Tuesday. The vaccine could be available to children as young as 12 in New York as early as Thursday, he said.
School districts in Alaska end the year as early as this week , and health departments are planning to set up school-based vaccination clinics this week, Anne Zink, chief medical officer for the state of Alaska, told reporters. The hope is by vaccinating these children the state will see fewer cases when the new school year begins in the fall, she said.
“Kids have really struggled this year, and this is our best chance to get a healthy, happy school year,” Zink said.
Some states are converting their drive-in vaccination clinics to offer the Pfizer vaccine to target this new population.
Unlike people 16 and older, the younger age group would need parental consent to get a vaccine, officials say. One task for states is ironing out how to make sure that doesn’t become a hurdle.
Nirav Shah, director of the Maine Center for Disease Control and Prevention, said parents can sign forms allowing their children to get vaccinated without being present or can give consent over the phone.
There are almost 17 million people who are 12 to 15 years of age in the U.S., according to the Kaiser Family Foundation, or about 5.4% of the U.S. population. Nearly half of that age group are people of color.
Who Gets Doses
While the FDA authorized broader use of the vaccine, agency leaders noted during a press briefing Monday that it’s up to state medical and pharmacy licensing boards to decide which providers can administer them. Those regulations can vary state to state, even though it’s the same vaccine given to adults.
“That’s with good reason,” Marks said. “And with good reason because a 12-year-old is not the same emotionally as an 18-year-old. There is a difference there.”
But federal health guidance preempted those varying state laws to allow pharmacists to vaccinate kids 3 years old or older, Mitchel Rothholz, chief immunization policy lead for the American Pharmacists Association, noted.
The broader authority applies to all vaccinations, not just Covid-19 ones, and Rothholz said his group is in discussion with states to make some of those changes permanent.
“It really shouldn’t matter where a patient gets the vaccine, as long as it’s getting communicated into the immunization registry, which every provider has access to, for keeping track of what vaccines individuals got,” Rothholz said.
A number of individuals, especially in the adolescent population, don’t have a medical home, he added. “But a pharmacy’s an access point for them to get some services, but also get referrals, and reminders about well child visits.”
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