The Daily: When Will Kids Get the Coronavirus Vaccine?

From The New York Times, I’m Michael Barbaro. This is The Daily.

Today. When the U.S. completes its campaign to immunize every eligible American against Covid-19, about 1/4 of the population will remain unvaccinated. My colleague, science reporter Apoorva Mandavilli, on what exactly happens to kids. It’s Friday, February 19.

Apoorva, if you are an adult in the United States, you are starting to see the end of the pandemic on the horizon for yourself, right? A clear timeline has emerged. The summer of 2021, you’re probably going to get vaccinated. But if you are a parent, I feel like there are some burning questions that complicate that timeline about your kids, and so that’s what we want to talk with you about today.

You know, we’ve all been really excited that we have these vaccines, and the focus has been so much on who gets sick and getting to them first — and of course, that’s been older people, frontline workers — that we’ve sort of forgotten to talk openly about the fact that kids need to be vaccinated.

Right.

I think even I, as a parent, didn’t spend that much time thinking about it. But kids make up about 24 percent of the U.S. population —

Wow.

— almost one in four. So even if almost every adult gets vaccinated, that’s still a huge percentage of the population that will not have any protection.

Right, 1/4 of the American population will be not vaccinated at the point at which we all kind of regard vaccinations as having been completed. But remind us why kids are not being vaccinated.

Kids are not being vaccinated because we haven’t tested these vaccines in kids. We don’t know that they are safe or that they’re effective in kids. We’ve mainly tested these vaccines in adults, and we know it works in them. And there’s a pretty good likelihood that they’ll work in kids, but we can’t be sure until we’ve actually done the trials. And the reason we haven’t done those trials yet is because kids just don’t get sick at nearly the same rate as adults do. For the most part, Covid is very mild in kids. Most kids don’t even have any symptoms. And so it’s just not been a priority to get them vaccinated as quickly as possible.

And when you see that kids don’t get sick at the same rate as adults, I wonder if you can quantify that. Because my sense from previous conversations we’ve had with our colleagues on the show is that kids can get sick from Covid. In fact, they can get quite sick. And they do transmit the virus, but they don’t transmit it with quite the same efficiency as adults.

Yeah, you are right. But we should probably first say what we mean by kids because the risk for kids is very different based on whether you’re talking about a nine-year-old versus a 17-year-old. We think that kids under 10 are not very likely to be infected and not very likely to get sick. But as you get closer to the older teens, it starts to look more and more like adulthood. But let’s talk about younger kids. It’s true that most kids don’t really have any symptoms, they don’t get very sick, but that some do develop this very severe condition — immune condition — and some kids do die. We’ve had, overall, about 250 deaths in kids. But compare that to the 500,000 in adults, and it’s a very, very small slice.

Right. And so that kind of crude math is a big reason why we have decided to vaccinate adults first, not children.

Yes, and it’s a very practical reason, too. Because when we think about how we cope with this pandemic, one of the huge issues is the load on hospitals. If we want to make sure that hospitals are not overloaded, if we want to make sure that people aren’t dying just because the doctors can’t get to them all, we have to make sure that we get to the people who get the sickest. And that’s just not kids.

And what about transmission by kids? What’s our latest understanding of that phenomenon?

This is one of those topics that has changed a lot over the course of the year. We started out not really knowing whether kids transmit the virus. It was very clear that they don’t get sick at the same rates, but we didn’t know about the spread. What we think now is that most likely, kids under 10 — so elementary-school-age kids — transmit the virus about half as efficiently as adults do or maybe even less. But that’s a little bit different as you start to move towards middle school or high school age. So older teens, around 15, something happens. There’s a switch of some sort. And now, kids are more likely to transmit, and they start to behave pretty much like adults. We don’t know if some of that is because teenagers just like to hang out with each other. Some of that could just be how they socialize. But it definitely looks like the advantage that we have with low transmission is really only for young kids.

And do we yet understand why young kids are not great at transmitting the virus?

There are a lot of theories, but no, we do not know.

OK. So the essential thing to know about kids — especially younger kids — and the coronavirus is that they are not great spreaders, but they are still spreaders of the virus.

Absolutely.

So given that, how big a deal is it that children are not in line for vaccinations at this moment and that 25 percent of our population, nearly, will be unvaccinated at the end of this vaccination process that’s now underway in the United States?

On a very temporary basis, it’s not a huge deal. But long term, as in by the end of the year or early next year, we do need to have kids vaccinated, because I’m sure you’ve heard Dr. Fauci and everybody else say we need to get to something like 80 percent of the population vaccinated in order to reach herd immunity. That’s that point at which the virus basically runs out of people to infect. But we are not going to get to that 80 percent without kids. As you noted, kids make up 25 percent of the population. So even if every single adult were to get vaccinated, which is looking very unlikely, we will not stop the virus completely until we have stopped it circulating. And until we stop kids from spreading it too, we just won’t reach herd immunity.

I feel like nobody quite explained that to all of us when we started talking about the idea that the country was going to be vaccinated. Am I wrong?

It’s fair. That’s fair to say. I think it’s mainly because so much of the focus was on hospitalization and death. So we really weren’t thinking about kids as much. The goal was just to get to these older people and the high-risk people, get them vaccinated as quickly as possible. Because kids weren’t getting sick, we just weren’t thinking about them quite as much, and so we didn’t make it clear that when we talk about herd immunity, we have to take the kids into account.

OK. So knowing now how important it will be to get children vaccinated in order to achieve herd immunity, what exactly is the plan for getting most children in the United States vaccinated? What is the plan, and what is the timeline?

So there is a plan, and it’s already in motion. Pfizer and Moderna both have clinical trials for their vaccines in kids 12 and older. And we will have answers from those trials probably by the summer. And once we know how the vaccines work in those kids, we’ll also start to test them in kids younger than that. But we won’t know the results for that until probably the fall, which means we won’t actually have the vaccines in hand and get them into kids until the end of the year.

So we’re talking about five or six or so months after all adults who are eligible get vaccinated before children will really get vaccinated?

That’s right, and that’s if everything goes well. If we hit a few snags, there are a few production problems, it probably can go on until early next year sometime.

But then the question becomes, if these vaccines are approved for children, will parents let their kids get the vaccines?

Yeah, that’s a very, very big question. Because as we’ve been saying, kids don’t get very sick. So what is the incentive for a parent to opt for the vaccine? I can see a lot of parents saying, my kid’s not going to get very sick. Why should I even take the chance of side effects with a vaccine if Covid is actually less of a problem? The answer to that, of course, is that kids do keep transmitting the virus. And if we want to see the end of this pandemic, we do have to have the kids vaccinated. But at an individual level, knowing how hard it is to get all parents to vaccinate even for things like measles, this may be a challenge.

We’ll be right back.

Apoorva, it feels like what you just described is a form of parental vaccine hesitancy. I don’t know if it’s called that, but it sounds like you anticipate — and the people that you talk to in public health anticipate — that this is going to be a problem, given the unique situation we face where children don’t get very sick. They’re not even that great at transmitting it, and the side effects from these vaccines could be meaningful.

So I think what this does is it puts the onus on the companies to show that these vaccines are so safe, and so free of side effects, that it’s really not a big deal to get them.

And by all accounts, is that what the clinical trials are showing so far?

The trials have barely begun, so we don’t know. We’re just going to have to wait and see.

I’m going to boldly ask you. You’re a parent.

I am.

Are you going to vaccinate your children?

Absolutely. I believe in science. I’m a science journalist. So yeah, I’m skeptical of companies, lots of things that companies do. I ask tough questions about what they do, and I ask tough questions of the government. But on these vaccines, I have no doubt that they are safe, they are effective, and they are what we need to get out of this pandemic. So yes, the second those vaccines are available for my kids, I’m going to take them.

OK. So knowing that this hesitancy is real and that a meaningful gap period will exist between when parents and adults are vaccinated, let’s talk about the world that’s going to exist when adults do have the vaccinations and their kids don’t. And I wonder if we should start with schools. What will it mean for the reopening of schools?

Schools should reopen this fall, whether kids are vaccinated or not, because we already know that kids are not the ones who are at highest risk in these schools. The risk is to the adults. And teachers will have had their vaccines. The staff will have had their vaccines. And hopefully, all the people who are vulnerable in their homes will have had vaccines. And the C.D.C. said last week that even vaccinating teachers is a priority, but it shouldn’t be a prerequisite. So we should really be planning to reopen schools by the fall, if not sooner.

But can teachers still theoretically come into contact with kids who have the virus and become carriers themselves? Because there’s no evidence that vaccines prevent you from carrying the virus.

There’s very much that possibility, so I’m going to say something that is going to be very unpopular. Everyone is still going to need to wear masks for quite a while longer. So teachers will need to wear masks in school. They can be a little bit less worried about getting sick or dying, but they cannot be confident that they won’t give it to somebody else. So they should really be wearing masks and so should the kids.

Interesting. So masks will continue to be a major part of our lives, in part because we’re dealing with this gap between adults and children in vaccinations?

It’s in part because of the gap, but let’s also remember that not every adult is going to be vaccinated. There will be people who don’t want to get the vaccine. There will be some people who can’t get the vaccine, for whatever reason. So there will be other people who are susceptible and whom we need to protect. So we will need to wear masks until we’re at herd immunity, and then we might be able to stop wearing masks.

I want to present you another scenario. A vaccinated adult wants to start traveling again, wants to get on a plane, wants to take their unvaccinated children on that plane — maybe even, say, travel internationally, once global travel restrictions ease. And of course, they will be allowed, we think, to do that. But should they think about not doing that? Is it unwise?

I don’t know if they’ll be allowed to do that, to be honest. I think the adults will be. I’m not sure that the kids will be until they’re vaccinated.

Interesting. You imagine that rules may soon be in place that will only allow for vaccinated people to fly?

I think that’s highly likely. We already have rules forbidding people from coming into the country unless they can show that they have a negative test. We don’t even accept vaccination as proof. We want them to show that they actually are free of the virus, and that’s because of that little loophole where even if you’re vaccinated, you can still transmit. So I don’t even think, even if it’s allowed, that it’s a good idea for parents to take their kids to, I don’t know, Morrocco. I say that because I was supposed to go there last year. But yeah, Morrocco could be crawling with all kinds of variants of the virus that my kids are not immune to and maybe I’m not even immune to.

So the real danger is not just that, for example, kids might transmit the virus on the plane or catch the virus on the plane. It’s that anyone on that trip, including the vaccinated adult, might contract a variant of the virus, bring it back to the U.S., and cause even more trouble.

Especially true of kids. But yes, it could happen to anybody.

OK, a final scenario — grandparents, quite likely to be vaccinated in the next few months, very likely to want to see their unvaccinated grandchildren. And I suspect the inclination will be, I’m vaccinated. What’s the worst thing that happens? I might carry the virus, but I’m not going to get very sick from it. Is that the right calculation?

I don’t know if it’s the right calculation, but it’ll be the one that most people make. I think a lot of people will hug their grandkids without masks on. But I would say, ideally, maybe hug them and then put the mask on right away because —

Why?

— there will still be a risk that someone who’s older who’s vaccinated might get infected. And yes, these vaccines are amazing at protecting people. But if that older person has some other health conditions or is particularly weak in some way, it’s better not to take the risk of even giving them the virus at all.

Right. And 90 percent, which I believe is the most effective version of these vaccines so far, is not 100 percent. It means that one out of every 10 people could still get sick.

That’s right, and so there are no guarantees. Having said that, I fully understand why so many people will actually hug others and be close to others without wearing masks because I know everyone misses that. I know I miss that. But I think as much as possible, if we can put those masks back on as soon as we can after getting that personal touch, that would be the safest.

We are having this conversation with you at a moment of general optimism about the course of the pandemic because infection rates have been plunging over the past few weeks from a high — I just looked it up — of 300,000 a day on January 8 to under 65,000 a few days ago. I know that number may fluctuate. So it feels like the pandemic is, at the moment, starting to feel more under control, despite the variants that have entered the United States. And so how much of a factor is that, as you think about the risks involved and having children be unvaccinated?

I don’t want to puncture anyone’s optimism here. I think it is great that these numbers are falling. But the best explanation we have for why these numbers are falling not just in the U.S., but all over the world, is that over the winter, when the cases were horribly high everywhere, governments and individuals started to put precautions back into place. So if the numbers are falling now, it’s because we’ve done all the right things. And the worst thing we can do is celebrate too soon and stop doing them because the numbers will come back up if that’s the case. You mentioned variants, and that’s a very big wildcard here. We saw in the U.K. that B117, this variant that was circulating there, went from almost nothing in September to being everywhere in the country by December. And scientists are predicting the same thing will happen here. By mid-March or late March, B117 will be the dominant form of the virus in the United States. So depending on how that goes, depending on how careful we are, depending on how conservative political leaders are in lifting restrictions, we could and we probably will see an increase in cases again. And the other thing that we should remember is a lot of the most susceptible people in the population will be vaccinated. So we may see a big rise in cases, but not necessarily a big rise in hospitalizations or deaths.

You’re describing potentially a new wave.

Potentially.

And this prospect of a fourth wave would seem to bring even more urgency to the mission of vaccinating everyone in the United States, not just adults, but children. Because as you said, herd immunity is, ultimately, the only real answer.

Well, we are not going to be vaccinating kids by the spring, which is really when we’ll see this wave. So we can’t prevent it, and we won’t have enough vaccinations, even in adults, to really stop it, probably. But what we can do is really minimize it. We are not powerless here. We have a lot of agency. There are a lot of things we can do, that we know to do — wash our hands, wear masks, social distancing. We know exactly what works. We’ve been talking about how this is going to be probably over by the end of the year, so it’s just a matter of holding on for just a while longer.

Thank you, Apoorva. We appreciate it.

It’s been a pleasure. Thanks for having me.

On Thursday, the federal government released new data showing that because of the pandemic, life expectancy in the United States has fallen by a full year, the largest drop since World War II. In the first six months of 2020, the expected lifespan of an American fell from 78.8 years to 77.8 years. In a sign of the disproportionate impact of the virus on people of color, the data showed that the decline in life expectancy was even deeper among Black Americans, falling 2.7 years.

We’ll be right back.

Here’s what else you need to know today.

On Thursday, congressional allies of President Biden introduced his plan to overhaul the immigration system.

The centerpiece of the legislation is an eight-year path to citizenship for most of the 11 million undocumented immigrants living in the United States as of January 1. If adopted, the measure would represent the most far-reaching changes in immigration law in more than 30 years. And —

NASA has landed a new robotic rover on Mars, its most ambitious effort in decades to directly study whether there was ever life on the Red Planet.

The rover named Perseverance will explore a crater that was once filled with water. NASA scientists believe that the piles of sediments there could contain remnants of ancient Martian microbes.

Today’s episode was produced by Alexandra Leigh Young with help from Austin Mitchell. It was edited by M.J. Davis Lin, Paige Cowett and Lisa Chow and engineered by Chris Wood.

That’s it for The Daily. I’m Michael Barbaro. See you on Monday.