Smaller COVID vaccine doses may protect children as well as full doses in adults, Pfizer study finds

Friday, September 24, 2021
Coronavirus NC: Latest updates on COVID-19 in North Carolina
Coronavirus NC: Latest updates on COVID-19 in North Carolina

RALEIGH, N.C. -- Here's the latest news and information on COVID-19 and the COVID-19 vaccines.

6:20 p.m.

North Carolina Governor Roy Cooper issued an executive order extending, but not waiving, proof-of-immunization and health assessment documentation deadlines for school and child-care facilities.

Cooper's office said the EO was put in place to ensure children are not excluded from school because of increased demands on health care providers amid the ongoing COVID-19 pandemic.

The order will give students and families more time to complete their required vaccines and health assessments.

3:05 p.m.

People who are 65 years or older, 18 years or older with underlying medical conditions or work in a high-risk setting like healthcare workers, teachers and childcare providers or food workers are now eligible to get a COVID-19 booster shot in North Carolina.

"Pfizer boosters are now authorized for certain groups of individuals to extend the protection of vaccines against severe illness," said NCDHHS Secretary Mandy K. Cohen, M.D. "If you are eligible, get your booster. If you aren't vaccinated yet, don't wait. The COVID-19 virus is more contagious than ever and we are seeing it attack the unvaccinated and make them very sick at an alarming rate."

3 p.m.

North Carolina residents that need transportation assistance to vaccine sites for their COVID-19 booster shots can contact their local transit agency to help shuttle them to and from the location.

The state-administered program has already helped transit services statewide pay for more than 10,000 people needing transportation to get a COVID-19 vaccine.

If you need transportation assistance to access a vaccine site, you can contact your local transit agency. All North Carolina transit agencies can be found on the NCDOT website.

1:20 p.m.

5,805 new daily COVID-19 cases were reported in North Carolina on Friday.

The percent of positive tests in the state is at 8.6%.

3,359 people are currently hospitalized in the state with COVID-19.

16,108 COVID-19 deaths have been reported in North Carolina.

There are currently 895 adult ICU COVID-19 patients.

354 confirmed COVID-19 patients have been admitted into hospitals in the last 24 hours.

11:30 a.m.

More than one-third of the 56,000 North Carolina government employees included in Democratic Gov. Roy Cooper's executive order compelling them to get a COVID-19 shot or face weekly testing have not been fully vaccinated, according to new state data.

Law enforcement officials are getting vaccinated at the lowest rates, though the state said it is still processing a large set of data from the Department of Public Safety. Less than 53% of the 21,804 employees within that department who are subject to Cooper's directive have been fully vaccinated.

This is substantially lower than the 63% of North Carolina adults who have gotten one Johnson & Johnson vaccine or two Pfizer or Moderna shots, as of Thursday.

Cooper said in a news conference Tuesday that he is particularly concerned by the number of prison officials who have thus far refused to get a COVID-19 vaccine.

"It's probably the most concerning because we know there's close quarters and congregated populations there, so we really want to work on those percentages," Cooper said. "Right now, we're setting up discipline procedures for people who do not do the vaccination or the testing, and there are some employees who are beginning to fall in that category."

The Department of Public Safety is the largest agency covered under Cooper's order, followed by the state Department of Health and Human Services, which has three-fourths of its more than 15,000 employees subject to Cooper's directive fully vaccinated.

The North Carolina Office of State Human Resources, which provided the employee vaccination numbers of Cooper's Cabinet agencies to The Associated Press on Wednesday evening, has largest share of workers within a given agency fully vaccinated at 93%.

Nearly 61% of the more than 9,000 Department of Transportation workers included in Cooper's order are fully vaccinated, which represents the second-lowest share of the covered agencies.

Most Cabinet-level agencies reported employee vaccination rates of 75% to 85%, including the Department of Commerce, State Bureau of Investigation, Department of Revenue and Department of Environmental Quality.

"Data continues to fluctuate as agencies finetune their processes, including connecting individually with employees who do not typically use email as part of their daily work duties," said a statement from Jill Warren Lucas, a state human resources spokesperson.

Cooper reiterated the need to get more North Carolinians vaccinated, particularly when they hold jobs where they have to interact with members of the public. "Vaccine requirements can get more people vaccinated. That's what gets us to the end of this pandemic so we can stop having these press conferences and stop talking about this and move forward."

11 a.m.

Walgreens announced that eligible individuals can now receive Pfizer COVID-19 booster vaccinations in stores nationwide.

Beginning tomorrow, appointments for a COVID-19 booster shot and additional immunizations can be scheduled through, by calling 1-800-Walgreens or by calling a local Walgreens store.

10 a.m.

President Joe Biden is urging those now eligible for COVID-19 booster shots to get the added protection. His plea comes a day after the Centers for Disease Control and Prevention endorsed the doses for millions of older or otherwise vulnerable Americans.

CDC Director Dr. Rochelle Walensky signed off on a series of recommendations from a panel of advisers late Thursday. Biden praised the decision and aimed to set aside any unease about the vaccination by saying that he would get his own booster soon.

9:05 a.m.

In light of the CDC's new recommendation for some people to get a third COVID-19 shot, are you considered fully vaccinated if you have just two doses?


The CDC said even people who qualify for a booster but turn it down would be considered fully vaccinated--at least for now.

As with anything related to COVID-19, as scientists receive more data they may update their guidance. But for now, two doses of the Pfizer vaccine means you are fully vaccinated.


Pfizer just released its first safety data about COVID-19 vaccines for children ages 5 to 11, reassuring parents that a safe and effective vaccine soon could be available for those younger than 12, according to ABC News.

A trial of 2,268 children showed that a smaller dose of Pfizer vaccine -- one-third the amount given to adults and adolescents -- provided robust and adequate immune responses among those ages 5 to 11.

If the FDA agrees with Pfizer's assessment, finally those younger than 12 can get vaccinated -- in this case, if authorized, with the smaller dosage.

But that smaller dosage has led some parents to question the vaccine's effectiveness compared with a larger dose. Experts have stressed that size isn't everything. Because the lower dose still mounts a strong and sufficient antibody response to COVID-19, even an 11-year-old who's taller or weighs more than a kid over 12 should be protected.

Meanwhile, the director of the Centers for Disease Control and Prevention partially overruled her own advisory panel's suggestions about COVID-19 booster shots.

CDC Director Dr. Rochelle Walensky and the advisory panel agreed that a third shot should be available to high risk individuals six months after the second dose of the Pfizer vaccine.

Walensky and the advisory panel diverged on exactly which high risk individuals should be included. Walensky, who has the final say in this matter, authorized a larger group than the advisory panel suggested--including immunocompromised individuals over the age of 18 as well as people with high risk jobs (such as health care workers and teachers).

"In a pandemic, even with uncertainty, we must take actions that we anticipate will do the greatest good," Walensky said. "While today's action was an initial step related to booster shots, it will not distract from our most important focus of primary vaccination in the United States and around the world."

With Walensky's final sign-off, booster shots will now quickly become available for millions more Americans at pharmacies, doctors' offices and other sites that offer the Pfizer vaccine as soon as Friday.


5 p.m.

Governor Roy Cooper visited Cone Health Wesley Long Hospital in Guilford County to see their monoclonal antibody infusion center.

"We're focused on vaccinations as the way to beat this pandemic, but we also know the importance of monoclonal antibody treatment to help keep people out of the hospital when they do get sick," Governor Cooper said in a statement. "Cone Health is working to ensure everyone can get the care they need so we can emerge on the other side of this pandemic stronger than before."

Cone Health has its own monoclonal antibodies infusion center to provide treatment to patients. The hospital also conducts outreach about monoclonal antibody treatment to members of the community who are at high risk for hospitalization if they have tested positive for COVID-19.

On September 2, the Governor signed Executive Order 232 to make it easier for people to access treatment for COVID-19. The Order authorizes and directs State Health Director, Dr. Betsey Tilson, to issue a statewide standing order to expand access to monoclonal antibody treatment, which if taken early can decrease the risk of severe disease, hospitalization and death.

To date, North Carolina has administered more than 11 million doses of the vaccine. Sixty-eight percent of adults have received at least one shot, including 90 percent of North Carolinians ages 65 and older. Sixty-three percent of adults have been fully vaccinated.

2 p.m.

5,953 new daily COVID-19 cases were reported in North Carolina on Thursday.

The percent of positive tests in the state was at 9.1%.

71 more COVID-19 deaths were reported. The state has surpassed 16,000 COVID-19 deaths with a total of 16,012.

3,231 people are currently hospitalized with COVID-19.

There are 860 adult ICU COVID-19 patients. That's the lowest the state has seen this month.


Durham Public Schools Board of Education meets later today to talk about vaccine and face mask mandates.

The staff vaccine mandate is set to go into effect October 31. The district is also launching a voluntary weekly testing program for students and staff in October.

Full details about both of those plans will be discussed and finalized at tonight's meeting.

Last week, DPS reported 2 active COVID-19 clusters with 85 students and 12 staff members testing positive.

Moore County Schools voted Wednesday night to keep the face mask mandate for students and staff. The district will re-evaluate the policy next month.

'This is beyond crazy': Shaw unvaccinated student says he was kicked out of even online classes

An unvaccinated student is frustrated after Shaw University locked him out of even taking online classes.

A CDC panel is set to meet Thursday to vote on the use of a booster shot with Pfizer's COVID-19 vaccine.

The FDA already authorized that booster shot for seniors and people with underlying conditions in jobs that put them at high risk for COVID-19. Several hurdles, including the CDC's decision, lie ahead before the booster shots become US policy.


2 p.m.

Wake County Public School System administrators announced that, due to limited staff and other resources, the district will pause the Extended Learning Program (summer learning), effective end of day on Friday, Sept. 24 through the end of the fall semester.

"We are investigating potential learning options for the spring semester and will have more information about those options in the coming weeks," the district said.

The district said a shortage of teachers, bus drivers and space were reasons that most principals supported pausing the program.

Opportunities for working in the Extended Learning program could be revisited for spring semester, the district said.

12:45 p.m.

North Carolina health officials are reporting 6,288 new COVID cases Wednesday.

The state is reporting an 11.4% positive test rate.

There are currently 3,400 COVID patients hospitalized throughout North Carolina.

Throughout the state, 130 more people have died from the virus. A total of 15,941 North Carolinians have died from COVID since the pandemic started.

According to NCDHHS, 68% of North Carolina adults have been vaccinated with at least one dose of a COVID vaccine and 63% are fully vaccinated.

Wednesday morning headlines

President Joe Biden is set to announce that the U.S. is doubling, to 1 billion doses, its purchase of Pfizer's COVID-19 shots to share with the world.

Biden is also set to embrace a goal of vaccinating 70% of the global population within the next year. The stepped-up U.S. commitment will be the cornerstone of a global vaccination summit the president is convening virtually Wednesday on the sidelines of the U.N. General Assembly.

Biden will push well-off nations to do more to get the coronavirus under control around the world. Word of Biden's plan comes from two senior Biden administration officials who spoke on the condition of anonymity to preview the president's remarks.

A North Carolina-based health care provider says nearly 400 of its workers face firings for failing to comply with a mandatory coronavirus vaccination program.

The Winston-Salem Journal reports that Novant Health said Tuesday that 1.4% of its overall workforce, or 375 employees, are not being allowed to work.

Novant announced its mandatory vaccination policy July 22, saying then that it would require full compliance by Sept. 15.

In a news release, Novant Health says the affected workers will have five days to comply with the vaccine mandate. If they don't get the shot before the deadline, they will be fired.

ABC News learned from multiple sources that the FDA will likely authorize a third Pfizer dose Wednesday.

It's anticipated that the authorization will be for people ages 65 and up, people at high risk for severe illness and possibly frontline workers.

The CDC independent advisory committee (ACIP) is then scheduled to come up with specific recommendations and vote on Thursday. That can only happen if the FDA has authorized boosters by then.

After the CDC independent committee votes on the recommendations, the CDC Director usually endorses those recommendations.

That same CDC committee (ACIP) is meeting Wednesday to hear presentations but a vote will not be made at that time.

Methodist University is working to help students and staff meet next month's deadline to be fully vaccinated.

Students must show proof by Oct. 15. Faculty and staff have until Oct. 29.

The Fayetteville university is requiring full vaccinations in order to live, work, attend classes and participate in activities on campus.

About one-third of the nearly 9,500 virus-related deaths in the last week came from just three states: Texas, Georgia and Alabama.

About 90,000 Americans are currently hospitalized with COVID-19, compared to more than 100,000 patients about three weeks ago, according to federal data. But in the past month, at least 10 states -- Alaska, Idaho, Kansas, Maine, North Carolina, Oregon, South Carolina, Tennessee, Washington and West Virginia -- have reported record hospitalizations.

The Federal Emergency Management Agency is processing a request to send 50 ambulances and 100 personnel to North Carolina to help with the COVID-19 response.

The FEMA support information was detailed in a federal planning document obtained by ABC News.

Jaclyn Rothenberg, a spokeswoman for FEMA, told ABC11 that the request being "in-process" means there may be adjustments to the actual allocations.


9 p.m.

During a Wake County school board meeting Tuesday afternoon, county staff were told to work on a voluntary COVID-19 testing program for students.

The district said it is too short-staffed to run the testing program itself, but there was an understanding there will be an additional burden on staff in some capacity.

The board is also in the process of figuring out the best way to comply with the soon-to-come federal mandate that requires companies with 100 or more staff have to be vaccinated or tested weekly.

"Increased testing at schools would ensure all students and teachers regardless of socioeconomic status have access to a test," said Christina Jones, Wake County mother of a first and second-grader. "We are the largest school district in North Carolina so it is our responsibility to lead the way for the rest of the state, it is time to be bold and strong for our kids

"This is about public health, vaccine mandates have been in place for years. Schools have always required you show vaccine records when you enter schools. This is no different, the only difference is that it's a new illness and we're in a pandemic," said Shruti Adiga, mother of a kindergarten student at Penny Road Elementary. "The more layers the better, the earlier we catch asymptomatic infections, the less transmission we'll have of the virus, the less students out on quarantine."

Adiga spoke at Tuesday's meeting to ensure the mask mandate stays and that there will be a robust testing program.

"Let me remind you that y'all were elected to make sure our kids get a great education. It is a parent's right, not yours to make medical decisions for our children," said Jessica Lewis, Wake County mom. "Why do the children have to sit six seats apart in the cafeteria, not allowed to talk and then hurry up and put their masks back on? My family can go into a restaurant and not even be asked to put a mask on and we are closer to other people."

3 p.m.

Gov. Roy Cooper held a briefing to update residents on the status of the state's COVID-19 response and highlighted an effort to get faith leaders involved in strengthening community vaccination efforts.

"We remain laser focused on helping more North Carolinians make the decision to get vaccinated," Cooper said. "(State Health) Secretary (Mandy) Cohen and I are sharing a letter to faith leaders asking them to encourage their congregations to get vaccinated and to help combat misinformation about vaccines and treatment. Some houses of worship have served as vaccination sites and I hope more will. Faith leaders from all religious backgrounds can be trusted figures in their communities. Their word can go a long way in encouraging people to talk with doctors and understand that vaccines are safe."

In the letter, Cooper and Cohen wrote:

"Getting vaccinated is one of the deepest expressions of our shared values to protect human life and love our neighbor. It is an act of love to our families and our communities. While we have made much progress in the state, too many people are needlessly getting seriously ill, being hospitalized, and dying. Our hospitals are strained, and in other states we've seen that care is not readily available for people experiencing non-COVID life-threatening health crises. We need your help."

The letter outlines three actions that faith leaders can take, including directing their congregation and faith community to trustworthy sources about COVID-19 vaccines, serving as vaccine ambassadors, and hosting vaccination events.

Raw video: Gov. Roy Cooper held a briefing to update residents on the status of the state's COVID-19 response and highlighted an effort to get faith leaders involved in strengthening community vaccination efforts.

Cooper also again urged vaccinations, saying it's not too late to get vaccinated if you haven't done so already.

"Every vaccine given is a potential life saved," Cooper said.

He noted that 90% of North Carolinians 65 and older have received at least one dose of COVID-19 vaccine

Cooper talked about an initiative to get faith leaders to encourage those in their congregations to get vaccinated.

The governor also said state government is pressing employees to comply with vaccination or testing requirements.

"Under my Executive Order, NC cabinet agencies are working to require employees to verify they have been vaccinated or collect their weekly COVID test results," Cooper said. "It's positive that many agencies are reporting high percentages of vaccinated employees, but there is more work to do."

To date, North Carolina has administered over 11 million doses of the COVID-19 vaccine, with 63 percent of the adult population fully vaccinated. Sixty-eight percent of adults have received at least one dose of the vaccine.

Raw video: State Health Secretary Dr. Mandy Cohen discusses COVID-19 metrics and trends in NC.

1 p.m.

The American Rescue Plan Act provides U.S. cities and counties with $130.2 billion through December 31, 2024. The City of Raleigh will receive more than $73.2M as part of this allocation.

At the Tuesday City Council work session, staff presented on Phase 2 of the City's plan to allocate American Rescue funding. Phase 2 will focus on meeting community needs for recovery from COVID-19 and the associated economic impacts. Staff received feedback from City Council on prioritizing the following areas: Economic Recovery, Housing/Homelessness, Community Health, Infrastructure and Transit.

Based on City Council feedback, staff proposed the following budget amendments:

$10 million for affordable housing strategic acquisition

$10 million for health initiatives awarded through a request for proposals (RFP) and review process

$5 million for small business assistance through the Carolina Small Business Development Fund

$500,000 to support the development of outdoor seating to turn public spaces into vibrant community spaces

City Council authorized the budget amendments on Tuesday.

12:15 p.m.

4,381 new daily COVID-19 cases were reported in North Carolina on Tuesday.

The percent of positive tests in the state is at 11%.

3,464 people are currently hospitalized in the state with COVID-19.

There are 908 adult ICU COVID-19 patients.

334 confirmed COVID-19 patients have been admitted into hospitals in the last 24 hours.

The number of COVID-19 patients on ventilators is on the decline after months of increases.

11:50 a.m.

The Federal Emergency Management Agency is preparing to send 50 ambulances and 100 personnel to North Carolina to help with the COVID-19 response.

The FEMA support information was detailed in a federal planning document obtained by ABC News.

Ambulances were provided to the state of Mississippi last month and Louisiana earlier this month.

11 a.m.

The U.S. reported more than 225,000 child COVID-19 cases, marking the fourth consecutive week with over 200,000 new pediatric cases reported, according to a newly released weekly report from the American Academy of Pediatrics and the Children's Hospital Association.

In the last five weeks alone, the country has reported more than 1.1 million pediatric cases, according to the organizations.

"The weekly figure is now about 26 times higher than it was in June, when just 8,400 pediatric cases were reported over the span of a week," the organizations wrote in their report.

The South accounted for about half --110,000-- of last week's pediatric cases, according to the report.

The organizations added that more than 2,200 children are hospitalized with a confirmed or suspected COVID-19 infection.

6:30 a.m.

A second dose of Johnson & Johnson's COVID-19 vaccine given two months after the first leads to stronger protection, according to the company.

The new data, announced in a press release, adds to a growing body of evidence suggesting that booster shots could enhance vaccine protection against breakthrough infections -- though experts agree all three vaccines are still doing their job to protect against more serious illness.

Compared to the Pfizer and Moderna vaccines, Johnson & Johnson's single-shot vaccine always had slightly lower efficacy. Peak efficacy from the two-shot Pfizer and Moderna vaccines was 95% and 94%, respectively, against symptomatic illness.

But two Johnson & Johnson shots, given two months apart, resulted in a similarly high effectiveness level: 94% protection against any symptomatic infection in the U.S., and 100% against severe disease.

Q&A: What do families need to know about Pfizer's data on shots for kids

Dr. Alexa Mieses Malchuk answers questions about COVID-19 and the COVID-19 vaccines.

Tuesday morning headlines

Gov. Cooper and members of the Coronavirus Task Force will share an update on COVID-19 in the state at 3 p.m. today.

During the Raleigh City Council meeting on Tuesday, city staff, along with staff from the Greater Raleigh Convention and Visitors Bureau and the Centennial Authority, will provide Council with an update on the status of tourism in Raleigh amid the pandemic, current and future challenges, expectations for the coming year and status of hotels.

Council is also expected to discuss the current status of the ongoing response to the COVID-19 pandemic, review the city's indoor face covering proclamation, and discuss current vaccine/testing requirements for employees.

The deadline for Duke Health employees to get vaccinated is Tuesday. On Monday, a spokesperson told ABC11: "Nearly 97% of Duke University Health System employees have fulfilled the COVID vaccination requirements as of today."

The workers who have not complied with the vaccine requirement by 10 a.m. could get a final written warning, followed by administrative action, including loss of their jobs.

The Wake County School Board is meeting on Tuesday. During the work session. Paul Koh, Assistant Superintendent of Student Support Services and Kelly Creech, Senior Director for Health Services are expected to share information and potential strategies for COVID-19 testing and vaccination for the 2021-2022 school year.


6:40 p.m.

UNC Health spokesperson Alan Wolf said COVID vaccination statuses or granted exemptions have been confirmed for 95 percent of employees. The status of 1,400 employees is still awaiting confirmation.

"We are confident we will get the vast majority of our teammates vaccinated. We want to keep everyone employed who wants to stay with UNC Health, and are working hard to accommodate employees with medical and religious concerns. We've approved about 1,100 exemptions for medical or religious reasons," said Wolf.

Any employees who are non-compliant as of Sept. 21 will enter a probationary period. The period ends Nov. 2 and employees have until then to enter receiving a complete vaccination series.

3:15 p.m.

NCDHHS has announced four new locations offering monoclonal antibodies for COVID-19 treatment.

"While vaccines provide the best protection from COVID-19, treatment options such as monoclonal antibodies are available for people at high risk for severe illness if you have had symptoms of COVID-19 for 10 days or less or have been exposed to COVID-19," said Dr. Elizabeth Tilson, NCDHHS State Health Director and Chief Medical Officer. "Expanding access to this potentially lifesaving treatment can, if taken early, reduce the risk of severe disease, hospitalization and death."

The four new sites are located in Harnett, Robeson, Johnston and Wilkes counties.

  • Wilkes County: The Health Foundation in North Wilkesboro. Call 336-528-1637.
  • Johnston County: Smithfield Hospital Campus in Smithfield. Call 919-268-1621.
  • Harnett County: Central Carolina Community College Harnett Health Sciences Center in Lillington. Call 910-893-0653.
  • Robeson County: UNC-Southeastern Ambulatory Care Center in Lumberton. Referrals based on a positive COVID-19 test are required for this location.

2:55 p.m.

The Johnston County school board voted to keep its mask mandate in place during a Monday meeting.

The board voted 4-3 in favor of the mandate.

Masks remain required inside all JCPS facilities and buses for all students, staff, and guests.

1 p.m.

Wake County announced that 87% of its employees have attested that they are fully vaccinated.

Out of 4,185 employees, 3,623 have responded that they are fully vaccinated, the county said.

In August, Wake County announced a program that required staff to attest by Sept. 15 that they were fully vaccinated, or they would be required to get tested weekly for the fast-spreading virus.

12:15 p.m.

North Carolina Department of Health and Human Services reported 3,257 new COVID-19 cases Monday, the third-straight day of declining new cases since the state reported 7,905 cases Friday.

The number of people hospitalized for COVID-19 also continued to drop, falling to 3,323. Currently, there are 887 adults in ICUs across the state with COVID-19.

However, the percentage of positive tests rose above 10% for the first time in four days--as of Saturday 10.3% of tests are positive.

Since the beginning of the pandemic, 15,776 people have died from COVID-19. That's an increase of 161 deaths since Friday.

11:40 a.m.

The Union County Board of Education held a special meeting at 7 a.m. on Monday as it faces legal action from the state's health department over the district's COVID-19 protocols inside schools.

Just after 8:30 a.m., the School Board voted 8-1 to "continue following its legal obligations of reporting positive cases to the local health department and providing relevant information to the local health department," according to WSOC.

The School Board also agreed to require students who are symptomatic or have tested positive for COVID-19 to stay home, and the district will recognize quarantines in accordance with state law, of students and staff who are considered close contacts with a COVID-19 positive case.

The board previously passed a motion to halt all activity of contact tracing and quarantine by Union County School staff and nurses and called for the immediate return of all students who were excluded from school because of COVID-19 exposure.

11 a.m.

The House Wake! COVID-19 Financial Assistance Program is making changes.

Beginning Sept. 20 applicants can self-attest to the information required to process their application when documentation is not readily available. They are also eligible for up to six months of additional financial assistance and have in-person access to support from Legal Aid of North Carolina at the Wake County Courthouse.

In addition, landlords can now receive bulk payments for rent owed to them instead of monthly payments and the online portal for the program will be launching tonight.

10:40 a.m.

President Joe Biden will ease foreign travel restrictions into the U.S. beginning in November, when his administration will require all foreign travelers flying into the country to be fully vaccinated.

White House COVID-19 coordinator Jeff Zients says they'll need to demonstrate proof of vaccination before boarding, as well as proof of a negative COVID-19 test taken within three days of flight.

Biden will also tighten testing rules for unvaccinated American citizens, who will need to be tested within a day before returning to the U.S., as well as after they arrive home.

Monday Morning Headlines

Pfizer vaccines

Data shows the Pfizer and BioNTech COVID-19 vaccine is safe and effective for children ages 5 to 11, the companies announced Monday morning.

"We are eager to extend the protection afforded by the vaccine to this younger population, subject to regulatory authorization, especially as we track the spread of the delta variant and the substantial threat it poses to children," Pfizer chairman and CEO Albert Bourla said in a statement. "Since July, pediatric cases of COVID-19 have risen by about 240 percent in the U.S. -- underscoring the public health need for vaccination."

There were 2,268 participants ages 5 to 11 in the trial, which, while it still followed a two-dose regimen, used a lesser dose than the amount given to people ages 12 and older, for the "safety, tolerability and immunogenicity" of younger children.

Wake County Vaccine Clinics

Starting Monday, all five permanent Wake County Public Health vaccine locations in the county are adding staff, expanding hours and offering both Pfizer/Comirnaty and Moderna.

That's to prepare for the potential approval of booster shots for all Americans.

In addition, all vaccinations will require appointments beginning Monday.

"Temporarily ending walk-ins and moving to only appointments will allow slots to be reserved for those seeking first and second doses, those with weakened immune systems needing additional doses, and those seeking booster doses," Wake County Public Health said.

Wake County's Northern Regional Center in Wake Forest and Southern Regional Center in Fuquay Varina had only been administering Moderna at their vaccine clinics. Now, they are adding Pfizer.

Wake County officials say the changes will help them administer about 2,000 vaccine doses per day.

Johnston County COVID-19 protocols

The Johnston County School Board meets on Monday to take up the mask mandate debate.

Last week, hundreds of people -- including U.S. Rep. Madison Cawthorn -- showed up to the Johnston County School District Headquarters to rally against a mask policy.

The Johnston County school board was initially going to make a decision on whether to continue requiring face masks in schools on that day. However, the vote was delayed due to a death in the family of a chairwoman.

The vote will now be considered on Monday at 2 p.m.

Governor Roy Cooper did not extend the order that was in place last year that required schools at a state level to mandate mask wearing. Now, the decision is being left up to individual school districts. However, a new law does require school boards to vote monthly on their masking policies.

The Center for Disease Control and Prevention still recommends students older than 2 wear masks in school to help reduce the spread of COVID-19, which is now infecting children at higher rates than ever before seen.

WWE RAW returns to Raleigh

WWE RAW returns to Raleigh for the first time in a decade on Monday.

The event will be held at PNC Arena.

Masks are required upon entry. There are no vaccination or testing requirements for the event.

Booster shots

The National Institutes of Health director says a government advisory panel's decision to limit Pfizer COVID-19 booster shots to Americans 65 and older as well as those at high risk of severe disease is a preliminary step and predicts broader approval for most Americans "in the next few weeks."

Dr. Francis Collins told "Fox News Sunday" that the panel's recommendation Friday was correct based on a "snapshot" of available data on the effectiveness of Pfizer's two-shot regimen over time. But he said real-time data from the U.S. and Israel continue to come in showing waning efficacy among broader groups of people that will need to be addressed soon.

Collins, who also appeared on CBS' "Face the Nation," said: "I think there will be a decision in the coming weeks to extend boosters beyond the list that they approved on Friday."

Dr. Anthony Fauci, who is President Joe Biden's chief medical adviser, on Sunday praised the advisory board's plan for covering a "good chunk" of Americans. But he stressed that "this is not the end of the story" based on evolving data and said the recommendations will likely be expanded in the coming weeks to months.

The Food and Drug Administration will consider the advisory group's advice and make its own decision, probably within days. The Centers for Disease Control and Prevention also is set to weigh in this week.

COVID-19 in South Carolina

South Carolina is setting records for COVID-19 hospitalizations, and new cases are approaching the peak levels of last winter.

Since ending South Carolina's state of emergency on June 7, Republican Gov. Henry McMaster has maintained that parents alone should decide if children wear masks in schools, even as the state's new cases soared from 150 a day on average to more than 5,000.

Now teachers, students and parents are struggling with the fallout as more young people contract the delta variant, forcing nearly two dozen schools and two entire districts back to online learning within a month of returning in person.

State health and education officials say the statewide mask ban in schools took away one of their best tools to stop the spread of COVID-19. The state hit nearly 2,600 COVID-19 patients hospitalized in early September, a record.

"We spiked the football too early. Instead of continuing to listen to medical professionals and interpreting the data, he has been guided by Republican Governors Association talking points," Democratic state Sen. Marlon Kimpson of Charleston said.

Some lawmakers from both parties are pushing for a special session to repeal the rule and allow local governments to make decisions. The state Supreme Court is considering a lawsuit over whether the mask provision is legal.