Within minutes of the Food and Drug Administration's decision Friday to authorize the lower-dose Pfizer-BioNTech COVID-19 vaccine for children ages 5 to 11, teams began packing up the vaccines to be shipped. The vials are being packed with syringes, dry ice and tracking labels and are being loaded into shipping containers that were specially designed for the pediatric vaccine.
But a top White House official is cautioning that parents shouldn't expect to be able to get their kids vaccinated the very next day if the Centers for Disease Control and Prevention recommends the vaccine, as it is expected to on Tuesday. Patience may be needed, as it could take several days before shots are readily available.
"We're talking about a specialized vaccine for children," said Jeff Zients, the White House's COVID-19 response coordinator, in an exclusive interview with NPR. "We are hard at work, planning the logistics and making sure that vaccines will be available at tens of thousands of sites that parents and kids know and trust."
The process isn't as simple as just opening up appointments at pharmacies, as it was when adult boosters were authorized in recent weeks. Younger children will be getting a smaller dose delivered via smaller needles for smaller arms. It's a different formulation, in different packaging — a new program for a new population that requires greater sensitivity.
"We urge parents to get ready and make a plan, and the program will be fully up and running the week of November 8th," Zients said.
Last week, the administration asked states, pharmacies and pediatricians to put in orders for vaccine doses, and the administration and Pfizer are now working to get the supplies pre-positioned.
"Our goal is to get as much vaccine as possible pre-positioned, as we await CDC's decision mid next week," Zients said.
Zients said vaccines are being shipped to 20,000 locations around the U.S. and the process of packing and shipping will take time. He said pending the CDC's decision, parents should be able to start finding appointments late next week (locations offering vaccines for children will be listed on vaccines.gov).
"While we hope to see the first set of kids start to get vaccinated at the end of next week, the bulk of vaccines will be in their locations by the week of Nov. 8," Zients said. "Between now and then, the program will be ramping up to its full strength."
In the U.S., 28 million children are ages 5 to 11, and the White House is starting by pushing out 15 million vaccine doses, with more to come. It has enough doses ordered to vaccinate every eligible child in the country, though it doesn't expect every one of them to roll up their sleeves.
While some parents will be racing to vaccinate their elementary-age children as fast as possible, the Biden administration is anticipating many others will have questions or not want to go first. Zients says the government will launch a campaign of paid advertising, as well as efforts to get out the word through trusted local leaders and doctors and high-profile nationally known figures.
The FDA granted emergency use authorization to the Pfizer vaccine for children ages 5 to 11 based on a study of approximately 4,700 children. The vaccine was found to be safe and 90.7% effective at preventing symptomatic disease.
A key part of the Biden administration's plan for vaccinating kids is getting vaccines into places that parents already take their children to for health care: pediatricians and family doctors, children's hospitals and neighborhood pharmacies. There will also be pop-up and mobile clinics and eventually school-based clinics, on evenings or weekends, when families are free.
For pediatrician Nicole Baldwin, this moment is both exciting and daunting. "We love these kids and we want to vaccinate them," she said, adding that a pediatrician's office will be a familiar place for young patients who already come in for well visits and other childhood vaccines.
"Pediatricians' offices are so strapped and overwhelmed right now," Baldwin said, whose practice is in Ohio. "How do we get these patients in? How do we do these clinics? How do we have time to document all of this? So I think that needs to be realized and pediatricians need to be given a little bit of grace."
NPR's Allison Aubrey contributed reporting to this story.