COVID-19 update: Vaccines for children 5-11

By Mandie Svatek
COVID-19 update: Vaccines for children 5-11

Why has authorization for kids in this age group taken so long?

For kids 5-11, what the CDC and the FDA had to look at was assuring that we didn't have further adverse vaccine events associated with administering the vaccines before they gave that approval. And because they had this associated myocarditis, they had to look at that further and get reassurance and look at the current dosing they were administering for the younger kids to assure that they weren't seeing other side effects or further effects associated with myocarditis. They were looking at late summer perhaps, trying to initiate this vaccine. But because of the cases of myocarditis, it was important to gather more data.

The more data you gather, the more you can be reassured that this is a very extremely low number of cases. In fact, it's much lower than the number of individuals that have COVID-associated myocarditis or pericarditis, and so having those numbers to assure that we weren't getting an increased number of cases with younger children associated with this is reassuring. So that's where the hope is, that by October they can give us that answer for that EUA.

Should this give parents peace of mind?

I think this is a very positive thing that's happening that we are looking at that EUA (Emergency Use Authorization) approval hopefully at the end of October. What that will help with is continuing to send our kids back to school. If they are vaccinated, then we can think about potentials of when they get exposed, perhaps not developing disease from COVID, or having much less side effects from the disease.

I think this is very reassuring and it gives parents that opportunity to get them feeling safer as their child goes back to school or back to other activities.

Should parents be concerned about myocarditis with the COVID-19 vaccine?

If you compare getting COVID, in comparison to getting the vaccine, your risk of developing myocarditis is much higher with COVID than with getting the vaccine.

Explain what is meant when pediatricians say “kids are not just little adults.”

For me as a pediatrician, when I'm taking care of patients, I have my own book that I look at for information, and my own resources. Their immune system is much different than the immune system of an adult. Even babies' immune systems are much different than the immune system of a child.

So we have to understand that when we are administering a vaccine, or if a child gets exposed to a certain virus, that their symptoms might be different. They might be less, they might be more, but we need to understand that population and not just rely completely on what we see from the adult population.

If children don’t get as sick as adults, why should they be vaccinated?

That's a question that I think we still need to understand in time. When COVID-19 first came about, we were finding that less than 1% of our children were being hospitalized for COVID. But as COVID has mutated over time into different variants, we are seeing that more children are being hospitalized. Since the delta variant came in, I've had more children in the hospital, and my colleagues have had more children in the hospital than we have seen over the past year and a half with COVID pneumonia.

So we don't know, necessarily, that it's going to continue to only be an adult severe disease process associated with COVID. This can traverse to our younger population. We even worry about our infant population being really adversely affected by COVID.

Will children be able to get their COVID-19 vaccine at the same time as other vaccines?

Children will be able to get their COVID vaccine at the same time as other vaccines. What the CDC has said, and they looked at also the association with receiving the vaccine in the adult population, and they've had the ability to give them at the same time and have not seen adverse effects. So the CDC is currently stating that we can give them at the same time.

Could young children have different side effects?

Just as we know that young children are affected with different diseases and different viruses, there could be the potential for different side effects. So it's important that as children start to get vaccinated for COVID, that we continue to report certain side effects that we're seeing. It is possible, so we always have to be constantly looking at them.

Are there certain conditions or medical reasons parents should take into consideration before getting a younger child vaccinated?

If they're giving approval, I think the important thing is that you follow up with your pediatrician to ensure that this is the right time for a child receiving the vaccine. If they are immunocompromised, then this might not be a good opportunity. So it's important to follow up, especially if that child has other comorbidities to assure that they are the appropriate setup to receive the vaccine.

What is the best way to explain the benefits of the vaccine to children, especially if they have heard a lot of negative talk about it from friends or other family members?

We start with simply talking about vaccines and what vaccines do, and how they can protect from infection. Then we can focus on things like the flu vaccine, which we have to receive on a yearly basis, and that's something that each year they look for the appropriate strain and that vaccine changes each year.

This is a new vaccine, but this vaccine has provided the immune support to protect individuals from dying from COVID. And if we can let them know to give that support, that we are giving them something that has protected our adult population and has protected family members that care for them, then it's important for them to understand that this is something that can protect them as well.

Can you explain why CDC recommendations about COVID-19 have changed over the course of this pandemic?

This has been hard for all scientists, all doctors, for the CDC, for the World Health Organization because COVID-19 is a new virus. It's been around for the last year and a half and they have had to constantly follow new data and look at the populations as more information has been brought to them. And so, certain decisions that were made in the previous month shift as that new data comes in if they're seeing associations with COVID and other comorbidities, or they're seeing that the COVID strain is changing. As it changes, it may have a different defense system that we can't fight off.

So we constantly have to be thinking and looking at that as well as looking at the individuals that are receiving the vaccines and looking at the side effects. That's why there's a constant system that's updating, and it can sometimes be day by day.

We feel that it's important that we continue to update our population so that we can build and ensure that trust. So if you report that real-time data and then it shifts over time, then I understand that can be a little bit confusing, but it's important that we share that real-time information and then understand that that information can change as we look at it over time.

Talk about why you allowed your own daughter to participate in a clinical trial.

When the clinical trial came up for my 13-year-old daughter at the time, I had to put trust in the science that I know and how I use that science to take care of my patients. That doesn't necessarily mean that I was not afraid. I think when you're in a study there's questions that aren't completely answered. So you need to make that decision to either wait for those answers or you can contribute and be a part of science and have an opportunity to protect your child.

So it was weighing that decision-making process to understand that and what we already knew about the vaccine with adults receiving it, knowing that she was kind of reaching into those adult ages, and with those side effects she would be okay and not be experiencing adverse side effects. This was something that we had to talk about, but there still is some uncertainty there.

We have that opportunity to contribute to science and to protect our own child. And if she was in support of that, we needed to explain those risks and benefits with her. So this became a group decision and an important decision that we were able to move forward and get her vaccinated at the time.

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