**7. Vaccination availability: a gateway to normalcy**

On December 14, 2020, the U.S. COVID-19 Vaccination Program began, with vaccines from Pfizer (New York, NY); Moderna (Cambridge, MA); and Johnson & Johnson (New Brunswick, NJ) being deployed [54], first for domestic then for global use. To date, Pfizer and Moderna each require two shots to achieve fully immunized status, whereas Johnson & Johnson requires a single shot [55]. Pfizer vaccines must be given to patients ages 12 and older, while Moderna and Johnson & Johnson vaccines must be given to patients ages 18 and up [55]. An additional booster dose has been recommended by all companies for patients ages 12 and up [55]. Other countries also deployed their own vaccines to meet local needs [56]. As of April 1, 2022, as many as 561,173,692 COVID-19 vaccines have been administered (255,582,575 have received at least one dose and 217,703,007 are fully vaccinated); thus, 77% of the U.S. population has received one dose, and 65.6% are fully vaccinated [54]. Studies have shown that Pfizer and Moderna vaccines are approximately 94-95% effective for patients who have received the second dose and 64% for those who have received just one dose [57]. The Johnson & Johnson vaccine has shown 66.3% effectiveness in clinical trials for patients with no prior COVID-19 infection [58]. Compared to fully vaccinated patients, unvaccinated children are 1.6 to 2 times more likely to be hospitalized, and adults are 5 times more likely to be hospitalized [55]. According to the CDC, the number of new COVID-19 hospital admissions has been generally decreasing from April 19 to June 22, 2021 [55]. Therefore, the global distribution of COVID-19 vaccinations appears to be providing immunity against the virus, shown by the decline in hospitalization and a slower increase in new cases of COVID-19.

Increased vaccination rates in eligible candidates significantly help to curb virus transmission rates within a population. This, in turn, may be able help neighborhoods to lift quarantine and lockdown measures, aid in a quicker return to "normal", which therefore may help reduce the toxic stressful environment and its harmful consequences on children. Consequently, well-implemented vaccination programs are critical to international health security, the well-being of the global population inclusive of children, as well as our current best attempt at the return to normalcy [59].
