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White House outlines the beginning of a vaccination campaign for the youngest children

The White House outlined the early stages of a plan for making coronavirus vaccines available to roughly 18 million children younger than 5, should the doses be cleared by federal regulators.PAUL RATJE/NYT

The White House on Thursday outlined the early stages of its plan for making coronavirus vaccines available this month to roughly 18 million children younger than 5, should the doses be cleared by federal regulators for the last group of Americans yet to be eligible.

The Biden administration has made 10 million doses available to states and health providers, with roughly 85 percent of children in the age group living within 5 miles of possible vaccination sites, according to a White House fact sheet.

Half of the 10 million doses were made available for order last week, the other half this week, with equal numbers of Pfizer-BioNTech and Moderna vaccines, the two that federal regulators are reviewing and could authorize as soon as next week.

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“Let’s actually take a moment to understand what a historic moment this is,” said Dr. Ashish Jha, President Biden’s coronavirus response coordinator. “It would mean that for the first time, essentially every American from our oldest to our youngest would be eligible for the protection that vaccines provide.”

Orders from states have been somewhat tepid so far, according to data that senior administration officials provided to reporters in a briefing Wednesday evening. Of the 5 million doses offered last week, 58 percent of those made by Pfizer-BioNTech have been ordered, as have roughly a third of those made by Moderna.

The officials, who spoke on the condition of anonymity to preview the formal announcement Thursday, said the initial orders were typical of COVID-19 vaccination campaigns thus far, as states typically increase their orders over time.

Still, uptake of the vaccine among children ages 5 to 11 has been plodding, a trend that health experts have worried could continue with the youngest group.

A Kaiser Family Foundation survey conducted in April found that just 18 percent of parents with children younger than 5 said they would get them vaccinated right away, while 38 percent said they would wait and see. Their hesitation could be at least partly due to the fact that the virus is typically less risky for young children.

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Jha on Thursday said health officials expected many children younger than 5 to be vaccinated by pediatricians and primary care physicians, a contrast to other age groups. But he and other officials Thursday said they had organized a network of other locations that would work to get shots to families, including pharmacies and children’s hospitals.

To reach smaller pediatric offices and rural providers, the White House said Thursday, doses are being packaged by the hundred.

Government programs such as Medicaid, the Children’s Health Insurance Program, and the Women, Infants, and Children Program will work with families to encourage vaccination. Other groups, including the American Academy of Pediatrics, the Association of Children’s Museums, and the National Diaper Bank Network, will provide educational materials.

Delivery of the vaccines is contingent on the Food and Drug Administration authorizing pediatric doses — a step that could take place as soon as next week — and the Centers for Disease Control and Prevention recommending them, which would formally initiate the campaign. The FDA and its outside panel of vaccine advisers are set to meet Wednesday to discuss the shots for young children; the CDC’s expert committee is scheduled to meet days later.

CDC Director Dr. Rochelle Walensky would be the last to sign off.

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Jha said he expected vaccinations to begin in earnest the following week, perhaps starting June 21, but he suggested it could take time for some families to gain access.

“Realistically, it means we could see shots in arms of kids under 5 as early as the week of June 20,” he said of the federal review timeline, adding that the federal Juneteenth holiday on that day — a Monday — would mean many offices would begin administering the shots June 21.

“The vaccination program is going to ramp up in the days and weeks that follow with more and more doses and more and more appointments becoming available,” he said.

Moderna is seeking authorization of its two-dose shot for children younger than 6, while Pfizer is asking regulators to clear its three-dose vaccine for those younger than 5.

Federal officials have said that they are not preempting regulatory actions by announcing distribution plans for the vaccine before it is authorized. Instead, they have said, they are working to prepare families and physicians for the possible rollout. Last year, the White House was criticized for subverting the regulatory review that usually precedes vaccination campaigns when it announced a broad booster shot campaign before FDA officials or their outside advisers had weighed in, a decision that proved divisive.

The deliberations over the vaccine for the youngest children are not expected to provoke the same kind of dissent. Parents have long clamored for the option and were briefly given hope over the winter when FDA officials worked to make an initial two doses of Pfizer-BioNTech’s shot available to children as they studied a third dose. That plan backfired when data showed that two doses did not provide significant protection against the Omicron variant.

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Moderna is proposing a two-dose regimen for children ages 6 months through 5 years old, using one-fourth the strength of an adult dose. Pfizer and BioNTech are working on a three-dose regimen for children ages 6 months through 4 years old, at one-tenth the strength of the adult dose.