COVID-19 vaccine for children – what parents should know

Andy Goodner, M.D., Mayo Clinic Health System family medicine physician at Winneshiek Medical Center answers questions about the pediatric COVID-19 vaccine:

Andy Goodner, M.D., Mayo Clinic Health System family medicine physician at Winneshiek Medical Center answers questions about the pediatric COVID-19 vaccine:

1. Which vaccine is available for pediatrics?
The two-dose Pfizer vaccine received Emergency Use Authorization (EUA) for children ages 5-11 on 10/29/2021.  Pfizer is also available for youth ages 12-18 as well as adults.   

2. Is it the same formula as the adult version?
The pediatric Pfizer dose is the same messenger RNA or mRNA but at 1/3 the dose of the adult vaccine. The mRNA is the instructions to your body to make a spike protein that is part of the outside of the virus so that your immune system can learn to attack this protein if it encounters it during an exposure or infection with COVID-19. This dose was selected because during studies the 10 mcg dose produced the same immune response to higher doses that were investigated and had fewer side effects.

3. How effective is the vaccine in kids?  
Preliminary data shows that a week after the second dose vaccine was 90.7% effective in preventing symptomatic COVID-19 in children 5-11 years of age. While preventing all COVID infection is ideal, and this vaccine does a great job of that, prevention of serious illness, hospitalization, and death is the main goal. It is not known how effective the vaccine is at preventing children from becoming infected or spreading the coronavirus, as that was not explicitly studied in the clinical trial. However, if the vaccine performs similarly in children as in adults, the pediatric vaccine should reduce — although not eliminate — both infection and transmission.

4. Will kids experience side effects of the vaccine?
The most common side effects in children were pain, redness or swelling at the injection site, fatigue, headache and muscle pain. However, these side effects were generally more mild and less frequent in children than in those receiving the adult dose. Most of these reactions were mild and resolved within one or two days and often were worse after the second dose. Less than 1% develop rash or lymph node swelling.

5. I am hearing lots of conflicting opinions on the safety of the vaccine for children.  Is it safe?
No kids in the vaccine trial developed dangerous allergic reactions or myocarditis or pericarditis. However, because those conditions have on rare occasions occurred in people following vaccination with Pfizer/BioNTech’s adult vaccine, we do expect them to occur once the pediatric vaccine is rolled out to millions of children. It is not yet known how common myocarditis will be in children following vaccination with the pediatric Pfizer/BioNTech vaccine but is expected to be very rare. Vaccine-related myocarditis appears less common in 12- 15-year-olds than in 16- to 29-year-olds, suggesting the risk would be even lower in younger children, especially given the lower amount of mRNA used in the vaccine. The FDA modeled a series of scenarios assuming the myocarditis rate in vaccinated kids 5-11 years old is the same as in 12-15-year-olds. According to the model, the vaccine prevents more bad outcomes from COVID-19 than it causes. Vaccine-related myocarditis is usually less serious than typical myocarditis and a child is less likely to get myocarditis from the vaccine than from COVID-19 infection.  In summary, no vaccine is completely safe, nor is any illness. The COVID-19 vaccine appears to have less risk than COVID-19 infection.

6. Is it recommended to get my child vaccinated? 
The CDC and the American Academy of Pediatrics both recommend children 5 years and older get vaccinated. While it is true that most children that get COVID-19 infection have mild disease, this is not always the case, and thousands of children have been hospitalized and nearly 100 US children have died of this illness. While 100 may not seem high, this is enough to have made COVID-19 one of the top 10 causes of death in children in this age range. The most common underlying health problems in serious illness with COVID-19 were common conditions such as asthma and obesity and 1/3 of hospitalized children with COVID-19 had no underlying health problems at all. Several thousand cases of a serious multisystem inflammatory syndrome have occurred in children following a COVID-19 infection and 7-8% of children have long term symptoms following COVID-19 infection.

7. Does my child still need to take COVID-19 precautions after being vaccinated?
Protection from COVID-19 infection and transmission of COVID-19 to others is best thought about using a layered approach. With each additional layer, you decrease the chance of infection and transmission to others. Vaccines are only one part of those layers. Layers of protection for your child and others include: 
Get vaccinated
Wear a mask or face covering indoors, especially if crowded or close quarters
Practice social distancing with those outside your household
Clean your hands frequently with soap and water
Stay home if you feel sick

8. How can my child get the vaccine?
Iowa Department of Public Health distributes the vaccine to clinics and other vaccine locations for administering to patients.  Locally, the pediatric vaccine is available through medical clinics, pharmacies and Winneshiek County Public Health.  To receive the vaccine at Winneshiek Medical Center, call 563-382-2911 to schedule an appointment.  You do not need to be a patient of Winneshiek Medical Center or Mayo Clinic Health System to receive your vaccine from us.

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