🧵 1/12 To report successful pediatric off label(<12) use. Disclaimer: I make no recommendation on using Novavax off label for your child and only report our experiences. I was one of the first few thousand outside of clinical trials to receive mRNA vaccines. I am thankful. 
2/12 But I now only receive Novavax because the literature shows it has less side effects and may provide more durable immunity while immunity from mRNA vaccines may wane more rapidly. Novavax has been approved for 6 and up in Japan and I felt it should be safe for my 6 year old.
3/12 I mentioned all of this to the pharmacist that gave me Novavax this year. I asked if he would give Novavax to my 6 y/o with a doctor's prescription. He said yes he would. I immediately sent over a message to my child's pediatrician asking about off label use of Novavax.
4/12 I stated that I understand Novavax is not approved for his age & had not been fully studied in the US but that it should be safe based on the following: many children got Novavax in the large, ongoing Hummingbird trial and it has not been terminated due to safety concerns.
5/12 In a study in India, 460 children aged 2 to 11 were given Novavax and they found no safety signals and a noninferior immune response compared to adults. The dose was the same 0.5mL(5mcg of antigen and 50mcg of adjuvant) as adults and the approved 12 and up doses.
6/12 The same dose of the Matrix-M adjuvant was used in a pediatric malaria vaccine study with participants aged 5-36 months and found good safety with 5,477 subjects. This vaccine is WHO approved and given as a *4 dose series* in malaria endemic countries.
7/12 A 2021 analysis determined that it would be legal & ethical to use covid vaccines off label prior to approval for children. Again I stated that I understood this would be unapproved and off label but that this evidence supports use. The articles were included in my message.
8/12 After a couple of days the pediatrician replied & agreed it would be okay and sent over a prescription to the pharmacy where a pharmacist had previously agreed. The prescription went to another pharmacist who asked corporate for approval and said it would take weeks.
9/12 Undeterred, I also went to multiple other chain pharmacies to discuss if they would accept an off label prescription for Novavax. All of them would want higher approval and I opened up cases with their corporate offices. There are no independent pharmacies here with Novavax.
10/12 After a week of waiting I got a phone call from the manager of our local Costco pharmacy. They agreed it would be okay to give Novavax off label with a doctor's prescription. Much to my surprise, insurance even covered it. My son got his flu shot at the same time.
11/12 Novavax was well tolerated and didn't seem to affect him any more or less than getting Moderna + Flu shot in previous years. He did experience a headache, muscle aches & fever about 16-20 hours post vaccination. This was short lasting.
12/12 Attribution: I got the idea of off label use and found the studies on the Novavax_vaccine_talk subreddit. I believe one of the users that posted there is also @Biff234523 but he has not responded. Here are the studies: drive.google.com/drive/folders/…
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