The COVID-19 Child Pioneers

I overheard a conversation between teachers regarding the COVID-19 vaccine as I was waiting in line to pick up my 3-year-old daughter from daycare.

"I will get the vaccine but not my kids."
"Absolutely. They're kids, not guinea pigs."
"I have already given birth. I want my children to have the same
opportunity to have children of their own, and who knows what this
vaccine will do."

Their conversation sparked other thoughts for me, aside from the obvious hesitancy that seems to follow discussions regarding vaccinations. I was most curious about the reasons behind parents' decision to include their young children in the initial phases of COVID-19 inoculation. The United States has a precedent, of course, owing to the work of Dr Jonas Salk.

In 1952, the United States was in the grip of a terrible polio epidemic that affected more than 58,000 children and caused more than 3000 deaths. A year later on March 26, 1953, Dr Salk on national radio announced the successful test of a vaccine against poliomyelitis, a virus that can cause paralysis. A large-scale field trial would soon follow in 1954 with more than 650,000 children receiving either a vaccine or a placebo and an additional 1.2 million others receiving no injection as a control group. In April 1955, the study would declare the polio vaccine safe and effective, and a campaign to inoculate the nation's children was undertaken. The public celebrated Dr Salk and the children were bestowed with the moniker of "polio pioneers."

I spent time reading The History of Vaccines from The College of Physicians of Philadelphia, a blog that collected comments from those who participated in the 1954 polio trial. Two themes kept recurring as I read:

The parents who decided to vaccinate their children knew someone whose child was afflicted by polio.
Many of the children, although initially scared, felt pride after receiving the vaccine.

Now, in the midst of a global pandemic, a new group of child pioneers is emerging. In July 2020, Pfizer began recruitment of more than 3000 children between 12 and 17 years old for the phase 3 clinical trials of the Pfizer-BioNTech COVID-19 vaccine. The initiation of a global phase 1/2/3 continuous study in March 2021 expanded the Pfizer study cohort to include children between the ages of 6 months and 11 years. Likewise, Moderna has undertaken its own research study, named KidCOVE, to test their mRNA vaccine in children between the ages of 6 months and 12 years. Moderna hopes to enroll over 6750 children for its study.

Two of my colleagues enrolled their children in my institution's vaccine trials, and their reasons for participating echo those made by parents back in 1954. They have seen first-hand the devastating effects of COVID-19 on children and understand that the vaccine trials are an opportunity to protect their own. They also understand that their children's participation provides vital information that gives other children the chance to one day receive the vaccine.

Do we then allow ourselves to call these children guinea pigs? Do we judge their parents harshly for making this decision for their child? Presumably, these parents made their choices after weighing every potential risk and benefit to their child. Moreover, a good parent, one would further surmise, would not knowingly place their child in danger.

Just like the pioneers who moved West with hopes for a brighter future, the parents and children participating in the trials are taking a calculated risk to create a healthier future for themselves and others. Commendation, not rebuke, should follow.

I humbly thank the brave COVID-19 pioneers (adults and children) and their parents for deciding to participate in the vaccination trials. Perhaps one day these children, too, can look back on their contributions with pride.

How would you feel about yourself or your children participating in the COVID-19 vaccine trials?

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About Dr. Giancarlo Toledanes

Giancarlo Toledanes, DO, is an assistant professor of pediatrics and a pediatric hospitalist at Texas Children's Hospital and Baylor College of Medicine in Houston. His professional interests include quality improvement, health equity, faculty development, and social psychology. When he is not in the hospital, he is a cook and a handyman to his wife, an amateur LEGO builder to his son, an aspiring unicorn to his daughter, and a walking burp cloth to his baby daughter. Connect with him on Twitter: @ToledanesGian

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