Answering Your Questions About Getting Kids Vaccinated Against Covid

Photo Credit: Thiago Cerqueira/Unsplash

With summer camps open and kids mingling and socializing more, many parents eagerly awaited the moment when COVID-19 vaccines would be available to their young children. With formal authorization from the FDA and CDC’s strong recommendation, the moment arrived three weeks ago. Now, everyone 6 months and older is eligible to be vaccinated against Covid.

We’re all tired of the pandemic, but the virus isn’t tired of us. SARS-CoV-2 is infecting people at high rates in the United States and in many other parts of the world. Omicron continues to quickly mutate and new sub-variants are outcompeting previous ones. Currently, BA.4 and BA.5 are taking hold and these and/or future variants could springboard us into a new infection surge in the U.S. and across the globe.

Vaccines remain our most effective defense against severe Covid disease, and the youngest amongst us are now eligible for the benefit of that protection. It’s no surprise that parents have questions and concerns about the new vaccines — even Elmo’s parents did! Below I address some common questions from parents. If you still have questions, talk to your pediatrician or other health care provider.

Can Covid make kids sick?

The vast majority of kids experience mild to moderate disease if they get infected. But some kids can become very sick, spread it to their families, suffer complications such as MIS-C, or develop long Covid.

In the U.S.,1,564 kids under the age of 18 have died from Covid since 2020, according to the latest data from CDC. Although the risk fo death is far lower than it is for adults, this places Covid as a top 10 leading cause of death for children. In the BA.1 Omicron wave last winter, kids under 5 were hospitalized at a higher rate than any other child age group. Among those hospitalized, 30–50% were previously healthy and had no underlying medical conditions. Although it is very rare, MIS-C, an inflammatory reaction caused by an overactive immune response, emerges in some kids during an acute Covid infection. Since the beginning of the pandemic, 8,639 children had suffered from MIS-C, and 70 have died from it.

Millions of people, including kids, continue to suffer from long-term health conditions such as fatigue, shortness of breath, brain fog, and digestive issues months after getting infected with Covid. Long Covid is more common among adults, but data from the UK suggests approximately 1–2% of children have long Covid, and symptoms can be debilitating. There’s still a lot we don’t know about long Covid, including who’s at risk and effective treatments. And although the risk may be lower with Omicron than other variants, even a rare complication of a common infection can cause a lot of suffering in disability in a large number of people.

In addition, children spread infection effectively. Vaccines prevent infection, particularly in the first few months of vaccination. The fewer infections there are in kids, the less they will spread it to people around them, including vulnerable parents, grandparents, relatives, neighbors, teachers, or other older adults.

How do we know Covid vaccines are safe and effective for kids?

Pfizer and Moderna both conducted extensive clinical trials that were then reviewed by independent scientists and medical experts. Both of the trials had large sample sizes (Pfizer included 4,500 children and Moderna included 6,300 children) to assess safety and vaccine effectiveness. In both trials, no significant safety concerns were raised.

The trials showed that antibody levels after vaccination among young children were the same or higher than those in adults who were vaccinated with a larger dose. Efficacy against infection matched vaccine effectiveness for adults during Omicron. Although vaccines can reduce the risk of infection and transmission, their main objective and benefit is to prevent severe illness and death. Given high antibody levels in the clinical trials, we expect the vaccines to work extremely well against severe disease and death.

Dr. Katelyn Jetelina, epidemiologist and founder of the newsletter ‘Your Local Epidemiologist’ put together an excellent one-pager that breaks down the evidence supporting the safety and efficacy of vaccination for kids under 5.

Why did it take so long for vaccines to be made available to kids under 5?

Kids are not tiny adults — they have a different physiology, which means it’s important to have careful, rigorous studies of new vaccines or medications . In the U.S., we use a clinical trial method called “age de-escalation”. This means we test new vaccines in older populations first and when we see that they are safe and effective, we move down in age groups.

Correct dosing is critical for optimal effectiveness. Getting the correct dosage for this age group was challenging, and created some unexpected hurdles. This isn’t uncommon — 1 in 5 of all pediatric trials fail. Thankfully, tweaks to the recommended doses of vaccine to administer were successful to reach optimal effectiveness.

We also needed to ensure a large sample size for safety, which caused delays in the clinical trials.

We can be confident in these results because we know the process was not rushed and that evidence-based decisions were made to give confidence that these vaccines are safe and effective.

How can we convince parents who may be on the fence to vaccinate their young children against Covid?

We need to equip trusted messengers — such as pediatricians, family doctors, health departments, school officials, and other parents — with the information and tools necessary to communicate that vaccines for young children are safe and effective.

We also need to make it as easy as possible for kids to get vaccinated. That means making Covid vaccines available at pediatrician visits, flu shot appointments, and more. Vaccine campaigns will be critical in the beginning of the school year.

Conversations with friends and family members can have a significant impact encouraging people to get themselves and their children vaccinated. These conversations should include listening to questions and concerns and having open conversations, including about the benefits and side effects and how the vaccines were developed.

Although it will take time to increase vaccine confidence, we can make steady progress by increasing access, empathetic listening to questions and concerns, and by pointing people to evidence-based information, empowering trusted messengers, and tailoring our messages for the concerns of specific communities. The more of us who are up-to-date with Covid vaccines, the better individuals and communities will be protected.

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Dr. Tom Frieden

Dr. Tom Frieden

President and CEO, Resolve to Save Lives | Former CDC Director and NYC Health Commissioner | Focused on saving lives. twitter.com/drtomfrieden