(film reel clattering) - Welcome to today's news briefing co-hosted by Ethnic Media Services and Vaccinate All 58 with the California Department of Public Health.

I'm Sandy Close, EMS director, and today's moderator.

Today our news briefing explores what parents and caregivers need to know about vaccinating California's youngest kids, especially those age 6 months to 4 years against COVID-19.

The U.S. Food and Drug Administration authorized emergency use of two COVID-19 vaccines made by Moderna and Pfizer BioNTech for children 6 months to 4 years old.

Vaccination is an important tool to protect their long-term health against COVID-19 and helps achieve full family protection against this deadly virus.

The approval comes on the heals of news that COVID-19 is now the fifth leading cause of death in children 1-to-4 years old and the fourth leading cause of death in children younger than 1.

Sobering statistics for all of us.

Our speakers include Dr. Lucia Abascal with the California Department of Public Health.

So, we begin.

Welcome, Dr. Lucia Abascal.

Thank you!

- Hi, good morning.

Thank you, Sandy for that introduction.

I'm very happy to be with all of you.

As Sandy mentioned, I am with the California Department of Public Health.

I also work at UCSF as a global health researcher focusing on vaccine uptake.

And, my 19 month old daughter just got COVID two weeks ago!

(chuckles) I've been waiting for two-- I mean, I was pregnant when the pandemic started.

I've been waiting for the vaccine all this time and she tested positive, but I guess that's how these things are!

In our case, she did transmit the virus both to my husband and I, and I am 32 weeks pregnant!

(chuckles) So, that was, I mean, I was being extra careful myself but well, just like a heads up of the situation we're living right now.

We've seen an increase in cases in California.

I mean, globally, but in California seems to be-- get flattening out, but we are still seeing in some spaces a lot of cases.

This is due to the highly contagious omicron subvariants that have been circulating.

So, there is definitely still a need for vaccinations for the whole population.

But, now we have a new population that has a vaccine available for them.

This is very important.

There's this idea that omicron is milder.

But, if we look at children data in this age group, we can actually see that hospitalizations peaked the record in January, February when the omicron surge started for this group as well as deaths.

So, definitely there is a need to vaccinate young kids.

The misconception that kids are safe, that nothing happens to kids is wrong.

We have more and more evidence that kids are at an acute risk of being hospitalized for COVID.

We've definitely seen some deaths.

Kids can also suffer from, like, midterm consequences such as multi-inflammatory syndrome in children and long COVID has also been reported in kids.

So, there's definitely a need to protect these young kids.

We also know that even though people can get COVID vaccinated as we've seen in adults, you can also get them in children but protection for severe disease is there.

And, that's what we saw with the FDA's authorization.

So, just going over a little bit of what the steps for the approval were.

We had an independent expert panel that went over the data that both Moderna and Pfizer submitted.

They are expert in these topics.

They're not government workers.

So, that's why it's called an independent panel.

They went over the data and they all voted unanimously.

They all voted to recommend that the FDA approve the vaccine.

After that, we had a big FDA meeting where they went over everything that is public data.

You can go over the slides that were presented.

You can go over the data.

This is to create trust, to create transparency.

Similarly to the independent panel, they all approved the vaccine.

Why?

Because the vaccine was shown to be effective.

The efficacy numbers we were shown in that meeting, even though weren't as high as what we saw when the adult vaccine was approved two years ago.

Well, no.

Sorry!

Like, one year ago for the adult's vaccine.

We did see efficacy that was expected with the subvariants that are circulating now, right?

So, we know that the vaccine works.

And, another thing that was presented was the safety profile of both vaccines.

And, we were shown that both vaccines were safe.

Okay?

So, after the FDA approved this then the decision jumps to the CDC.

Right?

So, the CDC then makes a public health recommendations from the federal level to states and they approved it, as well.

Now, going down to California.

So, I just wanted to show you all the steps that go into the approval of the vaccines.

So then, that when the CDC makes the recommendation, approves the vaccine, California goes over the data.

And, as with the neighboring states, they decided that it was the best for children in California to get the vaccine.

So, what is going to happen with the deployment of the vaccines in the states?

We knew this was happening.

We weren't sure when, but California knew this was happening.

So, while back, the state started working directly with pediatricians, for them to get enrolled in a program to receive the doses they might need.

So, with this program, the state enrolled a lot of pediatricians that actually cover around 85% of the state's children.

It gets a little bit tricky with younger children.

Why?

Because adults can get a COVID vaccine at the pharmacy, right?

But, federal regulations don't allow pharmacies to vaccinate children under 3.

So, we have in this population, a small group that will be able to be vaccinated at the pharmacy but we have the bigger group between 6 months and 3 years that will need to go either directly to their pediatrician or small community clinics that will be set up depending on the county where children live.

So, it will be very important that parents reach out to their care providers for this because we don't have either the mass vaccination sites and we don't have this big access with pharmacies.

The state has purchased enough vaccines for every children in California, and they will start coming in batches.

So, by this week we're expected to receive around half a million vaccines which will start vaccinating children.

So, we are expectant.

We haven't seen the uptake in older kids that we would want to see.

There's a lot of work to do informing parents, really getting them to understand the need that exists for this vaccine.

So, that's very important.

In terms of what vaccines will be offered, this will also be different to what we've seen with older groups of children.

Why?

Because both Moderna and Pfizer will be available for children since the beginning.

What will be different?

So, this can also be tricky and confusing to parents but we have two vaccines, both Moderna and Pfizer.

The Moderna is a two-dose, just like adults.

The first vaccination schedule is two doses with a month in the middle.

Then, we have the Pfizer.

So, Pfizer is actually three smaller doses.

And, that's why the Pfizer data took a little bit longer to come in.

So, what is a timing for those vaccines?

So, for Moderna, we have the first dose then a month, and then the second dose.

So, we would expect children to be "fully vaccinated" two weeks after their second dose.

That is compared to Pfizer which will take a little bit longer.

We'll have the first dose then 21 days later, children can get their second dose, and then 60 days later, children can get their third dose.

So, this schedule of vaccination might take not might, but takes longer than the Moderna.

So, some parents might prefer to go with a faster effectiveness compared to those slower one.

But, why is this?

Moderna uses a bit of a stronger dose.

So, the Moderna vaccines are one-fourth of the adult dose.

The Pfizer vaccines are one-tenth.

So, you can see how Moderna is a higher dose than the Pfizer.

Both are very safe but a little bit of, like, stronger side-- immediate side effects were seen with the Moderna.

What do I mean with that?

Children presented a little bit more fever and a little bit more irritability after the Moderna vaccines than the Pfizer.

Just want to make clear that these were minor, treated at home and disappeared after two days.

So, both safety profiles are very good, very positive.

We did not see any, like, severe effects in the children but we have to remember that most of the rare side effects, we see once we've vaccinated millions of children.

So, we still have to wait and see and we're definitely going to follow up on side effects that children can develop.

So, those are the two vaccines that have been approved for this age group in California.

- Can I interrupt you just quickly?

A question in the chat.

You said 16 or 60 days?

- 60.

- That's-?

- Two months.

- I just wanna emphasize that for interpreters.

Thank you.

- Yes.

Sorry.

So, just in terms of California, we're looking at 2.2 million children that will be eligible to receive this vaccine.

So, definitely a very, very big state with a very big group of eligible children.

- Now go ahead, please.

- No, no.

We can go with questions and that way I can just answer them.

- Well, a couple of questions before we go to the chat.

How did your child do with COVID?

How serious a case was it?

And, would you-- there is a question of if your child does have COVID how long do you need to wait before you get vaccinated?

The vaccination for the child?

- Yes.

So, my daughter actually was fine.

I mean, she did have a fever for three days.

She's a very healthy child.

So, that was surprising.

She was tired.

I think the hardest part was staying inside with her.

We continued to test positive up to, like, 10 days!

So, definitely being inside!

Both of us, both parents were sick.

We were fine also, but just like-- all you want to do is watch TV and rest, but you have a one-and-a-half-year old that just wants to do the opposite!

So, that for us was the toughest.

I mean, also for me, I am in my third trimester of my pregnancy.

So, also managing that closely with my doctors to see if I should take medication or not.

But, thankfully, I was also fine.

And my-- the son I'm expecting is also fine.

So, we're all doing great.

But, I think actually my daughter was the one that had it the toughest.

My husband and I did never get a fever.

'Cause we're both vaccinated and boosted.

So, definitely a need there.

In terms of waiting for the vaccine, there is no-- so at the beginning of the vaccine rollout, everybody said, if you just got COVID, wait.

This was more of a supply issue, right?

So, we know that even though natural immunity is not as good as the vaccine immunity, it exists.

Right?

So we, at the beginning of the vaccine rollout a while back, we did not have enough vaccines to serve everybody we wanted to vaccinate.

So, there was this idea that people that had just recently gotten COVID could wait a little bit to get their vaccine.

Now, we have enough supply for everybody.

So, people can get vaccinated immediately after having COVID, once they end their isolation period.

There's no side effects.

There's no issue with doing that.

I'm getting my daughter vaccinated as soon as possible.

And, I'm not waiting.

- You mentioned that the vaccines are now available.

Could you tell us if it is your recommendation that if people don't have a medical provider to go to, that they could visit myturn.ca.gov.

Could you give us a little information about that?

- Yes.

So, our first recommendation for parents that have access to a pediatrician or have worked with pediatricians before is to go that route, but definitely using myturn.ca.gov also works for parents and they can also find their kids' vaccines that way.

- And, another question that has been texted to me is if the symptoms are mild in young kids and what is the point of vaccinating them?

Why expose them to possible side effects?

What is your best argument on that, Dr. Abascal?

- Well, first, I would ask them to define "mild", right?

I mean, I definitely say that my child got a mild infection.

She was still in bed three days with a fever, which is I think more than I would expect after the vaccine.

She also transmitted the disease to me and to my husband.

Right?

So, I mean, that's a risk I did not want to take.

We have a lot of families.

I am Mexican.

And, in our community we have a lot of multigenerational families.

So, this time, my daughter infected both healthy adults but there's a lot of grandparents that also live with children, right?

And, that's another risk we have to consider because vaccines serve different functions.

The first one is to protect oneself, right?

So, even if it's not a perfect protection, there's protection against getting infected.

So, you do slash that out.

We actually saw that with Moderna with the vaccine in this case; that's around 30% to 50% reduced infection.

With Pfizer, their reported data is up to 80% after the third dose.

So, there's definitely a smaller probability of getting infected, right?

So, that's the first step.

Then if we do get infected, which could definitely happen, we have a way, way lower probability of ending in the hospital.

If we end up in the hospital, a lower probability of ending in the ICU.

We end up in the ICU, a lower probability of death.

So, we see benefits in all of the steps of the disease, right?

So, it protects oneself.

It protects others in our household.

It protects others in our community, right?

My daughter got infected at daycare, right?

So, we have there a cluster of children and this is happening in their households, as well.

I know that other parents in my daughter's classroom also got infected, right?

So, if we slash the probability of children getting sick, we slash the probability of these clusters happening.

And then, lastly, we have the global idea, right?

So, if more people have immunity because of vaccines, we make COVID cases less explosive.

We also-- subvariants.

We also fight against emergence of new variants that happen because the virus is not pressured by the immune system.

So, we do see a lot of benefits of infecting-- of "vaccinating"- sorry- children, but everybody as well.

Also, we know that even children with mild infections, even children with asymptomatic infections are at risk of developing multi-inflammatory system syndrome in children.

That's a disease that can make them go to the hospital.

All of their body, all of their organs get inflamed because of an exaggerating immune response.

And, similarly, children with mild infections can also have long COVID.

We have, even if it's not great data, and we have seen very different numbers.

We have seen evidence that vaccines do reduce the risk of long COVID.

So, definitely even if it's a mild case, we should vaccinate.

And then, in terms of reinfection, we've seen that vaccines hold up way better against new variants and subvariants than natural immunity.

Even though the body does create immunity after being exposed to COVID, this is very dependent on the person's immune system but vaccines create a stronger and better immune response that can protect against different variants.

And, this is something we don't see as strong as with natural immunity, and a mild case can have a mild immune response.

So, even if your child has a mild case, vaccines will build up the better response.

Actually, Moderna did show the data comparing natural immunity and vaccination.

We saw that vaccination did create a bigger immune response.

And then, they compared that to children that had been previously infected and gotten a vaccine, and children that had been previously infected and got the vaccine, were actually the most protected group.

This is not surprising.

This has been reported as hybrid immunity and has been widely reported.

And, it's a very, like, big case for vaccinated children that have had COVID before.

And, I think I'm even excited (laughs) that my daughter will now get the vaccine because she'll have these, like, super strong antibodies!

- Right.

Two questions quickly from the chat.

Myocarditis, you referenced myocarditis.

Could you just say one or two sentences about the very low risk of myocarditis, which leave-- and what the trials with the vaccines demonstrated for the youngest kids?

- Yes.

What was seen on the trials.

There were no cases of myocarditis reported.

This is good, but is expected, given that myocarditis shows up when we vaccinate a lot of children.

What we've seen, what has emerged in population-based studies, not only in the U.S., but worldwide is that myocarditis affects older children, right?

So, from 16 and up, and it seems to be mixture of hormones and the vaccine.

So, it's really not a risk expected in this population but we have to wait and see what the followup as we ramp up vaccination is.

- Thank you.

And then, (reads) "can my child receive the COVID-19 vaccine and other vaccines on the same day?"

- Yes, they can get vaccinated.

There's no interference.

- Alia Lee asks, and this again goes to the choice between Moderna and Pfizer.

(reads the chat) "My child is 18 months old.

"Is there a preference depending on age for three doses versus two doses?"

Or, does it come down to whatever is available, Dr. Abascal?

- I think what is available will be the best.

Just to add something on the Moderna vaccine.

We also expect that to have a booster just as we we've had with other vaccines.

So, eventually that will also be three doses, even if it takes a little bit longer.

That's what it looks like.

So, I think it, it really depends on what's available.

And what kind of, like, do you want-- if you have both options, like, do you prefer to wait but get maybe lower, immediate side effects even though we don't expect anything severe from any?

Or, just get Moderna?

I think I have Moderna available at my pediatrician's office as well.

And, I think I'm going to do that with my daughter just to get her vaccinated.

But, I mean both vaccines-- and we have data on other age groups for the Pfizer vaccines and we know that it works and that it's safe.

So, I think we have enough data to, like, confidently say it's okay.

Like, you can't go wrong.

And, I think that's the message.

We also say to adults, right?

Like both Moderna and Pfizer are equal, so you can't go wrong.

- And, all of us are storytellers, most of us serve communities that disproportionately were impacted by the pandemic.

Gradually, the vaccination rates for Black, Latino, and Asian and Native peoples, peoples of color, have risen at a par.

And, even in some areas, more-- higher rates of vaccination than their white, Caucasian counterparts.

But, will this be true for children?

And, I guess what is your message for communities of color [video freezes] parents of color and their children?

[video freezes] - Yes, I think this is a message I usually give to my Spanish speaking public I speak with, but I think it applies to all, like, racial, ethnic minorities, is that we know COVID has disproportionally affected these groups.

We know that.

But, we now have a chance to turn the table and really have a tool that can help us reverse that.

So, it's on us as CDPH, as a public health agency.

But also as parents to take that decision.

We always want to make the right decision for our children as a mother, as a doctor, as a researcher, I know that.

I know how hard it is, but we also have the tools to inform ourselves with our doctors, looking at information, asking questions.

And, if you want to make a decision, just make sure it's the right decision, because we have vaccines that work.

And, I mean that's what I usually tell them.

Like, we have the tools to not be as affected as we've been.

- On behalf of all of our media on today's call, my heartfelt thanks for your time.

And, my thanks to the California Department of Public Health, Vaccinate All 58, for supporting us in today's briefing.

Thank you all.

This conference is now adjourned.

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