NEW YORK (AP) — The U.S. on Saturday opened COVID-19 vaccines to infants, toddlers and preschoolers.

The shots will become available this week, expanding the nation’s vaccination campaign to children as young as 6 months.

Advisers to the Centers for Disease Control and Prevention recommended the vaccines for the littlest children, and the final signoff came hours later from Dr. Rochelle Walensky, the agency’s director.

“We know millions of parents and caregivers are eager to get their young children vaccinated, and with today’s decision, they can,” Walensky said in a statement.

While the Food and Drug Administration approves vaccines, it’s the CDC that decides who should get them.

The shots offer young children protection from hospitalization, death and possible long-term complications that are still not clearly understood, the CDC’s advisory panel said.

The government has already been gearing up for the vaccine expansion, with millions of doses ordered for distribution to doctors, hospitals and community health clinics around the country.

Roughly 18 million kids will be eligible, but it remains to be seen how many will ultimately get the vaccines. Less than a third of children ages 5 to 11 have done so since vaccination opened up to them last November.

Here are some things to know:

WHAT KINDS ARE AVAILABLE?

Two brands — Pfizer and Moderna — got the green light Friday from the FDA and Saturday from the CDC. The vaccines use the same technology but are being offered at different dose sizes and number of shots for the youngest kids.

Pfizer’s vaccine is for children 6 months to 4 years old. The dose is one-tenth of the adult dose, and three shots are needed. The first two are given three weeks apart, and the last at least two months later.

Moderna’s is two shots, each a quarter of its adult dose, given about four weeks apart for kids 6 months through 5 years old. The FDA also approved a third dose, at least a month after the second shot, for children with immune conditions that make them more vulnerable to serious illness.

HOW WELL DO THEY WORK?

In studies, vaccinated youngsters developed levels of virus-fighting antibodies as strong as young adults, suggesting that the kid-size doses protect against coronavirus infections.

However, exactly how well they work is hard to pin down, especially when it comes to the Pfizer vaccine.

Two doses of Moderna appeared to be only about 40% effective at preventing milder infections at a time when the omicron variant was causing most COVID-19 illnesses. Pfizer presented study information suggesting the company saw 80% with its three shots. But the Pfizer data was so limited — and based on such a small number of cases — that experts and federal officials say they don’t feel there is a reliable estimate yet.

SHOULD MY LITTLE ONE BE VACCINATED?

Yes, according to the CDC. While COVID-19 has been the most dangerous for older adults, younger people, including children, can also get very sick.

Hospitalizations surged during the omicron wave. Since the start of the pandemic, about 480 children under age 5 are counted among the nation’s more than 1 million COVID-19 deaths, according to federal data.

“It is worth vaccinating even though the number of deaths are relatively rare, because these deaths are preventable through vaccination,” said Dr. Matthew Daley, a Kaiser Permanente Colorado researcher who sits on the CDC’s advisory committee.

In a statement Saturday, President Joe Biden urged parents to get them for their young children as soon as possible.

WHICH VACCINE SHOULD MY CHILD GET?

Either one, said Dr. Peter Marks, the FDA’s vaccine chief.

“Whatever vaccine your health care provider, pediatrician has, that’s what I would give my child,” Marks said Friday.

The doses haven’t been tested against each other, so experts say there’s no way to tell if one is better.

One consideration: It takes roughly three months to complete the Pfizer three-shot series, but just one month for Moderna’s two shots. So families eager to get children protected quickly might want Moderna.

WHO’S GIVING THE SHOTS?

Pediatricians, other primary care physicians and children’s hospitals are planning to provide the vaccines. Limited drugstores will offer them for at least some of the under-5 group.

U.S. officials expect most shots to take place at pediatricians’ offices. Many parents may be more comfortable getting the vaccine for their kids at their regular doctor, White House COVID-19 coordinator Dr. Ashish Jha said. He predicted the pace of vaccination will be far slower than it was for older populations.

“We’re going see vaccinations ramp up over weeks and even potentially over a couple of months,” Jha said.

CAN CHILDREN GET OTHER VACCINES AT THE SAME TIME?

It’s common for little kids to get more than one vaccine during a doctor’s visit.

In studies of the Moderna and Pfizer shots in infants and toddlers, other vaccinations were not given at the same time so there is no data on potential side effects when that happens.

But problems have not been identified in older children or adults when COVID-19 shots and other vaccinations were given together, and the CDC is advising that it’s safe for younger children as well.

WHAT IF MY CHILD RECENTLY HAD COVID-19?

About three-quarters of children of all ages are estimated to have been infected at some point. For older ages, the CDC has recommended vaccination anyway to lower the chances of reinfection.

Experts have noted re-infections among previously infected people and say the highest levels of protection occur in those who were both vaccinated and previously infected.

The CDC has said people may consider waiting about three months after an infection to be vaccinated.

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By Amber Dance

Money to combat health disparities remains unspent

In May 2021, the CDC awarded $2.25 billion in grants to health departments of every state and dozens of large cities and counties. The purpose was to improve health and limit COVID-19 spread in minority groups and rural populations.

A year later, much of that money hasn’t been used, according to a Kaiser Health News review of 12 of those grants.

Missouri’s health department, for example, hasn’t spent a cent. Other states spent fewer than 2% of their grants. Of the nine states analyzed by KHN, the one that had invested the most was Montana, which has spent nearly a quarter of its grant amount.

The money is supposed to spent on programs such as improved data collection or expanded COVID-related health services.

“Because the term ‘health disparities’ encompasses challenges facing all kinds of population groups, the money can be applied to almost anything that affects health,” write Phil Galewitz, Lauren Weber and Sam Whitehead for KHN.

Republican lawmakers have cited unspent COVID disbursements as a reason not to approve any more federal funds for the pandemic, but the unspent grant dollars don’t mean the money isn’t needed.

Public health agencies said it’s time-consuming to get approval for specific spending projects, hire new staff, initiate collaborations with nonprofit organizations, and set up programs.

“The money is terribly needed, but we need to consider that these health departments have long been overburdened and they don’t really have enough people to handle it,” said Dr. Usama Bilal of Drexel University.

The CDC, which initially required grantees to use the money by May 2023, recently said states could apply for extensions.

Third shot’s the charm for Pfizer’s vaccine in youngest kids

Pfizer’s long-awaited trial data for the youngest Americans arrived last week, with positive results: Three doses of the company’s COVID-19 vaccine, for children ages 6 months to 5 years, produced an antibody response on par with that seen in young adults.

After Pfizer’s two-dose protocol failed to pass muster, the company tried a third dose, which was provided at least two months after the second.

The company also reported preliminary efficacy data, suggesting the vaccine was 80.3% effective against symptomatic disease during the omicron wave. That’s based on 10 symptomatic cases among study participants so far, and Pfizer needs to document more cases to firm up that efficacy rate.

The FDA’s external vaccine review committee is expected to meet on June 14 to review Moderna’s submission for ages 6 through 17 years , and on June 15 to discuss applications from both Moderna and Pfizer for younger kids.

The committee is also tentatively scheduled to meet June 7 on Novavax’s vaccine; and June 28 to discuss what versions of the coronavirus the vaccines should target in the fall.

Vaccine may not stymie long COVID as much as thought

The CDC now says that at least one in five people who’ve had COVID-19 have developed some lingering health condition that might be due to the virus, reports Jamie Ducharme at Time.

For people 65 and older, that proportion rises to one in four.

That’s based on a study of health records of more than 350,000 adults for at least a year following a COVID-19 diagnosis.

The long-term conditions included heart disease, respiratory problems, and neurologic conditions.

People who had COVID-19 were twice as likely to develop respiratory symptoms or blood clots in their lungs during the study period as those who didn’t get infected.

Being vaccinated has been thought to lower the odds of getting long COVID, but according to a separate study of more than 13 million veterans, the risk is only 15% less than it is in unvaccinated people.

This is a much lower reduction in risk than suggested by earlier, smaller studies, notes Sara Reardon at Nature.

The data are from before omicron dominated U.S. infections.

“We’re now literally solely reliant, not almost exclusively, on the vaccine to protect us and to protect the public,” said study author Ziyad Al-Aly. “Now we’re saying it’s only going to protect you 15% [from long COVID]. You remain vulnerable, and extraordinarily so.”

The vaccines did reduce the risk for some of the most serious long COVID symptoms such as lung disorders and blood-cutting problems, by 50% or more.

Experts told NBC’s Kaitlin Sullivan that boosters are unlikely to do much against long COVID.

These latest numbers suggest the nation can expect a continuing wave of people disabled by long COVID, some severely so.

The Biden administration says long COVID can be considered a disability, but individuals must clear a series of hurdles to get that status under the Americans with Disabilities Act.

Activists affected by the lingering symptoms told a House committee their employers are not making the accommodations they need, reports Joseph Choi at The Hill.

For example, being able to work from home or sit down at work could help some with long COVID.

Even the altered sense of smell that some people have after COVID can make going into an office a horrifying experience, reports Andrea Ball at USA Today.

A new virus offers chance to apply lessons from COVID

When the world locked down to halt the spread of COVID, a host of other viruses were also unable to reach new hosts. Now they’re coming back to a population with unusually low immunity — and they’re not always behaving like they used to, writes Helen Branswell at STAT.

For example, hospitalizations for flu surged in May, and a common stomach virus may be causing serious liver disease in kids.

Monkeypox, normally limited to West and Central Africa, has recently caused more than a dozen outbreaks and hundreds of cases in Europe and North America. In the U.S., there are at least 14 cases across eight states.

The virus, caused by a relative of smallpox, is thought to circulate regularly among rodents with occasional spillovers into people. Symptoms can include fever and painful lesions.

The new outbreaks provide “a test of the lessons the world has (or hasn’t) learned from COVID,” writes Ed Yong at The Atlantic.

The timing of its arrival, on the heels of the coronavirus, also influences responses. “Because the U.S. catastrophically underestimated COVID,” Yong writes, “many Americans are panicking about monkeypox and reflexively distrusting any reassuring official statements.”

Already, there are hints of the communication confusion that has dogged the government throughout the pandemic. Experts told STAT’s Branswell that their earlier warnings to watch out for the disease went unheeded.

And while a CDC representative told CNN, “The general public should not be concerned,” President Joe Biden said, “it is something that everybody should be concerned about.”

The good news is that monkeypox is a very different beast from the virus behind COVID, and it’s one that scientists already understand well.

For instance, monkeypox requires close contact to move from person to person, rather than floating through the air. And people aren’t typically infectious if they don’t have symptoms.

A vaccine, should it be needed, is already approved and on order. There are also approved treatments for smallpox that might help.

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