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As the number of adults in the U.S. who have been vaccinated for COVID-19 continues to increase, children under 16 aren’t authorized to receive COVID-19 vaccines. Children who are 16 and up can receive the Pfizer COVID-19 vaccine, but no one under 18 is eligible for the Moderna and Johnson & Johnson COVID-19 vaccines.

“Trials are ongoing now for pediatric populations,” said Dr. Melanie Swift, co-chair of Mayo Clinic’s COVID-19 Vaccine Allocation and Distribution Work Group. “Children are being vaccinated in studies now and will continue to be. There are several manufacturers that are doing pediatric trials.”

The types of vaccines will be the same as adults, but the difference likely will be in the dose.

“They may need a lower dose because they’re generally smaller,” Swift said. “And they also have reactive immune systems, so they may not need as high a dose as adults to mount a robust response. Sometimes, though, children need more doses of a vaccine in order to develop that first immunity. So, we will see.”

To approve for children under an emergency use authorization, trials need a large number of children to participate. And the trials need to follow at least half of the children for two months or more after their final dose of vaccine.

Swift said it will probably be late summer before a COVID-19 vaccine is authorized for children under 16.

“Children need to be studied separately because they’re not just little adults. They react differently to immune challenges,” she said. “They’ve generally had milder cases of COVID-19, so they may react better to vaccines. But we need to know that we’re giving them the right dose and the right number of doses at the right time for their younger immune systems to benefit the most.”

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