California Prepares for Rollout of Pfizer Vaccine for Younger Kids Ahead of Likely CDC Approval

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A boy wearing a mask and sitting along a wall with student work displayed looks at his shoulder as someone wearing purple gloves injects his shoulder.
Andrew Lai, 12, receives his COVID-19 vaccine administered by a medical assistant from St. John's Well Child & Family Center at Abraham Lincoln High School in Los Angeles on May 13, 2021, on the first day of availability of the vaccine for the 12- to 15-year-old age group. (Frederic J. Brown/AFP via Getty Images)

California has preordered 1.2 million doses of Pfizer-BioNTech's pediatric COVID-19 vaccine, and 4,000 medical providers are ready to administer the shots once they're approved by the Centers for Disease Control and Prevention, state public health officials said Wednesday.

The announcement was made a day after a Food and Drug Administration advisory panel voted to recommend a lower dose of the vaccine for emergency use authorization in young children.

State epidemiologist Dr. Erica Pan said the state’s 3.5 million children age 5-11 deserve to be protected from COVID-19 and added that vaccine doses will be ready to distribute within the first week after the shots get approved.

“They've weathered remote learning, adapted to wearing masks, put birthday parties and playdates on hold," Pan said. "These young heroes want to fully participate in life again with holiday gatherings and festivities approaching. Vaccine authorization could not come at a better time.”

According to Pan, vaccinating all those schoolchildren, who she said are 9% of the state's population, would give families and schools peace of mind and a sense of normalcy.

Public health officials acknowledged that reaching all eligible children will require offering shots at schools and doing outreach to some communities.

A change in approach to vaccinating kids

Parents and caregivers have options when it comes to getting their children vaccinated. Pediatric doses will be available at chain pharmacies, at public clinics and at pediatricians’ offices or hospitals, especially when those practices are part of a larger health care system.

Public health officials in the Bay Area are rethinking how vaccine clinics can be more kid-friendly. Many of these administrators are parents as well as medical professionals, so they realize that children might feel anxious about needles. Confronted with a syringe, many small children become afraid, but luckily they’re often easily distracted and respond to incentives, like stickers, balloons and temporary tattoos.

In San Francisco, health officials are planning to answer questions about vaccines from parents and caregivers at town halls in Spanish, English and Cantonese.

Kathleen Lund, school nurse at Longfellow Elementary School, said at least a couple parents ask her about kids’ vaccines each day. They worry about their children missing school when they come down with a sniffle and have to be tested or quarantine at home.

The principal at Longfellow reached out to the city’s department of public health to organize a vaccine clinic at the school in the Outer Mission, Lund said. Longfellow was not previously among the school district's vaccination sites. Those plans are moving forward, aiming for mid-November, and school staff are starting to reach out to families who speak Spanish, Tagalog, Chinese and Russian.

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“Timing will be a challenge," Lund said. "They want to do it in the morning. We’ll see if we can work out a time that works for our parents who work — that’s most of them here. The way that usually works best for the least amount of tears is for the child to sit on the parent’s lap.”

Santa Clara County’s vaccination site at the county fairgrounds will have trained staff and a bubble machine and scavenger hunt to keep kids occupied. There will be two sides, one for adults and one for kids, so the different dosages don’t get mixed up. Pfizer’s pediatric dosage comes in a vial clearly marked with an orange cap.

Appointments will be required at public clinics, said Dr. Jennifer Tong, associate chief medical officer for the Santa Clara Valley Medical Center.

“We do expect the demand is going to be quite high in those first few weeks, and we want to avoid as much as possible having parents and children stand in long, long lines,” she said.

Parents can choose the environment that will work best for their child: a large vaccine clinic like where many adults got shots, a small traditional medical exam room, or their vehicle, in a drive-up appointment where they won’t even have to unbuckle their seat belt.

Health officials wary of rise in cases in winter season

While celebrating the imminent approval of pediatric vaccines, health officials sounded a cautionary note in anticipation of winter.

Dr. Mark Ghaly, secretary of the California Health and Human Services Agency, said with holiday gatherings and more time spent indoors, there's a risk of COVID-19 cases spiking again, just like last winter. The concern is people might mistake cold and flu symptoms, fail to get tested and become a vector for COVID.

“We can't have history repeat itself. We still have so many unvaccinated Californians, kids as well,” Ghaly said at a press conference at the Asian Health Services clinic in Oakland’s Chinatown. “We need to keep our guard up, and getting young people vaccinated is part of that story.”

State health data showed a dramatic increase in cases and test positivity rates between October 2020 and January 2021.

“We all remember what occurred last winter. If the past has any instruction to the future, just consider these stubborn facts,” said Gov. Gavin Newsom before rattling off numbers to illustrate what happened when COVID precautions were eased without the protection of vaccines.

Newsom received a booster shot Wednesday: a dose of Moderna to shore up the Johnson & Johnson shot he got in April.

He urged older people, people with preexisting health conditions and anyone whose work puts them at elevated risk of contracting COVID-19 to get a booster shot promptly.

San Francisco public health officials say only about 20% of eligible older people have received a third shot since they started offering them in late September.

Dr. Naveena Bobba, deputy health director for the San Francisco Department of Public Health, said she thinks older people may be confused about boosters, waning immunity and who is currently eligible for a third shot.

She said the low numbers are concerning given the approaching holiday season.

“We do want our holiday season to be full of festivities and people gathering, but doing so in the ... healthiest and safest way, and the best way to do that is to get your COVID booster and flu vaccine,” Bobba said.

Moderna booster shots and Johnson & Johnson booster shots are now available to eligible people in California.