COVID-19 vaccine trials for kids are critical for Utah — its young population can’t hit herd immunity without them

Layton • Jackson Sweeten wants to be the first kid in Utah to get the COVID-19 vaccine.

“We’re hoping to be one, two and three for the vaccine trial,” 8-year-old Jackson said of himself and his siblings. “I’ll be one — ”

“No, I’ll be one,” interrupted his 10-year-old brother, Kaden, applying the ancient logic of the firstborn that the kids should go in order of age. Jackson, the middle child, naturally disputes this. Their 5-year-old sister, Emily, opts not to engage in the argument. “I’ll be three,” she declares.

Soon, the Sweetens of Layton will be among the first under-12s in Utah to be vaccinated against COVID-19 — as part of one of two clinical trials happening in the state to determine the vaccine’s safety and effectiveness with young children.

Meanwhile, a vaccine may be available to teenagers sooner than expected. On Wednesday, Pfizer and its German partner, BioNTech, reported that their vaccine was extremely effective against the virus when given to adolescents 12 to 15 years old. The U.S. Food and Drug Administration already has approved the Pfizer vaccine for people 16 and up — but the new findings could prompt the FDA to give the OK to administer the Pfizer vaccine to younger Americans within a couple of months.

The findings are “nothing short of great news for children, and for controlling the pandemic” — especially in Utah, said Dr. Andrew Pavia, a pediatric infectious disease physician at University of Utah Hospital.

Because around 30% of Utah’s population is under age 18, vaccinating children is imperative to reach the all-important “herd immunity” necessary to stop the spread of COVID-19, Pavia and state epidemiologist Dr. Angela Dunn agree.

“As long as the vaccine was restricted to adults, we were just not in a position to fully control this pandemic,” Pavia said.

“For our state population,” Dunn said, “we would have to get every adult vaccinated if we were going to reach herd immunity without kids. Even then, our schools would still be vulnerable because everybody in them wouldn’t be vaccinated.”

‘Our biggest gun’

To conquer COVID-19, getting the vaccine into the arms of children is a necessity, Dunn said.

“The vaccine is our biggest gun to combat COVID-19. It is the way we are going to end this pandemic,” Dunn said. Getting it to children, she added, “provides the ability to vaccinate the next-most at-risk population other than adults, which is our high-school and middle-school kids.”

If the Pfizer vaccine is approved for teens by summer, a large portion of high school and middle school students could be vaccinated by the time school starts, Pavia said.

“It will be great to get kids back in the stands for school sports, to have dances again,” Pavia said. “That can happen when teenagers are fully immunized.”

Once the FDA approves the vaccine for teens, Pavia said, the campaign will begin to convince parents to get the shots for their kids. “We have to communicate to parents that there are real benefits for their children, there’s real benefits for their family. And there are real benefits for the community,” Pavia said.

Mary Hill, epidemiologist for the Salt Lake County Health Department, said students chafing under “test to play” rules — which require high school students to get a negative COVID-19 test two weeks before extracurricular events — may welcome the vaccine.

“Anybody who is vaccinated doesn’t have to continue testing,” Hill said. “That’s a really great incentive for getting the vaccine is that your kids are not going to be going through quarantines in the fall.”

Calculating the right dose

Tristen Sweeten, a registered nurse and the mother of Kaden, Jackson and Emily, said her husband, Scott, contacted a recruiter for Velocity Clinical Research — a British-based company with a branch in West Jordan, Utah — to sign up the kids up for trials.

At this stage, the Sweeten children and a handful of others will receive varying amounts of the Moderna version of the vaccine, to figure out how much should go into a child-sized dose. Tristen Sweeten said she’s happy that, at this phase, her kids will be sure to get the vaccine, rather than a placebo — as will happen for kids at later phases of the trial.

“The kids will get it anyway, as soon as it’s released,” she said. “We would want to be first in line.”

While Velocity’s Moderna trial is getting started, Salt Lake City’s Foothill Family Clinic is in the early stages of another trial, to determine how to give the Pfizer vaccine to children as young as 6 months.

The first phase of the trial involves small groups, 48 participants each in age ranges 5 to 11, 2 to 5, and 6 months to 2 years. The goal is to figure out the proper amount of vaccine for each dose — small enough to be safe, but big enough to be effective, said Dr. James Peterson, principal investigator at the clinic’s Salt Lake City location.

While dosage sizes have been determined for adults in previous trials, Peterson said, “in the pediatric world, we have to start from scratch.”

Once the first phase is complete, Peterson said, the second phase of the trial would require thousands of participants. “To reach herd immunity, it’s all hands on deck,” he said.

Peterson’s research team at the Foothill clinic is working with J. Lewis Research, a Utah medical research company, to conduct the trials. The clinic is taking names of people interested in having their children participate in the trials. They can sign up at jlewisresearch.com.

Foothill also is well into a clinical trial to test the Pfizer vaccine’s use for children 12 to 17. The trial started last September, and the enrollment period is now closed, said Joy Nguyen, site manager at the clinic’s Salt Lake City location. The trial is being run through that clinic and its sister location in Cottonwood Heights, each with about 200 participants.

At the current phase of the trial, participants who did not have symptoms at the study’s outset are being swabbed every two weeks, Nguyen said. Like most trials at this stage, half of the participants are receiving the Pfizer vaccine, while the other half get a placebo.

Dunn said Utah, because of its young population, is a natural fit for companies running clinical trials with children.

“If I was a pharmaceutical company, I would certainly target Utah as part of my trial for kids,” Dunn said. “It’s really important to get as many kids as you can in these trials. Utah is one of the states where you can get the biggest bang for your buck.”

‘Part of the solution’

Since the Sweeten parents are both in the health care field, they got their vaccinations back in December. Scott works as a clinical research auditor, examining data for medical trials. This week, he was in California poring over a clinical trial for the AstraZeneca version of the COVID-19 vaccine, which is in use in parts of Europe but hasn’t been approved in the United States.

“It’s a pre-FDA audit,” Tristen Sweeten said of her husband’s work. “So when the FDA comes through, there aren’t any issues. His job is to find them before the FDA.”

Tristen Sweeten — who quit her job in the newborn intensive care unit at Primary Children’s Hospital in December because “doing that and school full-time for them was too much” — said that from the beginning, her family “wanted to be part of the solution to the pandemic and not part of the problem.”

Family members “don’t do large gatherings. We haven’t done school in person. We don’t do church in person.” she said. “We really haven’t seen our families much. We’ve started seeing them more, now that grandparents are getting vaccinated.”

The Sweetens have confidence in the vaccine, she said, even though she dealt with the side effects — including nausea, fatigue and joint pain — in the first 24 hours. “But it wasn’t anything crazy,” she said. “I could still do everything through it. I thought, ‘This is way better than COVID. I’ll take it.’”

That experience didn’t deter the Sweeten kids. “They saw the side effects,” Tristen Sweeten said. “They know the side effects, and they were still jealous that they didn’t get it.”

Getting the vaccine will allow the Sweetens “to see friends and family,” Emily said. Jackson added, “I want to be able to see a lot of people and not wear masks.”

Pavia said many doctors he knows have enrolled their own children in clinical trials, or have gotten them on the waiting lists. “We believe in this,” Pavia said. “We put our money — in this case, our kids — where our mouth is. And that should give people some real trust.”

Kaden Sweeten said he has become fascinated with the science behind the vaccine. He said he has studied “how it works, how it [creates] the antibodies [in] the person, and how they get the antibodies [after taking] the vaccine.”

Word that the Sweetens were getting into a clinical trial for the COVID-19 vaccine has spread. Tristen Sweeten said Jackson’s teacher at Davis Connect, the online school run by the Davis County School District, asked about how to get her children signed up for the trial.

In their email exchange, Sweeten said, the teacher “said ‘to congratulate Jackson on being a pioneer.’ We’re not going to walk across the plains to get to Utah, but we can be pioneers in different ways.”