What Parents Should Know About the COVID-19 Vaccination for Children

With cases of the Omicron variant making headlines in the United States — just ahead of the holidays — COVID-19 vaccinations and safety precautions are top of mind for parents and their kids. The Pfizer-BioNTech vaccine for children ages 5 to 11 was approved by the Food and Drug Administration in early November, just shy of a year since vaccines first rolled out to individuals ages 16 years of age and older. 

As with any new health measure, parents are left with questions about vaccine efficacy, side effects and how to assuage their kids’ fears of the “big jab.” Eileen Sullivan, Pharm.D., a registered pharmacist and assistant professor of health studies, weighs in on what parents can expect from the vaccine and how to prepare for the holiday season.
 

As a low-risk population, why do young children need the COVID-19 vaccine?

Even though the severity of the virus may not be as great in younger populations, the risk of them becoming carriers is. Children have a greater ability to fight off the virus with less complications than say the elderly, but there’s this carrier effect.

So, the thought process is, if we vaccinate the younger population, would we have less of a carrier effect, or passive effect, for the elderly population who may not be able to fight this off so readily? We have to think about individuals who are immunocompromised, too.

Younger populations may have less comorbidities — diabetes, heart disease, etc. — but those often increase as you age due to stress, lifestyle, changes in self care and ongoing genetic factors. And so, scientists believe that the greater age range we vaccinate, the greater the chances of passive immunity going forward and the lower the chances of spreading the virus to those who are more susceptible to becoming seriously ill.
 

What vaccine symptoms should parents watch out for in their kids?

The more common side effects that pediatric patients ages 5 to 11 are showing are pain at the injection site, fatigue and headache. Fever is about half as common in comparison to adult populations.

There are some less common side effects like myocarditis, or inflammation of the cardiac muscle, which has currently been shown to dissipate on its own in children. Now, we can’t make the assumption that that is always going to be the case, but we’re seeing less of that side effect happening in children than we are in adults with this lower dose vaccine.
 

And what about boosters? Will children need to go back for another shot in six months, similar to their parents or older siblings?

That hasn’t been announced yet, but that could change — it all changes so quickly. That said, children’s immune systems are different [from adults]. It’s almost like we’re using the vaccine on a “newer host,” if you compare someone who is 5 to 11 years old versus someone who is 65 to 95 years old. Children may be able to hold onto the vaccine response a little longer but, again, it’s just too new to say.
 

Will there come a time that the COVID-19 vaccine is added to the recommended immunization schedule for children?

Some people are of the thought that this vaccine should be included in the regular CDC vaccine schedule that a pediatric patient would follow. Children get MMR (measles, mumps, rubella) vaccinations, polio vaccinations, HPV (human papillomavirus) vaccinations, so why shouldn’t this vaccine be part of that regimen?

But some parents are fearful of that happening — and that’s because we don’t have more than a year’s worth of data on this vaccine. There’s a fear of, “what if there’s an adverse reaction in the long run?”

Right now, though, it’s a decision between parents and health care professionals of risk versus benefit. This virus is evolving quickly and so, it’s important to assess that balance. Time and evidence-based medicine play into that decision making.
 

What advice do you have for parents of children who are fearful of the big jab?

Education is key. We need to give children and parents a better understanding of the procedure and what’s going to happen so they’re not fearful of the unknown. So, “this is what’s going to happen, the pain is only temporary, these are the potential side effects, this is why we’re doing it.”

About a third of parents are unsure about the vaccine or have vaccine hesitancy, and that could be partly due to distress for the child. If we lessen the fear of the jab as opposed to the vaccine itself, perhaps more individuals would be willing to have their children vaccinated.
 

As we head into the holiday season, what do parents need to know?

If we look at the vaccination schedule, it’s two shots, 21 days apart, with the vaccine being fully effective two weeks after the second shot (or 35 days start to finish). Because the 5-to-11 year population was just approved for vaccinations before Thanksgiving, most children may not have full vaccination prior to the holiday season. Therefore, families should continue to use caution and continue to practice safety precautions as they plan their family gatherings.

For additional information on the COVID-19 vaccination for children, Sullivan recommends referencing the Centers for Disease Control and Prevention and the American Academy of Pediatrics.