In less than one year since the announcement of the SARS-CoV-2 pandemic, hundreds of vaccines have been developed, several of them reaching approval and usage around the world, including U.S. FDA emergency use authorization of the Pfizer/BioNTech vaccine for those age 12 and older.
The similarity of these vaccines is to produce antibodies to protect against COVID-19 infection, but each of these vaccines have different designs, compositions, number of doses, time intervals between dose administration, and efficacy.
An avalanche of information has been generated surrounding these vaccines. And to make it more challenging, a horde of misinformation disseminated with similar speed. Therefore, it is natural that caregivers and health care providers face the difficult task to make the decision whether or not to vaccinate these at-risk children.
|Name and Manufacturer||Platform||Age Indications||Dosages||Additional primary dose for people with immunosuppression||Description||Storage and Shelf-life Temperature||Approval||Efficacy|
BNT162b2/COMIRNATY Tozinameran (INN) 1,2,3,A,B,C
|mRNA||≥5 years||2 doses, 3 weeks apart||1 dose, afer 4 weeks||Suspension for IM injection||2 to 8°C for 5 days
6 months at -80 to -60°C
|*Pfizer-BioNTech COVID-19 Booster3||≥5 years||Full dose at least 5 months after completion of primary series|
Moderna COVID-19 Vaccine
|mRNA||≥18 years||2 doses, 4 weeks apart||1 dose, after 4 weeks||Suspension for IM injection||2 to 8°C for 30 days
7 months at -25 to -15°C
|*Moderna COVID-19 Booster6||≥18 years||Half dose at least 6 months after completion of primary series|
Janssen COVID-19 Vaccine (Johnson & Johnson)
|Recombinant, replication incompetent adenovirus type 26 (Ad26) vectored vaccine encoding the (SARS-CoV-2) Spike (S) protein.||≥18 years||1 dose||1 mRNA dose, after 4 weeks||Suspension for IM injection||3 months at at 2 to 8°C
24 months at -25 to -15°C
|*Janssen (Johnson & Johnson) COVID-19 Booster8||≥18 years||Full dose at least 2 months after completion of primary series|
Oxford/AstraZeneca COVID-19 Vaccine
|Recombinant ChAdOx1 adenoviral vector encoding the spike protein antigen of the SARS-CoV-2.||≥18 years||2 doses, interval of 8 to 12 weeks||Suspension for IM injection||6 months at 2 to 8°C||EUA (FDA)||70%|
|Covishield (Serum Institute of India)
|Recombinant ChAdOx1 adenoviral vector encoding the spike protein antigen of the SARS-CoV-2.||≥18 years||2 doses, interval of 4 to 6 weeks||Suspension for IM injection||6 months at 2 to 8°C||EUA (FDA)||70%|
|*A single booster dose of Pfizer, Moderna (half dose) or Janssen may be administered as a heterologous booster dose following completion of primary vaccination with a different COVID-19 vaccine.8|
Abbreviations: EOI = Expression of interest; EUA = Emergency Use Authorization; CMC = Chemistry, Manufacturing and Control; FDA = United States Food and Drug Administration; IM = Intramuscular.
Note : EOI. Expression of Interest (EOI). The first call for submission of EOI is open to candidate vaccines in phase IIb/III clinical trials that are expected to be submitted for evaluation by a National Regulatory Authority within the next 6 months. Priority will be given to candidate vaccines that are expected to meet all or most of the WHO published TPP characteristics (https://www.who.int/publications/m/item/who-target-product-profiles-for-covid-19-vaccines). EUA. Emergency Use Authorization. The Emergency Use Authorization (EUA) authority allows FDA to help strengthen the nation’s public health protections against chemical, biological, radiological, and nuclear (CBRN) threats including infectious diseases, by facilitating the availability and use of medical countermeasures (MCMs) needed during public health emergencies. CMC. Chemistry, manufacturing and control.
Clinical trials which include children are noted by letters.
A McNamara D. Children and COVID-19 Vaccine Trials: What to Consider. Medscape. 2021; Available from: https://www.medscape.com/viewarticle/949165
B Lovelace B. Pfizer begins Covid vaccine trial on infants and young kids. CNBC. 2021; Available from: https://www.cnbc.com/2021/03/25/covid-vaccine-pfizer-begins-trial-on-infants-and-young-kids.html
C Cross R. COVID-19 vaccine trials for kids ramp up. Chemical & Engineering News. 2021; Available from: https://cen.acs.org/pharmaceuticals/vaccines/COVID-19-vaccine-trials-kids/99/i10
D A Study to Evaluate Safety and Effectiveness of mRNA-1273 Vaccine in Healthy Children Between 6 Months of Age and Less Than 12 Years of Age; Available from: https://clinicaltrials.gov/ct2/show/NCT04796896
1 Comirnaty, INN-COVID-19 mRNA Vaccine (nucleoside modified). European Medicines Agency. 2021; Available from: https://www.ema.europa.eu/en/documents/assessment-report/comirnaty-epar-publicassessment-report_en.pdf
2 Centers for Disease Control and Prevention. Vaccine Storage and Handling Toolkit. 2022; Available from: https://www.cdc.gov/vaccines/hcp/admin/storage/toolkit/storage-handling-toolkit.pdf
3 U.S. Food and Drug Administration. Comirnaty and Pfizer-BioNTech COVID-19 Vaccine. 2022. Available from: https://www.fda.gov/emergency-preparedness-and-response/coronavirus-disease-2019-covid-19/comirnaty-and-pfizer-biontech-covid-19-vaccine
4 U.S. Food and Drug Administration. Spikevax and Moderna COVID-19 Vaccine. 2022. Available from: https://www.fda.gov/emergency-preparedness-and-response/coronavirus-disease-2019-covid-19/spikevax-and-moderna-covid-19-vaccine
5 Moderna mRNA-1273, COVID-19 vaccine. World Health Organization. 2021; Available from: https://www.who.int/publications/m/item/moderna-covid-19-vaccine-(mrna-1273)
6 Baden LR, El Sahly HM, Essink B, Kotloff K, Frey S, Novak R, et al. Efficacy and Safety of the mRNA-1273 SARS-CoV-2 Vaccine. N Engl J Med. 2020 Dec 30;384(5):403–16. Available from: https://doi.org/10.1056/NEJMoa2035389
7 Safety and Immunogenicity Study of 2019-nCoV Vaccine (mRNA-1273) for Prophylaxis of SARS-CoV-2 Infection (COVID-19). Clinicaltrials.gov. 2021; Available from: https://clinicaltrials.gov/ct2/show/NCT04283461
8 U.S. Food and Drug Administration. Janssen COVID-19 Vaccine. 2021; Available from: https://www.fda.gov/emergency-preparedness-and-response/coronavirus-disease-2019-covid-19/janssen-covid-19-vaccine
9 Centers for Disease Control and Prevention. COVID-19 Vaccines for Moderately to Severely Immunocompromised People. 2022. Available from: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/immuno.html
10Villafana T. AstraZeneca COVID-19 Vaccine (AZD1222). CDC. 2021; Available from: https://extranet.who.int/pqweb/vaccines/who-recommendation-janssen-cilag-international-nv-belgium-covid-19-vaccine-ad26cov2-s
11 ChAdOx1 nCoV- 19 Corona Virus Vaccine (Recombinant) COVISHIELD™. Serum Institute of India. 2021; Available from: https://www.seruminstitute.com/product_covishield.php
12 WHO recommendation Serum Institute of India Pvt Ltd - COVID-19 Vaccine (ChAdOx1-S [recombinant]) - COVISHIELD™. 2021; Available from: https://extranet.who.int/pqweb/sites/default/files/documents/COVISHIELD_TAG_REPORT_EULvaccine.pdf
The COVID-19 Vaccine Working Group on Pediatric Oncology convened in early March 2021 to answer vaccine questions. Members are a multidisciplinary group of oncologists, infectious disease physicians and nurses representing all major regions of the world and several countries.
The COVID-19 Vaccine Working Group on Pediatric Oncology is led by Dr. Miguela A. Caniza (Pediatric Infectious Disease Specialist, St. Jude), Dr. Jessica Bate (Pediatric Oncologist, University Hospital Southampton, United Kingdom) and Maysam R. Homsi (Project Coordinator, St. Jude). Consultants to the working group are Dr. Kenneth Alexander (Vaccinologist and Pediatric Infectious Disease Specialist, Nemours Children’s Hospital, Orlando, Florida), Dr. Sheena Mukkada (Pediatric Infectious Disease Specialist, St. Jude) and Dr. Robert Phillips (Pediatric Oncologist, Senior Clinical Academic and NIHR Post-Doctoral Fellow Honorary Consultant in Paediatric Oncology, CRD, University of York, York, United Kingdom).
The COVID-19 Vaccine Parent/Carer Advisory Group is made up of individuals who represent cancer patients and their families from around the world. Their questions and concerns about vaccines are addressed by the working group below.