We are the parents, caregivers, and loved ones of children under 5, and we urgently ask you to make life-saving COVID-19 vaccines accessible to this age group. Many of us have children too young to remember a life before the pandemic. We have birthed babies, raised newborns, and cared for toddlers and preschoolers, all while striving for the impossible balance between our children’s physical and emotional well-being. 

For nearly two years, countless parents have lived with the dread and fatigue of every decision: Can my family hold my baby? Is daycare or preschool safe? What are the long-term emotional and developmental consequences of denying my child playdates and family holidays? What is the impact of intense and abiding isolation for the whole family? As the author of a recent Time magazine piece wrote, “The stress of playing Russian roulette with our children’s lives—or refusing to, keeping them home as much as possible—is crushing.” 

COVID-19 is hurting our children

COVID-19 is a serious issue for children, currently igniting record hospitalizations for kids under 5. Approximately 1,000 kids have already died from the virus in the US, 250 of them under 5 years old, and thousands have been hospitalized for severe illness. Among these complications is the life-threatening multisystem inflammatory syndrome in children (MIS-C), whose frequency we know from recent studies could be reduced with vaccination. 

Long COVID, which can have debilitating neurocognitive and physical effects, is still being studied and may be common in children." COVID-19 has also been associated with the development of Type 1 Diabetes. Our children have their entire futures ahead of them; they deserve the chance to live to their fullest potential, without lifelong health conditions to navigate. They deserve to be protected.   

As Omicron devastates the nation, we are continuously advised that the best defense is vaccination and the next best step is to wear a mask. Yet neither of these options are possible for our youngest children. They still don’t have access to these life-saving vaccines, and we have also been advised that it is not safe for children under 2 to wear masks, making them even more susceptible.

Our doctors are telling us that the science is there to safely vaccinate children under 5, but there is procedural red tape that is delaying access, and with devastating consequences. The number of children infected with Omicron is already soaring; as they re-enter daycare centers, preschools, and other unavoidable group settings, cases will continue to rise exponentially. Without quick action, this situation will develop into the largest health risk that kids have faced collectively throughout the entire pandemic.

Make vaccines safely accessible to children

Following the lead of doctors and medical researchers, we suggest implementing the following two solutions in tandem to make it possible for our youngest children to receive vaccines:

Solution #1

Allow physicians and parents the option of joint decision making to immunize children with the Pfizer 10ug vaccine off-label. 

This is an especially critical option for kids who are at a very high risk of severe disease. Opponents to this approach may argue its risk, but we believe the safety of this vaccine has already been vehemently proven.  In the US alone, the Pfizer vaccine has already been given to 8 million children aged 5-11, with a resulting safety profile that is both robust and astonishingly positive. Moreover, 9 billion doses of mRNA vaccines have been administered worldwide, with their safety scrutinized more than any vaccine in history. There is no other vaccine that has been so widely distributed and studied before being de-escalated for administration to children. Let parents work with their pediatricians to make the best and safest decisions for their families.

Solution #2

Remove the age de-escalation barrier to vaccine approval.

The de-escalation requirement is understandable in regular trials, but unacceptable during a raging pandemic. Removing this red tape would allow approval for the 3ug dose for children aged 6 mo-2 years, which the Pfizer trials found to be safe and effective. Delaying distribution and administration to babies and toddlers simply because of procedure is morally unacceptable in light of our current circumstances. 

The two aforementioned courses of action would be the quickest ways for our children to safely gain access to these life-saving vaccines, but they may not be the only options available. In November, Novavax submitted favorable data to the FDA that could provide yet another route toward providing safety to our children. We urge the FDA to investigate and implement alternative options as soon as safely possible, including issuing an emergency use authorization for the Moderna vaccine for children 6mo-6 years as soon as it is shown to be safe and effective. 

The bottom line is this: There are ways to protect our children, but the FDA needs to act urgently to make it happen.

We need urgent action

Throughout this pandemic, our children have paid the price of society’s choices. Many of them have yet to meet grandparents, cousins, and other beloved friends and family members, all while missing out on critical educational and developmental experiences. Moreover, children in low-income families and communities of color have already disproportionately suffered the impacts of COVID-19. The longer they wait for access to vaccines, the more likely they will struggle with repercussions for years to come.  

At this point in the pandemic, every hospitalization, medical complication, death, and case of long COVID or MIS-C occurring in a child under 5 due to COVID-19 is a travesty that could have been prevented. Mere hope is not an acceptable strategy when we already have the medical knowledge and technology to protect them. As a country, we have not yet utilized all of our resources to make their protection an absolute priority. This must change immediately. We implore you–please don’t make us wait any longer to protect them. It is time that we put our kids first.