Clinically Speaking: October COVID-19 Vaccine Update

The latest Clinically Speaking COVID-19 update focuses on the pediatric population, as well news about booster shots and a promising new medication.

COVID-19 in Children

From the onset of the pandemic to the end of September, more than 5.7 million children under age 18 tested positive for COVID-19, representing 16% of total U.S. cases. However, children now account for 22% of active cases.

Some good news is that severe illness resulting from COVID-19 appears to be uncommon among children, and hospitalization is extremely rare, at less than 0.2% of cases. Yet, there is still a lot we don’t know about the longer-term physical, emotional and psychological effects of the virus. The medical community will continue to track those effects.

Even better news is that Pfizer has formally requested emergency use authorization for its vaccine for children ages 5-11, and an FDA committee is meeting to review the request at the end of this month. Children in this age group would require two doses administered at least 21 days apart, each containing about one-third of the adult dosage. With Moderna actively in trials, we expect them to announce recommendations for use of their vaccine in children as well. 

In Pfizer’s trials, their vaccine demonstrated a robust neutralizing antibody response to prevent serious disease with no increased occurrence of side effects beyond what we’ve observed in young adult populations. Federal regulators have approved expanding trials for the Moderna and Pfizer shots for the purpose of identifying rarer side effects.

Pfizer is also studying the efficacy and side effects of its vaccine in children ages 6 months to 5 years. We expect those results to be available later this year. 

And importantly, based on findings from research into the vaccine’s effectiveness in protecting the newborn and the unborn, experts recommend and encourage COVID-19 vaccination for women who are pregnant or breastfeeding. Mothers can provide immunity, not only for themselves, but also for the tiniest of lives. Studies have shown that COVID antibodies are passed through the placenta in pregnant women and in breast milk in nursing mothers.

This is critical, as only 31% of pregnant woman in the U.S. have been vaccinated, while pregnant woman with symptoms of COVID-19 have a higher risk of admission into intensive care and a 70% increased risk of death

COVID-19 Vaccine Booster Shots

We continue to see a lot in the news about vaccine “boosters” for vaccinated adults.

The nation’s top health officials recommend a third dose of the Pfizer vaccine at least six months after the second shot of the initial vaccine series, at this time only for specific populations: Adults ages 65 and older; individuals ages 18-64 who are immunocompromised, because of their higher risk for severe cases of COVID-19; and individuals at high risk of exposure due to their occupations, including health care workers, airline employees and teachers, among others.

Recently, Johnson and & Johnson requested FDA approval for their COVID-19 booster. We anticipate that Moderna will soon announce their recommendation for boosters.

There have been questions as to whether you can get a Pfizer vaccine booster if you initially received the Moderna or Johnson & Johnson vaccines. As no data is available about the effect of mixing vaccines, we encourage everyone to wait for formal recommendations from the experts. 

A Promising New Medication: The Merck Pill

Lastly, as you may have heard, Merck announced on Oct. 1 that its new pill to treat COVID-19 reduced the risk of hospitalization and death by about 50% in clinical trials. Merck plans to seek emergency authorization for the antiviral medication – known as molnupiravir – for use in the U.S.

The pill is designed to be taken as soon as possible after a person shows symptoms – when the virus is replicating rapidly and the immune system has not yet mounted a defense. Early trials of this medication demonstrate a 50% reduced risk of hospitalization or death.  

The FDA could authorize the medication for use as early as the end of this year. We will continue to follow guidance from the nation’s top health officials regarding availability and prescribing.

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