Recommending COVID-19 Vaccines for 12-15 Year Olds
The Advisory Committee on Immunization Practices’ (ACIP) vote to recommend the Pfizer COVID-19 vaccine for individuals 12-15 years of age occurred on May 12, 2021, two days after Food and Drug Administration’s (FDA) authorization.
Today, May 14, 2021, the details of the ACIP vote and their recommendations were published in the MMWR. Please ensure your vaccination staff are familiar with the new recommendation which is updated in CDC's Clinical Considerations.
Clinical trials for the Pfizer COVID-19 vaccine in adolescents showed that the vaccine was 100% effective at preventing COVID-19, and the side effects were similar to what’s been seen in vaccinated older teens and young adults. The most common reactions were pain at the injection site, fatigue, and headache.
The FDA has updated its Pfizer COVID-19 vaccine fact sheet for caregivers and patients.
COVID-19 Vaccines Can Now Be Co-administered with Other Routine Vaccines
The ACIP also voted to update the CDC Clinical Considerations that all three authorized COVID-19 vaccines can be administered at the same time as other vaccines. This is an important update for preteens, teens, and adults who need to catch up on routinely recommended vaccinations.
COVID-19 vaccines and other vaccines may now be administered without regard to timing. This includes simultaneous administration of COVID-19 vaccines and other vaccines on the same day, as well as co-administration within 14 days.
When deciding whether to co-administer another vaccine(s) with COVID-19 vaccines, providers should consider whether the patient is behind or at risk of becoming behind on recommended vaccines, their risk of vaccine-preventable disease (e.g., during an outbreak or occupational exposures), and the reactogenicity profile of the vaccines.
If multiple vaccines are administered at a single visit, administer each injection in a different injection site. For adolescents and adults, the deltoid muscle can be used for more than one intramuscular injection.
Best practices for multiple injections include:
- Label each syringe with the name and the dosage (amount) of the vaccine, lot number, the initials of the preparer, and the exact beyond-use time, if applicable.
- Separate injection sites by 1 inch or more, if possible.
- Administer the COVID-19 vaccines and vaccines that may be more likely to cause a local reaction (e.g., tetanus-toxoid-containing and adjuvanted vaccines) in different limbs, if possible.
Reminder: Pfizer’s COVID-19 vaccine is authorized for those aged 12 years and older, Moderna and Johnson & Johnson (Janssen) COVID-19 vaccines are authorized for those aged 18 years and older. Each COVID-19 vaccine may be co-administered with routine vaccines within the parameters of their authorized age groups.
According to the CDC, vaccination rates dropped substantially during the pandemic, particularly among adolescents. Vaccination rates for three of the vaccines routinely given to adolescents — against diseases like whooping cough (Tdap), cancer-causing human papillomavirus (HPV), and meningococcal meningitis (MenACWY) — are down 15-19% nationally.
Update-Blood Clots with Low Platelets After Johnson & Johnson Vaccine Are Still Rare, But Like All Medications and Treatments, People Should Be Aware of the Risks & Benefits
At the ACIP meeting, the CDC also gave an update on Thrombosis with Thrombocytopenia Syndrome (TTS), a rare and serious blood clotting issue combined with low blood platelets seen in some people who had received the one-dose Johnson & Johnson COVID-19 vaccine.
In April, CDC and FDA temporarily recommended a pause in the use of the Johnson & Johnson vaccine after six cases of TTS were detected by U.S. vaccine safety monitoring systems. The cases were investigated, and health officials lifted the pause after a full review of the data found that even with the low chance of TTS occurring, the benefits of the vaccine still outweighed the risks.
While serious, the risk of TTS still appears to be rare. Twenty-nine cases of TTS have now been found in people who had received the Johnson & Johnson COVID vaccine out of about 9 million doses — one case was seen in the clinical trial and 28 cases (including three deaths) were reported after FDA’s emergency use authorization — with most cases reported in women aged 18-49. Symptom onset appears to occur from several days after vaccination to up to 2 weeks, with most cases having symptoms start around 1–2 weeks after vaccination.
The CDC and ACIP’s Vaccine Safety Technical Work Group still recommend the vaccine for everyone 18 years of age and older, but emphasized the importance of letting people know about this rare, but serious, risk before vaccination, especially considering the availability of other COVID vaccines.
TTS does not appear to be linked to mRNA COVID vaccines such as those made by Pfizer and Moderna.
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