Ready for 16- to 17-year-olds to get a COVID-19 booster? What you need to know
The Food and Drug Administration last week gave emergency use authorization for COVID-19 Pfizer booster shots for 16- and 17-year-olds. Previously, the authorization had been only for people 18 and older.
The Centers for Disease Control and Prevention followed suit and recommended boosters for everyone 16 and older.
As with those 18 and older, people ages 16 and 17 receive a 30-microgram dose of Pfizer, the same as the first two shots. The booster can be given six months after a second shot. The Moderna and Johnson & Johnson vaccines have not been authorized for people younger than 18.
We asked Dr. Stanley Spinner, vice president and chief medical officer at Texas Children’s Pediatrics and Texas Children’s Urgent Care, about boosters in this age group and when boosters for those younger than 16 will be allowed.
Why should 16- and 17-year-olds get a booster?
"We want to make sure they maintain that higher protection," Spinner said of those 16 or older who had a COVID-19 vaccination at least six months ago.
The data show that antibody levels begin to wane around six months after the second vaccination. The higher protection is important for the delta variant, which is the predominant variant right now and caused a surge in cases in the summer.
It's also been shown to be important for the new omicron variant. "We are learning that we need that booster to get added protection," Spinner said.
With the delta variant, one person could infect five to eight people. The omicron variant is thought to have at least double the transmission rate of delta, Spinner said.
Locally, the transmission rate (the amount of COVID-19 disease in an area) is slowly rising as is the number of people hospitalized with COVID-19.
"Get that booster dose as soon as they can," Spinner urged.
Having had COVID-19 doesn't give you as much protection as being vaccinated and getting a booster, he said.
What is the magic of six months after your last shot?
"It's not like before six months, you're OK, and six months plus one day, you're not," Spinner said.
What scientists have noticed in studies is that there's a gradual reduction in antibody levels, and beyond six months, there's a measurable decrease. This reduction makes you more likely to get infected and possibly more likely to be sicker if you are infected, Spinner said.
They've also noticed that length of time after the second shot makes a difference in who is having breakthrough cases and even hospitalizations.
"By giving that third dose, it increases the measurement of antibodies, which correlates with better protection," he said.
Why weren't ages 16 and 17 part of the initial booster group?
The FDA looks at data for a certain time period to see how well the booster works and to note any side effects, Spinner said.
When the recommendation for boosters for everyone 18 and older came down in November, we didn't yet have enough data for ages 16 and 17, he said.
When will boosters be recommended for 12- to 15-year-olds?
That group was approved for the Pfizer COVID-19 vaccine in May. Those in the first wave of vaccinated 12- to 15-year-olds are now at the six-month window.
The FDA is evaluating data to look at boosters for that age group, Spinner said. Researchers will look for efficacy and safety of the boosters and make their recommendations.
"It won't be much longer, probably," Spinner said.
For that group and anyone who is not yet fully vaccinated with a booster, it's important to weigh the risks of each event you attend.
"The more places you go with people that don't have the ultimate protection of a booster, yet there's more people around, especially indoors where it's crowded, there's more risk," he said.
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What about side effects for the newest group of vaccinated, ages 5 to 11?
One of the concerns with that age group was possible side effects that were seen in the teens and younger adults.
"We're actually seeing less side effects in that group than in adolescents and the adult group," Spinner said.
The most common were being tired, sore and achy, but this group has had less fever and less joint pain.
"It's partly because younger kids tolerate it better," he said, but it also could be that this group is getting one-third of the dose, or 10 micrograms instead of 30 micrograms. Pfizer is now studying whether that dosage is effective in ages 12-17.
When will kids 4 and younger get a COVID-19 vaccine?
Spinner and his colleagues think Pfizer and the FDA will break this age group into two: ages 2 to 4, and 6 months to 23 months.
The data for ages 2-4 will probably be submitted in January or February, he said. If that goes well, they will consider the youngest group a few months after that.
How much longer will this pandemic last?
COVID-19 is not going to go away.
"The expectation is that we will go from a pandemic, where it's everywhere all the time, to an endemic like the flu, where there are times of the year when people tend to be more inside together, when it may peak and then come down again," Spinner said.
Right now, flu is back in clinics and emergency rooms, he said, and that is why it's important to get a flu shot, too.
The hope is that through vaccination, we have enough community protection to get mild COVID-19 cases like with the flu, and that it doesn't overburden the hospital system, he said.
By getting as many people vaccinated and then boosted, "we make it more manageable to do the things we normally do without thinking about COVID," he said.