Children as young as 6 months old could be getting vaccinated against COVID-19 before the end of February.

The first shipment of 23,000 Pfizer vaccine doses that have been scaled down for children 6 months to 4 years old could arrive in Utah as soon as Feb. 21, the Utah Department of Health’s immunization director, Rich Lakin said Wednesday.

There’a already plans to quickly distribute those doses to local health departments, doctors and pharmacies throughout the state, even though the fast-tracked process for federal approval doesn’t get underway until the U.S. Food and Drug Administration’s vaccine advisory committee meets Feb. 15.

“We know that we’ve got more kids in this state so the more we get vaccinated, the less it spreads among families and in schools and etc.,” Lakin said. Utah has the highest percentage of children under 5, with 7.7% of residents in that age group compared to about 6% nationwide, according to the Kaiser Family Foundation.

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A recent survey by the nonprofit foundation found just 31% of parents nationwide with children under 5 intend to get them vaccinated right away once the shots become available, while 26% definitely would not vaccinate their young children, 12% would do so only if required, and the rest, 29%, want to wait and see.

Asked about the results during a White House briefing Wednesday, President Joe Biden’s chief medical advisor, Dr. Anthony Fauci, said Americans “need to be assured that any decision that the FDA makes, as is historically always the case with them, will really be based on the scientific data of both safety and efficacy.”

White House COVID-19 Response Coordinator Jeff Zients said the administration will be ready once the FDA and then the Centers for Disease Control and Prevention settle on recommendations for the only age group not yet eligible for the vaccine

“We’re launching a new program specially for kids under 5. The planning process is well underway. CDC is working with states to help them prepare. We’ve secured enough vaccine supply for all kids in this age group — all 18 million. We have enough needles, syringes and kits,” Zients said.

He said the federal government “can start packing and shipping the vaccine once FDA makes its decision. So, we will be prepared for those parents that are eager to get their kids vaccinated.”

But Zients acknowledged other parents aren’t convinced.

“We’ve learned through our efforts across the last year that the best messengers are local messengers — local community groups and leaders, doctors, and other health practitioners,” he said, so they’ll have the materials and training “they need to be able to answer the questions that parents have about getting their kids vaccinated.”

Lakin said he’s not anticipating big numbers of vaccinations in the new age group, at least not at first.

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When COVID-19 vaccinations were first offered last spring to teens, he said a quarter had gotten shots within six weeks in Utah and now, more than 58% are fully vaccinated, meaning it’s been two weeks or more since their final initial dose. About 10% have also gotten a booster shot, now available to anyone 12 and older.

But among Utah children ages 5-11, only about 25% are fully vaccinated even though the shots were approved for them last fall. Lakin said vaccination rates for infants and toddlers in the state are likely to “just be a stepping-stone down” from that.

Not only is the latest COVID-19 surge in cases, driven by the incredibly transmissible but largely milder omicron variant of the virus seen as subsiding in Utah and around the country, there is also confusion about how many doses of the vaccine young children will need.

Pfizer announced in December a third dose of vaccine was being tested as part of the ongoing clinical trials after a two-dose regime failed to produce a strong enough immune response. But instead of waiting several months for the study on a third dose to be completed, federal regulators are reviewing the initial results.

“I think the chances are very high for FDA to approve it,” Pfizer CEO Albert Bourla told CNBC Tuesday, adding that he believes the federal agency “will be pleased with the data” from clinical trials of the vaccine on children, expected to be made public Friday.

Lakin said questions surrounding a third dose could be an issue for some parents.

“It’s difficult to message — you give a two-dose series but the efficacy may not be very strong and they’re looking at data to see how a third dose would be recommended later,” he said, especially since two doses were seen initially as “super effective” with other age groups.

“I just think it will be confusing,” Lakin said.