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Parents hoping for an early-fall vaccine may have to wait until the end of the year to get children under 12 vaccinated.

This is a preview of the Well newsletter, which is reserved for Times subscribers. Sign up to get it in your inbox weekly.^[1]

As kids^[2] around the country head back to school, there has been disappointing news this week for parents of children under 12. While many health experts had hoped for an early fall approval of a vaccine for young children, two of the nation’s top public health officials said it’s not going to happen.

“I’ve got to be honest, I don’t see the approval for kids 5 to 11 coming much before the end of 2021,” said Dr. Francis S. Collins, director of the National Institutes of Health, on the NPR program “Morning Edition^[3].”

Dr. Anthony S. Fauci, the nation’s top infectious disease expert, offered a slightly more hopeful timeline. He told the “Today Show”^[4] on NBC that there was a “reasonable chance” that Covid-19 shots would be available to children under 12 by mid- to late fall or early winter. Both Pfizer and Moderna are gathering data on the safety, correct dose and effectiveness of the vaccines in children, he said.

“The data ultimately will be presented to the F.D.A. to look at for the balance between safety and risk-benefit ratio for the children,” Dr. Fauci said. “I hope that process will take place expeditiously.”

It’s not clear if the initial predictions for an early fall vaccine were just overly optimistic, or if officials now think the review process will take longer than expected. The revised timeline comes after the Food and Drug Administration in July asked Pfizer and Moderna to expand the size of their clinical trials^[5] for younger children to make sure they could detect potentially rare side effects.

But Pfizer said the number of children it planned to enroll was already large enough to meet the F.D.A. recommendations, and it had always planned to submit its data in September. A company spokeswoman said that it takes time to recruit and enroll children in a clinical trial. Pfizer is enrolling up to 4,500 children, including 3,000 in the 5 to 11 age group, and another 1,500 children younger than 5.

The news that a kid’s vaccine won’t be approved quickly is no doubt upsetting to many parents, who were counting on an early fall vaccine to keep their children safer in classrooms. Given the urgency of getting kids vaccinated, I asked the vaccine expert Dr. Paul Offit why it’s taking so long. Not only is Dr. Offit on the F.D.A.’s vaccine advisory committee, he’s also gone through the agency’s authorization process, as the co-inventor of a rotavirus vaccine for infants, which was approved in 2006.^[6]

Dr. Offit recalls that the trial data for the rotavirus vaccine was delivered in a truck. “If you took (the reports) and stacked one on top of the other, it exceeded the height of the Sears Tower,” said Dr. Offit. “It’s a lot of information.”

While Dr. Offit understands that parents are frustrated with the delay in approving a Covid vaccine for young children, it also should be reassuring that the F.D.A. is taking the time necessary to review the vaccine data, he said. The agency doesn’t just rely on the company’s summary of the data. Agency officials look at individual reports from every single child, reviewing the most mundane details of any side effects, blood tests and other data collected during the trial. The data on children are complicated by the fact that different doses are being studied.

“They don’t want to miss anything, because the No. 1 thing is safety,” Dr. Offit said. “You’re giving a vaccine or placebo to thousands of children as a predictor of what’s about to be given to millions of children. I know it seems like it should be faster, but it’s a long process.”

While parents will have to wait a little longer before young children can be vaccinated, studies show that schools have not been a major cause^[7] of Covid spreading events, particularly when a number of prevention measures are in place. A combination of precautions — masking indoors, keeping students at least three feet apart in classrooms, keeping students in separate cohorts or “pods,” encouraging hand washing and regular testing, and quarantining — have been effective. While many of those studies occurred before the Delta variant became dominant, they also happened when most teachers, staff and parents were unvaccinated, so public health experts are hopeful that the same precautions will work well this fall.

The overall news is reassuring when it comes to children and the risks of serious complications from Covid-19. Compared to adults, children diagnosed with Covid-19 are more likely to have mild symptoms or none at all. Children are also far less likely to develop severe illness, be hospitalized or die from the disease. In rare cases, some children infected with Covid may develop a serious inflammatory syndrome^[8], but that has been documented in only about 0.1 percent of pediatric cases. While the loss of even one child is devastating, deaths among children from Covid-19 are rare. Since the start of the pandemic, the C.D.C. has documented^[9] 454 deaths in the 18 or younger age group, accounting for 0.07 percent of the total 623,984 deaths in all age groups.

Parents can minimize a child’s risk by getting all eligible family members vaccinated. Take precautions daily to avoid crowds, wear a mask and encourage your child to wear a mask at school. Read more about how to keep kids safe in schools.^[10]

And to learn more about coping with kids, Covid and back-to-school, join me on Sept. 1 at 2 p.m. Eastern time for a New York Times^[11] Instagram live conversation with Lisa Damour, an adolescent therapist and Times columnist. We’ll be taking your questions, sharing the latest science and offering guidance for parents and families navigating the uncertainty of pandemic back-to-school.

Join the conversation:
Follow The New York Times on Instagram^[12] and join our live event!

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Share your medical bills

The New York Times is looking into the high costs of American health care and the wide price variation that patients face from one hospital or doctor’s office to another.

And we need your help. Medical bills help us see the prices that hospitals and insurers have long kept secret. If you have a medical bill that surprised you — maybe because of a high price, or an unexpected charge — we’d love to review it. Click here to fill out the form.^[13] We will not publish the information you submit without contacting you first.

Hospitals charge patients wildly different amounts for the same services. Learn more:
Hospitals and Insurers Didn’t Want You to See These Prices. Here’s Why.^[14]

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What’s in a pumpkin spice latte?

Starbucks recently announced the return of its fall drink lineup, including the ever-popular pumpkin spice latte. I don’t want to rain on the pumpkin patch, but it’s good to look up the ingredients of our favorite takeout items. It’s no surprise pumpkin spice lattes are delicious — the drink is pretty much just a dessert disguised as coffee.

According to Starbucks, a grande (16-ounce) pumpkin spice latte made with 2 percent milk has 390 calories and a staggering 50 grams^[15] (about 12 teaspoons) of sugar. The Starbucks label doesn’t break out how much of that is added sugar. About 22 grams of sugar probably comes from the natural sugars in milk, giving the pumpkin spice latte about 28 grams of added sugar. The American Heart Association recommends ^[16]no more than six teaspoons (25 grams) of added sugar a day for women and nine teaspoons (36 grams) for men.

Much of the sweetness in a pumpkin spice latte appears to come from the pumpkin spice sauce. The first ingredient is sugar, after all, followed by condensed skim milk, pumpkin purée and some additives. The whipped cream topping also contains sugar, in the form of a vanilla syrup.

If you’re trying to cut sugar, there are still ways to enjoy a pumpkin spice latte. A regular grande pumpkin spice latte has four pumps of pumpkin spice sauce as well as whipped cream. If you want to cut back on the sugar, skip the whipped cream and try it with just two pumps of sauce next time you order. You’ll get pretty much the same flavor and cut out more than half of the added sugar.

You can also try to make your own at home. This Food Network recipe^[17] for homemade pumpkin spice lattes includes espresso, milk, pumpkin purée, vanilla, pumpkin pie spices and one tablespoon of sugar (as well as sweetened whipped cream). But you can play with the recipe to cut even more sugar or use a sugar substitute if you prefer.

Read more about why cutting sugar is good for you:
How to Stop Eating Sugar^[18]

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The Week in Well

Here are some stories you don’t want to miss:

• Gretchen Reynolds explains how exercise may keep our memory sharp.^[19]

• Anahad O’Connor writes about R.S.V., a common childhood virus.^[20]

• Christina Caron explores whether teenagers should take mental health days, too.^[21]

• Jane Brody reveals five ways to ward off heartburn.^[22]

• And of course, we’ve got the Weekly Health Quiz.^[23]

Let’s keep the conversation going. Follow me on Facebook^[24] or Twitter^[25] for daily check ins, or write to me at well_newsletter@nytimes.com^[26].

Stay well!

References

1. ^{^} Sign up to get it in your inbox weekly (www.nytimes.com)
2. ^{^} kids (www.nytimes.com)
3. ^{^} Morning Edition (twitter.com)
4. ^{^} told the “Today Show” (twitter.com)
5. ^{^} expand the size of their clinical trials (www.nytimes.com)
6. ^{^} which was approved in 2006. (www.nytimes.com)
7. ^{^} schools have not been a major cause (www.cdc.gov)
8. ^{^} inflammatory syndrome (www.nytimes.com)
9. ^{^} the C.D.C. has documented (data.cdc.gov)
10. ^{^} how to keep kids safe in schools. (www.nytimes.com)
11. ^{^} New York Times (www.instagram.com)
12. ^{^} The New York Times on Instagram (www.instagram.com)
13. ^{^} Click here to fill out the form. (www.nytimes.com)
14. ^{^} Hospitals and Insurers Didn’t Want You to See These Prices. Here’s Why. (www.nytimes.com)
15. ^{^} 390 calories and a staggering 50 grams (www.starbucks.com)
16. ^{^} American Heart Association recommends (www.heart.org)
17. ^{^} This Food Network recipe (www.foodnetwork.com)
18. ^{^} How to Stop Eating Sugar (www.nytimes.com)
19. ^{^} how exercise may keep our memory sharp. (www.nytimes.com)
20. ^{^} R.S.V., a common childhood virus. (www.nytimes.com)
21. ^{^} teenagers should take mental health days, too. (www.nytimes.com)
22. ^{^} five ways to ward off heartburn. (www.nytimes.com)
23. ^{^} Weekly Health Quiz. (www.nytimes.com)
24. ^{^} Facebook (www.facebook.com)
25. ^{^} Twitter (twitter.com)
26. ^{^} well_newsletter@nytimes.com (www.nytimes.com)

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