COVID-19 Vaccines and Children
The most effective way to control the spread of an infection is to create an effective vaccine against it. Currently in the United States, we have three coronavirus vaccines available that have been shown to be effective against COVID-19 through clinical trials.
Coronavirus vaccines will not only decrease the number of people who suffer from this disease but is helping the world “return to normal” faster by allowing us to travel, go out in public, and socialize with family and friends again without restrictions.
There is a lot of confusing information out there about COVID-19 vaccines and children. We want to address some of the most common questions people ask us.
Should young people get the COVID vaccine?
Yes! We strongly encourage young people to get the COVID-19 vaccine. Currently, the highest numbers of COVID-19 infections are in those who are ages 18 to 29 according to the Centers for Disease Control and Prevention (CDC).
In young healthy people, COVID-19 is typically milder as compared to people who are older or have certain health conditions such as obesity. However, this is not always the case, because over 2300 people between the ages of 18 and 29 years and over 300 children and adolescents younger than 18 years have died from COVID-19 in the United States. Moreover, children who have mild or no symptoms from COVID-19 may develop multisystem inflammatory syndrome in children (MIS-C), a condition in which different body parts – including the heart, lungs, kidneys, brain, skin, eyes, or intestines – can become inflamed.
We know that a person can spread COVID-19 to others even if they have no symptoms. When young people become infected, they can spread it to others who are at high risk of having severe COVID-19 disease, such as their parents or grandparents. We have personally cared for people with COVID-19 in the hospital who contracted it from younger friends or family. Making sure everyone who can get the vaccine receives it also protects people with weakened immune systems in whom the vaccine may not be effective. Think of getting vaccinated as a way to protect yourself, your loved ones, and the people around you.
Is the coronavirus vaccine safe for children and what are the side effects?
The Pfizer/BioNTech vaccine is the only COVID-19 vaccine that is approved by the Food and Drug Administration (FDA) for adolescents. In the studies that tested the safety of this vaccine, the most common vaccine side effects in adolescents were pain at the site where the vaccine was given and tiredness.
There have been reports of young people between the ages of 16 to 30 years developing myocarditis, which is inflammation of the heart muscle, or pericarditis, which is inflammation of the sac that surrounds the heart, after receiving the Pfizer/BioNTech or Moderna vaccines.
We believe that myocarditis and pericarditis are true side effects of these vaccines. These side effects occur a few days after the second dose, and most people affected are adolescent boys and young adults.
Although myocarditis and pericarditis sound scary, this side effect is extremely rare. According to the CDC:
- among adolescent boys ages 12 to 17 years, for every one million second doses of the Pfizer-BioNTech vaccine, there may be 56 to 69 cases of heart problems.
- for adolescent girls ages 12 to 17 years, there may be 8 to 10 cases of heart problems.
- the vast majority of those who were affected completely recovered within a few days, and to date no deaths have occurred from this vaccine side effect.
It is also important to remember that COVID-19 and MIS-C both cause heart problems at a higher rate than the vaccine; COVID-19 and MIS-C also cause other severe complications that require hospitalization, including admission to the intensive care unit. Therefore, the risk of not receiving a COVID-19 vaccine is much greater than the risk of receiving one.
There also have been rare reports of severe allergic reactions (anaphylaxis) after vaccination, so vaccines should be given in a monitored setting, where severe allergic reactions can be quickly detected and treated.
Can COVID-19 vaccines cause infertility?
In short, no. This myth came from a theory that the viral protein that the vaccine acts against is similar to a certain protein found on the placenta. However, these proteins have been found to be quite different. Moreover, many women who have received the vaccines have become pregnant.
The mRNA vaccines haven’t been around very long. What about long-term side effects?
Most side effects from any vaccine occur within six weeks. Also, the mRNA in the vaccine breaks down quickly, so there is no biological reason to think that the vaccine would cause long-term side effects. These vaccines do not alter the cells’ own DNA.
When can kids get the coronavirus vaccine?
Adolescents 12 to 17 years old are able get the Pfizer/BioNTech vaccine. Anyone 18 years and older can get the either the Pfizer-BioNTech, Moderna, or Janssen (Johnson & Johnson) vaccines. Further studies are being done to ensure these vaccines are safe in younger children.
Once these vaccines have shown to be safe and effective, the FDA will allow their use in younger children. Pfizer-BioNTech has announced that they plan on requesting COVID-19 vaccine emergency use authorization for children ages two to 11 years in September 2021.
Is the coronavirus vaccine FDA-approved?
In response to the pandemic, the FDA has allowed available COVID-19 vaccines to be used and distributed through what is known as emergency use authorization (EUA), which is not the same as full approval. This EUA status makes the vaccines immediately available for use in public health emergencies such as the COVID-19 pandemic, prior to full FDA approval.
In order for a vaccine to receive EUA status, it must be shown through rigorous studies to be safe and effective. Currently, there are no FDA-approved vaccines to prevent COVID-19. However, Pfizer/BioNTech and Moderna submitted applications for full FDA approval of their COVID-19 vaccines in May 2021.
Will the vaccine be required for school?
Each state determines which vaccines are required for school/childcare centers. At this point, there is no requirement for children to get the COVID-19 vaccine in order to attend school in Rhode Island. It is unclear if it will be required in the future.
If you are unsure of whether your child should receive a vaccination, talk with your child’s pediatrician.
About the Author:
Katrina M. Byrd, MD, and Silvia Chiang, MD
Dr. Katrina M. Byrd is an internist specializing in infectious diseases.
Dr. Silvia Chiang is a pediatric infectious diseases specialist at Rhode Island Hospital, Hasbro Children's Hospital and The Miriam Hospital.
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