Transcription:

Deborah Howell (Host):  You know, there's so much information and misinformation going around about the COVID-19 vaccines, it's hard to know what to believe, especially when it comes to our kids. To talk about COVID-19 vaccines and pediatrics, today we're joined by Dr. Katie Hryniewicz, also known as Dr. Katie, a Pediatrician at Palouse Pediatrics, part of the Pullman Regional Hospital Clinic Network. Dr. Katie, that's what you like to be called? Right?

Katie Hryniewicz, MD (Guest): Yes absolutely. That's what all of my patients call me.

Host: What a total pleasure to have you with us today.

Dr. Hryniewicz: Yeah. I'm glad to be here.

Host: So, what's the current status and timeline for COVID vaccines in the pediatric population?

Dr. Hryniewicz: Yeah. So, we're at a really kind of exciting time in that timeline because finally, some of my patients are eligible and vaccine is getting a little bit more easy to come by. So, currently Moderna and Johnson and Johnson's vaccines are only approved for 18 and older. So, none of my patients, none of the pediatric patients are able to get those, but Pfizer's vaccine has approval down to 16 plus.

And so if you are 16 and older in the US, you are now eligible to get vaccinated. The timeline in younger populations is also kind of exciting because Pfizer also released in the last few weeks, their data in the 11 to 15 year age range and both the efficacy and the safety data look excellent. So, they've now applied for an extension of the FDA emergency use authorization into that age range. And I'm hoping that in the near future, by summer and before the fall school year, that those middle school aged kids will also be able to get vaccinated.

Host: Oh, wouldn't that be good. Now, which age groups of children are currently eligible to get the COVID vaccine?

Dr. Hryniewicz: So, currently that would be age 16 and up with the hope that very soon, that would be down to that 11 to 15 year age range.

Host: When do you think younger kids will likely be able to get vaccinated?

Dr. Hryniewicz: That's an excellent question. It's still up in the air. I am hoping that those less than 11, so probably in that five to 11 year age range that we might have data by late fall of 2021 or very early 2022. Time will tell, but really hoping that we'll have some ability to vaccinate those younger kids by that point.

Host: Just wondering Dr. Katie, why does it take longer to get approval for younger ages? Are there roadblocks?

Dr. Hryniewicz: Yeah. So, there's a couple things. So, we always start trials in the population that's most at risk. So, having the highest burden of illness and hospitalization and death, and we almost always start in adults and with this disease that is adults that are experiencing that highest burden. So, we started it in adults. And once we got that adult data, then we have to get kid data, because kids, they're just, they're not little adults. They have different immune systems, they respond differently. So, they need their own dedicated study. And what that requires is what's called age de-escalation trials. They start with adolescents that are closest to the physiology in adults, and then they kind of slowly work their way down. And often this means trialing different doses to ensure that we have the right dose, you know, for maximum benefit and least amount of side effects. So, that just takes time. The other thing is that pediatric trials, all pediatric trials, not just this COVID vaccine, it takes a long time to enroll trial participants in kids. People are just more hesitant to enroll kids in trials. So, even just getting the trial fully enrolled takes time.

Host: Understandable. What would you say about trials to, to any parents listening right now?

Dr. Hryniewicz: Yeah, so I think the thing that is, by the time we get to the pediatric trials, we have really good robust safety data in adults. And so at this point, then they're more looking at kind of what the efficacy looks like, what the side effects, you know, kind of the initial side effect profile looks like in kids and how their immune system responds. So, by the time we get to pediatric trials, it's pretty safe. I would enroll one of my kids in a trial, but we don't have any nearby.

Host: Right. So, do kids have different side effects than adults?

Dr. Hryniewicz: Often they have very similar side effects. They may just have more robust side effects because they have pretty exuberant little immune systems. And so that's why we just have to make sure that we're dosing it appropriately. Sometimes that means a smaller dose than in adults and things like that.

Host: Why is it important to study and get approval to vaccinate children and teens against COVID?

Dr. Hryniewicz: Yeah, that's and that's a question I hear all the time and I hear that all the time from parents in clinic, you know, kids are a overall lower risk population when it comes to COVID-19. But even though a large portion of our kids are lower risk, we have many medically fragile kids that are not low risk. And even in our healthy children, there can be more severe outcomes, like MIS-C, we're also learning a lot more over time, what those long-term effects of even mild or asymptomatic COVID infections are on kids' growing bodies. So, I think from that standpoint, just from a personal safety standpoint, it's important to be able to offer them vaccines.

But also there's 74 million children in the US, that's about 24% of our population. And if we're assuming that to get back to some sense of normalcy and get kids back to some sense of normalcy and wanting to hit that kind of herd immunity threshold that we hear people talk about, kids are, it's clearly, that clear that kids are going to be part of that equation.

Host: Sure. And do most teachers have access to vaccines at this point?

Dr. Hryniewicz: Yes, that is a great thing that we have finally gotten to the point that once it was kind of mandated by the president that teachers and educators and early childhood educators are able to get vaccinated, we are now at the point where all of those people are at you know, far enough out, that they've been offered vaccine and had that available to them.

Host: Awesome, well deserved. Here's the hundred thousand dollar question. Is the COVID vaccine safe?

Dr. Hryniewicz: Yes. So, my short answer is yes. I very much believe that this is a safe vaccine. I could get into, you know, you mentioned there's lots of misinformation and information in general, floating around about this vaccine. And I could get into all the minutiae of the safety, but I think the big thing is that this vaccine, even though the development felt rapid, went through full clinical trials, the normal steps, they did not skip any safety steps. It had independent reviewers, and it's has really robust, ongoing monitoring as well, through different modalities. You know, they have people signing up for V-Safe.

They have ongoing studies. Some of my colleagues, who were vaccinated very early on as healthcare workers, you know, a few of them were pregnant and they had personal phone calls multiple times from   the CDC to review things. So, there's a lot of extensive monitoring that's going on. And at this point, 140 million people in the US alone have received at least one dose of these vaccines. So it's a lot of people and serious side effects have been really rare.

Host: That's all good news. Now what's going to protect our kids in the meantime, while awaiting their ability to be vaccinated.

Dr. Hryniewicz: Yes. So, what I tell people, because I've had some parents say, when I tell them this may be early 2022, that their young kids are able to be vaccinated. People go what? That's too long. What I tell them is the absolute best way that we can protect our kids and our more vulnerable populations and help get lives back to normal is getting as many of the rest of us vaccinated that can, you know, those people who are eligible. So, getting parents, grandparents, teachers, childcare providers, coaches, everyone around our kids vaccinated. We pediatricians call this cocooning. And it's a concept we use in newborns, with getting caregivers, influenza or TDAP vaccines to protect newborns. So, this is something we're used to, but I think those are things that will get our overall prevalence down, which will protect children in the meantime.

Host: What about kids that have special needs? Is there any pathway for them to get a vaccine earlier than their friends?

Dr. Hryniewicz: Some of them in the older age ranges. So, we can't, we are unable to get those younger ones vaccinated any earlier, just until those studies happen. But prior to everything opening up to everybody, there is kind of earlier pathways for those 16 plus year old kids to get vaccinated.

Host: Got it. Well, Dr. Katie, you have all the answers and we so appreciate your time and everything you do. Thanks so much for being with us today.

Dr. Hryniewicz: Yeah, of course.

Host: Godspeed to you and all your kids and all your patients.

Dr. Hryniewicz: Thank you.

Host: For more information, as well as more podcast episodes and learn more at pullmanregional.org. This has been the Health Podcast from Pullman Regional. I'm your host, Deborah Howell. Thanks for listening and have yourself a terrific day.