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On Tuesday, the advisers to the U.S. Food and Drug Administration voted 17-0 in favor of recommending Pfizer’s COVID-19 vaccine for “emergency authorization” use on children ages 5 to 11. 
AP Illustration/Peter Hamlin

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Perspective: An FDA panel recommended a vaccine for 5- to 11-year-olds. Don’t mandate it

Parents need to be able to trust that the authorities approving these vaccines are fully transparent and seriously concerned with the best outcomes for children

Before the Centers for Disease Control and Prevention recommended the vaccine for pregnant women, I got the COVID-19 jab six months into my pregnancy. I’ve written about the importance of traditional childhood vaccinations in just about every major publication: The New York Times, The New York Post and The Washington Post. But, if the government wants to mandate the COVID-19 vaccine for my kids under the new emergency authorization, as many suspect they might after it’s approved, they need to make a much stronger public case that it’s necessary for kids as young as 5.

The case for adults remains self-evident, which is why my husband and I were vaccinated as soon as it was possible. We have friends who have hovered close to death on ventilators, and we know people who have died from COVID-19’s effects.

Mercifully, however, the data has shown that young children have reacted to COVID-19 much differently. Yes, children can get sick and can even die from COVID-19. But, statistically speaking, the risk for children under 10 of developing major complications from COVID-19 is really low. It’s close to nothing.

“The youngest children seem to be most protected from this virus,” according to Camille Sabella, director of the Center for Pediatric Infectious Diseases at the Cleveland Clinic. Sabella was commenting on a recent analysis from the CDC which found that children who died from COVID-19 tended to be older than 10 and had at least one underlying medical condition.

On Tuesday, the advisers to the U.S. Food and Drug Administration voted 17-0 — there was one abstention — in favor of recommending Pfizer’s COVID-19 vaccine for “emergency authorization” use on children ages 5 to 11. But, according to a recent CBS News/YouGov poll, only 37% of parents plan on vaccinating their children immediately.

If more parents like me are going to be persuaded to hop onboard with vaccinating under the emergency approval, the government needs to give parents all the facts so families can have the confidence that the CDC has the best interest of their children at heart. Full stop.

This will be particularly important as all kinds of institutions will inevitably begin to exert pressure on parents to vaccinate their kids. Last week, in anticipation of the vaccine’s approval, the Biden White House preemptively announced operational preparations for vaccinating as many American children between the ages of 5 and 11 as possible.

A fact sheet released from the White House explained,

The potential authorization of the first COVID-19 vaccine for children ages 5-11, which is currently under consideration by the Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC), would be another major milestone in our efforts to build on this historic progress and protect even more Americans.

In anticipation of the FDA’s independent advisory committee meeting on October 26 and the CDC’s independent advisory committee meeting on November 2-3, today the Biden Administration is announcing a plan to ensure that, if a vaccine is authorized for children ages 5-11, it is quickly distributed and made conveniently and equitably available to families across the country.

The White House’s pre-announcement and pre-purchase of 65 million doses felt a great deal like the vote was a foregone conclusion; a rubber stamp on a process to determine not only the safety — but also the necessity — of rapidly inoculating millions of elementary and middle school-aged children.

There’s no question the vaccine has saved lives and has been an absolute medical miracle for those most at risk. But we’re getting into a new stage of a vaccination campaign, one where the cost-benefit analysis is more complicated. Most adults are willing to stomach both known and potentially unknown risk for the sake of avoiding severe infection from COVID-19.

It’s a slightly different calculation for young children, who, by virtue of being young children, are on average at a lower risk unvaccinated than I am, a healthy 35-year-old, fully vaccinated woman. Parents deserve a frank accounting of the risks of the vaccine and of the virus for their children. While trying to decide how best to proceed with our children, we don’t deserve the bullying and condescension that has marked the campaign to vaccinate the reluctant among us adults up to this point.

Parents instead deserve a nuanced conversation based on the individual and personal situations in millions of households across America. The calculation looks different for every kid: An 11-year-old with diabetes does not carry the same risk as a healthy 5-year-old living in a home with other low-risk children and their vaccinated parents. Reporting on the FDA meeting, Katelyn Jetelina explained, “Two members voiced frustration that this was a binary choice: all or nothing vaccine for 5-11 year olds. Some asked whether they could rephrase the question for specific kids, like obese or immunocompromised. Some pointed to the number (that) 42% of kids have natural protection and that vaccines may not help that much.”

Each scenario should be analyzed independently and parents should be given the space to make personal calculations without fear of mandate or undue pressure.

Above all, parents need to be able to trust that the powers that be approving these vaccines are deliberating as seriously as they would were they making medical decisions about their own children. Unfortunately, many might have the opposite impression when concerns about a heart risk related to vaccination emerged for teenagers, in particular, teenage boys over the late spring and early summer. According to the New England Journal of Medicine,

On May 27, 2021, the Centers for Disease Control and Prevention (CDC) issued a statement regarding a possible link between vaccination to prevent coronavirus disease 2019 (Covid-19) and myocarditis for both the BNT162b2 vaccine and the mRNA-1273 vaccine (Moderna). On June 2, 2021, the Israeli Ministry of Health reported that 148 cases of myocarditis had been identified in Israel between December 2020 and May 2021.

If you thought that the CDC immediately met in order to evaluate this risk because another minute couldn’t be wasted when the health and safety of millions of teenage boys was potentially at risk, you would be wrong. They didn’t put a meeting on their schedule until June 19, which they then postponed until June 23 when the Biden administration at the last minute declared Juneteenth a national holiday.

These don’t seem like the actions of a bureaucracy that believes it has to earn the trust of American parents. The Biden administration and other government officials (like my Republican governor, Larry Hogan of Maryland, whose message on the issue echoed the White House’s) had a chance to make the process of approving the vaccination for our younger kids as serious as it should be.

Instead, they moved forward without the transparency and concern this subject merits.

There are millions of American parents ready to line up on the first day that the vaccine is made available for their children. There are many millions more with a “wait and see” approach or who as of yet have no intention of vaccinating their children. This isn’t a traditional vaccination debate with clear risks and benefits; this isn’t the MMR for children in 2018, nor is it a question of vaccinating adults or the elderly against COVID-19. It’s far more nuanced. On Twitter, journalist Leah Libresco Sargeant remarked, “Wish they could just say, ‘Safe, effective, and discretionary.’” As many parents wait to see what comes after the emergency use authorization approval for the vaccine for their kids, that should be the messaging from public health officials.

Bethany Mandel is a contributing writer for the Deseret News, editor at Ricochet.com and a contributor to the Washington Examiner blog and magazine.

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