Thread by @profshanecrotty

What COVID vaccine would I give my kid?
If I had a kid age 5-11, I would get them the Pfizer vaccine, ASAP.
Even if the Moderna vax were available, I would go with the Pfizer vax for my kids. Because the Pfizer vaccine is a 10mcg dose. 🧵

10mcg Pfizer gave great immune responses in 5-11 year olds in the Phase 2/3 clinical trial, as good as 30mcg in 20 year olds ( equal antibody levels & ~100% antibody positive). Great to see the kids COVID-19 vaccine results from Pfizer provided to the FDA.

Given that kids generally have a much milder course of COVID-19 disease, having a level of immunity equal to that of young adults (or somewhat less than young adults that got the Moderna vaccine) should be more than enough for a 5-11 year old.

No T cell data, as usual (sigh), but the T cells are probably there fine.

Also, I would probably get the kid two doses ~6 weeks apart. (instead of 21 days) But if my kid or wife wanted it done at day 28 to be finished, that's fine too.

(Pfizer adult dose is 30mcg. Moderna adult dose is 100mcg. Moderna kid dose proposed is 50mcg.)

The myocarditis risk from the RNA vaccines is small, but it is real, and I operate on the assumption that the 50mcg Moderna has somewhat higher risk than 10mcg Pfizer. That may not be true.

The current data only show a moderate trend (non-significant) for a difference between 30mcg Pfizer and 100mcg Moderna in young adults.

The FDA ran scenarios on risk:benefit, and by the parameters I though were most plausible, the Pfizer vaccine benefit outweighed the risk 5x. (~50 hospitalizations vs 250 hospitalizations, with COVID disease hospitalizations being much more concerning for long term consequences)

fda.gov/media/153507/d…

And, as the FDA & CDC noted, it is unconventional myocarditis that is transient and ‘mild’, (most hospitalizations were for observation as opposed to treatment). So, not super concerning, compared to viral infection myocarditis which can have severe long term consequences.

fda.gov/media/153514/d…

It looks like the 10mcg Pfizer has pretty low side effects in kids in general. Which is nice.

I certainly think choosing Moderna is fine!
But, of course, most parents won’t have that option for a while. And the risk:benefit ratio tilts more towards Pfizer for me for kids. Whereas, in adults I think it tilts towards Moderna.

fda.gov/advisory-commi…