by LIND­SEY TAN­NER, As­so­ci­at­ed Press

(AP) — The U.S. en­ters a new phase Wednes­day in its COVID-19 vac­ci­na­tion cam­paign, with shots now avail­able to mil­lions of el­e­men­tary-age chil­dren in what health of­fi­cials hailed as a ma­jor break­through af­ter more than 18 months of ill­ness, hos­pi­tal­iza­tions, deaths and dis­rupt­ed ed­u­ca­tion.

With the fed­er­al gov­ern­ment promis­ing enough vac­cine to pro­tect the na­tion’s 28 mil­lion kids ages 5-11, pae­di­a­tri­cians’ of­fices, phar­ma­cies, hos­pi­tals, schools and health clin­ics were poised to be­gin the shots af­ter the fi­nal OK late Tues­day.

“This is not go­ing to be ‘The Hunger Games,’” said Dr Al­li­son Ar­wady, Chica­go’s pub­lic health com­mis­sion­er, re­fer­ring to the chaot­ic ear­ly na­tion­al roll­out of adult vac­cines near­ly a year ago. Chica­go ex­pect­ed to have near­ly enough vac­cine in just the first week for near­ly half of its 210,000 school-aged chil­dren, and many more dos­es lat­er on.

“Our goal is to be ready, have a calm roll­out,” Ar­wady said.

Kid-sized dos­es of the Pfiz­er-BioN­Tech vac­cine cleared two fi­nal hur­dles Tues­day — a rec­om­men­da­tion from CDC ad­vis­ers fol­lowed by a green light from Dr Rochelle Walen­sky, di­rec­tor of the Cen­ters for Dis­ease Con­trol and Pre­ven­tion.

The ac­tions mean sleep­overs, play­dates and fam­i­ly get-to­geth­ers put off for more than a year will be back on the agen­da for many kids, along with a chance for few­er school in­ter­rup­tions.

“There are chil­dren in the sec­ond grade who have nev­er ex­pe­ri­enced a nor­mal school year,” Walen­sky said. “Pae­di­atric vac­ci­na­tion has the pow­er to help us change all of that.”

Thou­sands of pae­di­a­tri­cians pre-or­dered dos­es, and Pfiz­er be­gan ship­ments soon af­ter the Food and Drug Ad­min­is­tra­tion’s de­ci­sion Fri­day to au­tho­rize emer­gency use. Pfiz­er said it ex­pects to make 19,000 ship­ments to­talling about 11 mil­lion dos­es in the next sev­er­al days, and that mil­lions more will be avail­able to or­der on a week­ly ba­sis.

The vac­cine — one-third the dose giv­en to old­er chil­dren and adults and ad­min­is­tered with kid-sized nee­dles — re­quires two dos­es three weeks apart, plus two more weeks for full pro­tec­tion to kick in. That means chil­dren who get vac­ci­nat­ed be­fore Thanks­giv­ing will be cov­ered by Christ­mas.

“This is a big mile­stone for 5- to 11-year-olds be­cause they make up near­ly 40% of chil­dren un­der 18,” said Dr Jen­nifer Shu, a De­catur, Geor­gia, pae­di­a­tri­cian, who re­ceived her first ship­ment Tues­day morn­ing.

“The tim­ing be­fore win­ter hol­i­days is very for­tu­nate,” she added. “This age group will be able to spend hol­i­days with friends and fam­i­ly more safe­ly than they have been able to since the start of the pan­dem­ic.”

Kathy Zor­dan, 44, an in­sur­ance au­di­tor in Mor­ton Grove, Illi­nois, said she was “su­per ex­cit­ed” for her kinder­gart­ner, 5-year-old Liam.

“I told him, ‘Mom­my got two shots, Dad­dy got two shots. This is why peo­ple are wear­ing masks. Hope­ful­ly at some point we don’t have to keep wear­ing the mask. You’re go­ing to get the shots.’”

“He goes to school, he’s among hun­dreds of oth­er kids every sin­gle day and I want him to have this pro­tec­tion,” Zor­dan added.

Many lo­ca­tions planned mass vac­ci­na­tion events in com­ing days. And while many pae­di­a­tri­cians’ of­fices were ex­pect­ing strong de­mand at least ini­tial­ly, al­most two-thirds of par­ents re­cent­ly polled by the Kaiser Fam­i­ly Foun­da­tion said they would ei­ther wait or not seek out the vac­cines for their kids.

Han­nah Hause, a Col­orado moth­er of four chil­dren ages 2, 5, 7 and 8, is among those not in any rush. She’s vac­ci­nat­ed but wants more time to see how the child vac­cines play out and are stud­ied in the larg­er child­hood pop­u­la­tion.

“It’s not stud­ied long-term. It just makes me ner­vous be­cause that’s my whole world,” she said of her chil­dren.

“As long as I can wait, I will wait,” she said.

Gov­ern­ment au­thor­i­ties said pae­di­a­tri­cians and fam­i­ly doc­tors, whom par­ents de­pend on to give rou­tine child­hood vac­ci­na­tions, could help build trust.

Dr. Ada Stew­art, a Black fam­i­ly physi­cian in Co­lum­bia, South Car­oli­na, works at a clin­ic for un­der­served pa­tients that has been giv­ing COVID-19 shots to grand­par­ents, par­ents and teens and said she’s ready to add younger chil­dren to the mix. She’s seen the toll the virus has tak­en on them — not just in fam­i­ly ill­ness and death but with school dis­rup­tions, slip­ping grades and men­tal strain.

School clo­sures through­out the pan­dem­ic have dis­pro­por­tion­ate­ly bur­dened chil­dren of colour, widen­ing aca­d­e­m­ic gaps and wors­en­ing men­tal health, ac­cord­ing to da­ta pre­sent­ed Tues­day to CDC ad­vis­ers. That da­ta showed more than 2,000 COVID-re­lat­ed school clo­sures in just the first two months of the cur­rent school year. Ad­vo­cates say get­ting school-aged kids vac­ci­nat­ed will re­duce those dis­rup­tions.

But Stew­art thinks de­mand for kids’ shots will be mixed.

“Be­cause many of my pa­tients are Black, In­dige­nous and peo­ple of colour, I’ve seen the full spec­trum,” from par­ents ea­ger to get their chil­dren vac­ci­nat­ed to those who are more hes­i­tant “be­cause of a his­to­ry of mis­trust in the med­ical com­mu­ni­ty,’’ said Stew­art, past pres­i­dent of the Amer­i­can Acad­e­my of Fam­i­ly Physi­cians.

Her mes­sage to both is the same: “Vac­cines work, they’re safe, they’re ef­fec­tive and they save lives,” she said. “The more in­di­vid­u­als that we can get vac­ci­nat­ed in­clud­ing our chil­dren, the soon­er we will be able to get out of this pan­dem­ic.’’

A Pfiz­er study of 2,268 chil­dren found the vac­cine was al­most 91% ef­fec­tive at pre­vent­ing symp­to­matic COVID-19 in­fec­tions. The FDA ex­am­ined 3,100 vac­ci­nat­ed kids in con­clud­ing the shots are safe.

Some scep­tics have ques­tioned the need for kids to get vac­ci­nat­ed since they are less like­ly than adults to de­vel­op se­vere COVID-19. But with the delta vari­ant, they get in­fect­ed and trans­mit “just as read­i­ly as adults do,” Dr An­tho­ny Fau­ci said at a re­cent White House brief­ing.

Since the pan­dem­ic be­gan, at least 94 chil­dren aged 5 to 11 have died from COVID-19, more than 8,300 have been hos­pi­tal­ized and over 5,000 have de­vel­oped a se­ri­ous in­flam­ma­to­ry con­di­tion linked to the coro­n­avirus. Black and Lati­no young­sters and those with chron­ic con­di­tions are among the hard­est hit.

But while some health au­thor­i­ties say mi­nori­ties should be over-rep­re­sent­ed in COVID-19 vac­cine stud­ies be­cause they are dis­pro­por­tion­ate­ly af­fect­ed by the virus, near­ly 80% of kids in Pfiz­er’s study were white. Black young­sters to­talled 6%, Lati­nos 21%, Asians 6% and less than 1% were Amer­i­can In­di­an or Alas­ka or Hawaii na­tives.

In­fect­ed kids have con­tributed to the U.S. toll — al­most 46 mil­lion in­fec­tions and more than 740,000 deaths.

Lind­say Whe­lan, a nurse-ad­min­is­tra­tor who helped plan the roll­out of kids’ shots at Chil­dren’s Physi­cians clin­ics in the Om­a­ha, Ne­bras­ka, area, said be­ing a part of the na­tion’s first COVID-19 vac­ci­na­tion pro­gram “makes us proud.”

With this new round of shots, on­ly one of her six boys will re­main un­vac­ci­nat­ed, her 4-year-old. Pfiz­er and Mod­er­na are study­ing shots in kids that age and younger and Pfiz­er has said its re­sults may come be­fore year’s end.

The shots are im­por­tant “for pro­tect­ing them all, get­ting every­body back to nor­mal, and pro­vid­ing com­mu­ni­ty pro­tec­tion,” Whe­lan said.

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Pat­ty Nieberg con­tributed from Den­ver.