COVID-19 Vaccination for Kids 5-11: A Guide for Parents
YAY!!! It’s finally time for young kids to be vaccinated. The completion of clinical trials and comprehensive examination of safety and efficacy, as well as disease prevention, data is complete.
The study results are excellent, FDA and CDC committee conclusions are unified, and there is substantial benefit to vaccinating children 5-11. The following is intended to help parents navigate data to make informed decisions.
Reasons to Vaccinate
In the last pandemic surge caused by the Delta variant, over 30% of cases occurred in kids ages 0-17.
Almost 2 million children ages 5-11 were infected with COVID-19 from the beginning of the pandemic, with 20,000 of those children living in Iowa.
Of all vaccine-preventable diseases, COVID-19 causes more deaths and the highest rate of hospitalization.
MIS-C occurs more often in 5–11-year-old children than in any other age group. And 7-9% of kids in this age group experience long COVID-19.
More than 8,300 of those 2 million cases were hospitalized, 30% had no underlying health condition (e.g., diabetes, obesity), and 1/3 ended up in the ICU. This is likely a significant underrepresentation of the true number of cases.
Kids easily spread COVID-19 in school, to peers, and at home. Community transmission is impacted by school-age kids.
A great resource from the American Academy of Pediatrics - Webinar: COVID-19 Vaccination and Children: Answering Parents’ Questions - Public Health Communication Collaborative (publichealthcollaborative.org)
COVID-19 (coronavirus) in babies and children - Mayo Clinic
How is the COVID-19 Pfizer administered?
The Pfizer COVID-19 vaccine dose for kids 5-11 is 1/3 of the adolescent/adult dose. Children need two doses 21 days apart.
What side effects should parents of 5–11-year-old kids expect?
Side effects are generally mild and include fatigue, headache, and muscle pain. Fever and chills were reported less often than in earlier adolescent studies.
No serious adverse outcomes were reported. However, parents should be aware of the rare possibility for myocarditis/pericarditis (inflammation of the heart muscle and the lining around the heart). This reaction was reported in adolescents and young adults; more often in males and after the second dose. All persons with this rare event recovered. Of 133 million doses, 663 cases of myocarditis occurred. In adolescents, the rate of myocarditis varies by study from 2.13-15 per 100,000 (see below for study links).
Myocarditis after Covid-19 Vaccination in a Large Health Care Organization | NEJM (most recent)
COVID-19 mRNA vaccines in adolescents and young adults: Benefit-risk discussion (cdc.gov)
Myocarditis after BNT162b2 mRNA Vaccine against Covid-19 in Israel | NEJM
CDC COVID-19 Vaccination Planning Meeting
It is important to note, COVID-19 infection can cause myocarditis. Infected children are 37 TIMES MORE LIKELY to develop myocarditis than those not infected.
A known possible serious outcome can include anaphylaxis (allergic reaction). This occurs at a rate of ~2-5 people per million.
Parents should monitor children for any adverse reactions to the COVID-19 vaccine. If a reaction occurs, contact your healthcare provider.
COVID-19 Vaccination-Associated Myocarditis in Adolescents: A review of all known cases through Aug 2021 peds.2021-053427.full.pdf (aappublications.org)
Myocarditis With COVID-19 mRNA Vaccines | Circulation (ahajournals.org)
Selected Adverse Events Reported after COVID-19 Vaccination | CDC
Myocarditis and Pericarditis After mRNA COVID-19 Vaccination | CDC
Will I have to keep my child out of school after vaccination?
No, not because of the vaccination. Virus is not produced by vaccination and vaccine particles are not spread from someone who is vaccinated.
Clinical trial data summary
An original and expanded clinical trial was conducted at multiple sites across the US. In total, 4,647 children were included. Of those, 3,018 were vaccinated. Participants were followed for several weeks through 3.3. months.
Common side effects included fatigue (39%), headache (28%), and muscle pain (12%). Lymph node swelling and rash/skin irritation was reported in a small number of participants. No events of myocarditis, anaphylaxis or deaths were reported.
Detailed information from the FDA advisory committee and CDC ACIP meeting:
ACIP November 2-3, 2021 Presentation Slides | Immunization Practices | CDC
Is the Pfizer vaccine effective in kids 5-11?
The vaccine is 91% effective. Response against Delta was measured and is strong.
While the trial did not examine whether the vaccine reduces transmission in kids, it is assumed to as the vaccine reduces transmission as it does in adults.
Effectiveness of BNT162b2 Vaccine against Delta Variant in Adolescents | NEJM
If my child is 11, should I wait until my child is 12 to receive a larger dose of the vaccine?
Pfizer vaccine dosing is appropriate for a child’s immunologic age and will cause an adequate response in an 11-year-old with the 1/3rd dose and also a larger dose in a 12-year-old.
How long does the vaccine stay in the body?
Vaccines are made to disappear quickly from the body. The immune system rapidly recognizes vaccine particles and removes them. The immune system will also remember how to fight that infection in the future.
When the COVID-19 mRNA enters the body, it is coated by a type of fat bubble (a lipid nanoparticle). The bubble enters the cell and the mRNA is translated into a protein that makes the body think it is infected with COVID. The mRNA cannot go into the part of the cell where human genes are housed, nor can it change human DNA. The COVID-like protein and fat bubble are removed from the body by the immune system in about three days.
In rare cases, the body can have an inflammatory response to a vaccine up to 6-8 weeks after the vaccine is given. The inflammatory response is the body reacting to itself as vaccine particles are long gone after 6-8 weeks.
Does the COVID-19 vaccine affect fertility?
There are now multiple large-scale studies proving the safety of vaccines in women who plan to become pregnant and who are already pregnant. All studies reinforce that the COVID-19 vaccine does not impact fertility or pregnancy.
The CDC maintains several large registries that look for signs of adverse vaccine reactions, including a few focused only on pregnant women. Among pregnant women, the rate of miscarriage, premature birth, and preterm labor, among other adverse birth outcomes, was the same in vaccinated women compared to unvaccinated women. CDC also examined reports from 155,000 pregnant vaccinated women. Birth outcomes in this large population were the same as unvaccinated populations.
In addition, the FDA continuously receives data from vaccine manufacturers to assess ongoing safety and effectiveness.
COVID-19 | ACOG – American College of Obstetricians and Gynecologists
COVID-19 Updates and Resources | ASRM – American Society for Reproductive Medicine
COVID-19 | SMFM.org - The Society for Maternal-Fetal Medicine – Society for Fetal and Maternal Medicine
Covid-19 Vaccination during Pregnancy and First-Trimester Miscarriage | NEJM
Preliminary Findings of mRNA Covid-19 Vaccine Safety in Pregnant Persons | NEJM
Receipt of mRNA Covid-19 Vaccines and Risk of Spontaneous Abortion | NEJM
Effectiveness of the BNT162b2 mRNA COVID-19 vaccine in pregnancy | Nature Medicine
Will Moderna protect my child better than the Pfizer vaccine?
Both mRNA vaccines are providing excellent protection against serious illness, hospitalization, and death. Effectiveness of Moderna and Pfizer are very similar. Early safety and efficacy studies on Moderna’s child vaccine are promising, but the vaccine may not be authorized by the FDA until later this winter.
Additional Resources:
FAQ - Public Health Communication Collaborative (publichealthcollaborative.org)