CDC advisory committee covers COVID-19 vaccines, pediatric trials

In a meeting on Jan. 27, the Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP) discussed the statuses of the Janssen, AstraZeneca and Novavax COVID-19 vaccine trials, COVID-19 epidemiology among children, and clinical trials of vaccines for people under 18.

The ACIP also reviewed immune response data from the roughly 23 million Americans who have been vaccinated since December, and concluded that there are no present signals of significant adverse effects to the Pfizer or Moderna vaccines.

The Committee had previously recommended the Pfizer-BioNTech COVID-19 vaccine for people 16 and older and the Moderna COVID-19 vaccine for people who are 18 or older in two emergency meetings last month.

Following the meeting, Novavax announced that its vaccine had a 90% efficacy rate according to early analysis of a 15,000-person trial. However, Novavax’s vaccine appears to be less effective against the South African variant.

Stanley E. Grogg, DO, the AOA’s liaison to the ACIP, has shared additional relevant information about the vaccines and the emergency meetings with the AOA. Here is a summary of his reports from the meeting on Wednesday.

AstraZeneca’s Phase III trial

A representative from AstraZeneca reported that the company’s Phase III trial of its non-pathogenic, adenovirus vector vaccine is ongoing, with 32,459 participants. An emergency use authorization request to the FDA is expected soon. The vaccine can be stored at 2-8°C (roughly 36-46°F) for at least six months. Currently, reported efficacy is 62%, but the company needs to conduct more data analysis.

COVID-19 epidemiology among children

Data shows that children who are exposed to COVID-19 in their households had a similar risk of infection as adults, but that they have the lowest cumulative rate of COVID-19 associated hospitalizations, according to Angela Campbell, MD, MPH, of the CDC and the National Center for Immunization and Respiratory Diseases.

However, children with certain underlying conditions may be more likely to have a severe illness due to COVID-19.

Infected children can develop multisystem inflammatory syndrome (MIS-C), a severe condition that has been reported approximately two to four weeks after the onset of COVID-19 in children and adolescents, though cases are rare.

Pediatric clinical trials

Pfizer-BioNTech, Moderna, Janssen, and AstraZeneca all have adolescent trials that are set to begin in early 2021, while pediatric trials are still in the planning stages, according to Emily Erbelding, director of the Division of Microbiology and Infectious Diseases at National Institute of Allergy and Infectious Diseases/National Institutes of Health.

Adverse effects data from first month of vaccinations

The ACIP reviewed data from the Vaccine Adverse Event Reporting System from those who have received the Pfizer-BioNTech or Moderna vaccines. Commonly reported events include headaches, fatigue, fever and chills. There have also been a small number of anaphylaxis reactions to the vaccine (11.1 and 2.5 cases per million doses, respectively). But there are no current signals of significant adverse effects.

If you have questions, please contact Dr. Grogg at stanley.grogg@okstate.edu.