Next up: COVID vaccines for Michigan children under age 5

Very young Michigan children — those 6 months old through age 4 — may soon be able to be vaccinated against COVID-19.

On Tuesday, Pfizer-BioNTech asked the Food and Drug Administration to authorize its vaccine for this younger age group. The FDA’s Vaccines and Related Biological Products Advisory Committee (VRBPAC) will meet Tuesday, Feb. 15, to weigh the request.

If the FDA authorizes the vaccine, the U.S. Centers for Disease Control and Prevention still must sign off. A regular meeting of the CDC’s Advisory Committee on Immunization Practices (ACIP) is scheduled Feb. 23-24, although it’s not yet clear the vaccine request will be on that agenda.

Related: Child COVID vaccines are available in Michigan. Now comes the hard part.

In December, Pfizer announced that  1/10th of an adult dose — 3 micrograms — in children between 6 months and 2 years of age produced an immune response comparable to the response detected in people aged 16 to 25 years. But the same two doses were not as effective in children 2 and 5 years old.

Pfizer and its vaccine collaborator, BioNTech, said at the time they would test a third 3-microgram dose in children under 5, given at least two months after the second dose in children, and a third 10-microgram dose in children 5 to under 12 years old.

It may take the additional third dose “to achieve high levels of protection against current and potential future variants,” Albert Bourla, Pfizer’s chairman and CEO, said Tuesday in a statement.

Pfizer and BioNTech plan to ask the FDA to provide data on whether a third 3-microgram dose triggered an immune response in the older age bracket of the 2- to 5-year-olds.

Only Pfizer’s two-dose vaccine currently is authorized for people under 18 years old, and boosters are recommended for anyone 12 and older.

But interest in vaccinating older children has been lackluster, with Michigan families — like those across much of the country — slow to accept COVID vaccine doses.

Fewer than 25 percent of children ages 5 to 11 have been fully vaccinated against COVID nationally — a rate former FDA commissioner Scott Gottlieb, who now serves on the Pfizer board, this week called  “disappointing.” In Michigan, about 1 in 5 children in that age group are fully vaccinated, according to state data. 

Among Dr. Jenny Bush’s patients, the reaction to pediatric COVID vaccines is still “a mixed bag.” 

“In some conversations, it’s a firm ‘No, I'm never gonna do it,’” Bush, a Grand Rapids pediatrician, said of parents’ responses.  

But omicron has sickened more children than previous variants, though still at far lower rates than for adults. Some parents who originally had a ‘wait-and-see’ approach have begun to change their minds, said Bush, who practices at the Cherry Health—Heart of the City clinic in Grand Rapids.

Likely, she’ll see the same interest among families of infants and toddlers if the Pfizer vaccine is approved for them, she said.

“I expect about the same response that we got for the five-to-twelve-year olds, where some parents are eagerly waiting and feeling like their children have been almost neglected by our system … and some that are kind of having the same feelings as they had about the five-to-twelve year olds group — that the group doesn't get quite as sick,” she said.

As of Wednesday, Michigan hospitals were caring for 84 pediatric patients with confirmed or suspected COVID, though some likely were hospitalized for other reasons and incidentally tested positive for COVID.

Other children who aren’t hospitalized can still get very sick, missing school and spending days miserable, doctors have repeatedly said.

There are nearly 568,000 children under age 5 in Michigan, according to the 2019 American Community Survey — an age group that is already used to receiving shots during doctors visits, Bush noted.

“Sometimes people are more willing to do one more shot than they are to do a shot if you otherwise wouldn't need one,” Bush said. “There might be a little bit more of an acceptance (of a COVID vaccine for the youngest children) because that's kind of their normal expectation that when they come to the doctor there are shots.”