This story appeared in the University of Michigan Health Blog. Read more here.
As you consider getting your children vaccinated against COVID-19, you may find it challenging to filter through all the information you’ve heard.
And it can be hard to differentiate between facts and misinformation. With kids 12 and older eligible for the vaccine and authorization expected to extend to younger kids soon, parents may have understandable concerns as they weigh the decision.
“Parents ultimately want to do what’s best for their child and there’s understandable concern about not wanting to cause them any harm,” said Elizabeth Lloyd, M.D., a pediatric infectious disease specialist at University of Michigan Health C.S. Mott Children’s Hospital.
“We know there’s a lot of misinformation out there and we want to help answer any questions that make families hesitant about vaccinating their kids against COVID. We encourage families to continue the conversation with their child’s pediatrician.”
Here, Lloyd responds to frequently asked questions about the COVID vaccine and kids.
Concern: Can the COVID-19 vaccine affect my teen’s heart?
Truth: For more than 99% of kids, there won’t be any effect on their heart. Health officials are, however, monitoring a very rare occurrence of heart inflammation after the vaccine, known as myocarditis. Symptoms of this suspected immune response are usually mild, treated with ibuprofen and resolve after a couple of days.
But young people face a greater risk of myocarditis from infection with COVID itself than from the vaccine, Lloyd notes.
“The risk of heart inflammation after vaccination is very low and symptoms are usually short-lived. But if you’re concerned about this risk, it’s important to also keep in mind that COVID-19 infection causes myocarditis at much higher rates than the vaccine,” Lloyd said. “Getting vaccinated actually protects you from COVID-associated myocarditis.”
Vaccine-associated myocarditis can occur for any age or gender but has been observed mostly in males ages 12-29. More on myocarditis after vaccination and COVID and specific concerns for children with congenital heart conditions.
Concern: Can the COVID-19 vaccine affect my child’s fertility?
Truth: This is an unfounded myth that continues to circulate on social media.
Studies show that antibodies produced from vaccination to COVID-19 do not impact embryo implantation or early pregnancy development in women or fertility in men. There are also now numerous documented cases of women who got pregnant during or after vaccine clinical trials.
The false claim appears to stem from a rumor that the vaccine will teach the body to attack a placenta protein – but in truth, the vaccine teaches the body to attack an entirely different and distinct protein (the spike protein on the virus that causes COVID).
In fact, the vaccine is particularly important for people who are pregnant, planning to get pregnant and who are undergoing fertility treatment. Pregnant women with symptomatic COVID have twice the risk of requiring intensive care and a 70% increased risk of death, according to the Center for Disease Control. They’re also at an increased risk of negative pregnancy outcomes that could include preterm birth, stillbirth and admission into the intensive care unit of a newborn also infected with COVID-19.
Antibodies from vaccination can also protect newborns through the placenta and breastfeeding, research now shows.
“Vaccine hesitancy in reproductive-aged women is concerning and has resulted from the spread of misinformation on social media,” Lloyd said. “But there is zero biological connection between the vaccine and fertility in men, women or kids.”
“We also have plenty of data now showing that women go on to have healthy pregnancies after getting vaccinated.”
Concern: Was the COVID-19 vaccine developed too quickly for kids?
Truth: First, it’s important to understand that the research that went into developing the COVID-19 vaccine is not “brand new,” just like the coronavirus isn’t brand new.
There are actually four different types of endemic coronaviruses that circulate in the community, often causing mild cold symptoms. Two more aggressive coronaviruses that preceded COVID-19 also had potential to cause deaths and trigger pandemics – including the original severe acute respiratory syndrome (SARS) outbreak in 2002 (closely related to the SARS-CoV-2 virus causing COVID-19) and the Middle East Respiratory Syndrome (MERS) first reported in Saudi Arabia in 2012.
Because of these experiences, research into coronavirus vaccine development was already well underway before COVID-19 hit. But because COVID caused a global pandemic, agencies were able to move more quickly than usual.
“Being in a state of emergency has led to more cooperation and sharing of information than ever before, allowing us to build upon more than a decade’s worth of coronavirus vaccine research and expedite the vaccine development process,” Lloyd said.
“It’s important to understand that absolutely no steps were skipped. These vaccines went through extensive reviews and safety monitoring.”
Each of the authorized COVID vaccines underwent the standard development process including pre-clinical studies, clinical trials, a review by the Federal Drug Administration that double checks trial data, an additional triple check review by the Advisory Committee on Immunization Practices, or ACIP, as well as post-approval research that monitors and tracks study participants months to years after vaccination.
“We were fortunate that we didn’t have to start from scratch and had a solid foundation of coronavirus research to help us accelerate through the preclinical phase of research for COVID vaccines,” Lloyd said. “Speed shouldn’t be a reason not to trust these vaccines.”
Clinical trials for kids started only after months of solid data proving the vaccine was safe and effective in older ages groups. Pfizer and Moderna both launched their clinical trial for kids under 12 in March 2021 and any rare adverse reactions are promptly reported and investigated, Lloyd said.
Concern: Can the COVID-19 vaccine impact my child’s DNA?
Truth: No. Pfizer and Moderna’s COVID-19 vaccines contain a specific kind of genetic material called mRNA, which instructs the body to make the COVID-19 spike protein, which the immune system then recognizes as foreign. This process teaches the immune system how to fight the coronavirus if it is encountered again in the future. The mRNA stays in the outer layer of the cell and never enters the nucleus, which is where our DNA is stored, and does not change or interact with DNA in any way, Lloyd said.
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“The vaccine is basically a training camp to teach our bodies how to fight this infection appropriately. Our body uses the cell’s machinery to make copies of the spike protein that is on the coronavirus so that when the immune system sees this protein in the future, it will recognize and attack it,” Lloyd said.
“Once the body uses it to make the proteins, it’s degraded in a couple of days. It doesn’t stay in your body.”
Concern: Will there be long term side effects of the COVID-19 vaccine?
Truth: Severe side effects from vaccines are extremely rare but biologically, there would be no reason to see any side effects emerge more than six to eight weeks later Lloyd said.
And this has been proven over time back to at least the 1960’s with the oral polio vaccine, with side effects of a new vaccine always appearing within two months.
“We know historically from all other vaccines that if you’re going to have a reaction, it’s most likely going to appear days or weeks after the shot,” Lloyd said. “We have a solid body of research and data on vaccines that gives us confidence in their long-term safety.”
Scientists also continually monitor vaccine data before, during and after a vaccine is released to watch for any unexpected side effects that occur once vaccine is given on a larger scale. If any occur, they’re reviewed and investigated, and sometimes prompt a pause on distribution until the issue has been studied and resolved.
“This is all part of the process and how the system is supposed to work,” Lloyd said.
Concern: Can the COVID-19 vaccine impact menstruation?
Truth: While there have been anecdotal stories of some women experiencing temporary changes in their menstrual cycle after the vaccine, there isn’t any evidence suggesting a link.
Some ongoing studies are happening now to look for potential associations between COVID vaccination and cycle irregularity, cycle length and intensity of bleeding. But there doesn’t appear to be a plausible mechanism that would cause this, and it hasn’t been reported with other vaccines.
There is also little data available on whether other types of vaccines impact menstrual cycles.
The disease COVID-19 itself, however, along with other viral infections, may lead to prolonged periods of stress that could cause menstrual disruptions.
Concern: Are there children who shouldn’t get the COVID-19 vaccine?
Truth: Experts encourage everyone over the age of 12 to get vaccinated.
Vaccination is particularly important for children with a history of medical complexity that may increase risks of a severe COVID infection, including neurodevelopmental disorders, obesity, chronic lung disease or immunosuppression.
Children and teens with congenital heart diseases that are coupled with problems with their lungs, blood vessels, kidneys and their immune system may also be at increased risk of severe illness.
“Vaccination is particularly important for kids who are immunocompromised,” Lloyd said.
While the vaccine doesn’t contain any food or latex allergens, children with a history of history of any severe allergic reaction or anaphylaxis should also consult with their provider – although these reactions are extremely rare after the COVID vaccine, Lloyd said. Families with children who have had significant medical issues may also want to talk to their doctor about any concerns.
Concern: Will getting COVID-19 strengthen my children’s immunity to the virus, and if so, do they even need a COVID vaccine then?
Truth: Naturally acquired infection and the vaccine provide different types of immune responses. While there is some protection after recovering from COVID, no one knows how long it lasts and there’s a chance of reinfection.
“We’ve seen families who’ve had COVID run through their homes more than once,” Lloyd said.
“We have strong evidence that getting vaccinated after natural infection further boosts your immunity and gives you even more protection. As we move into fall and winter season, with more people being indoors and increased exposure risks and other viral infections, vaccine protection will be especially important.”
Concern: Is my child likely to experience side effects from the COVID-19 vaccine that could interfere with school or sports?
Truth: Side effects are among the biggest concern Lloyd hears from parents when it comes to the COVID vaccine. And that’s understandable, she said.
But most side effects are mild and short-lived, and some data indicates they are even less common among adolescents than adults. Like other vaccines, the most common response includes swelling or soreness at the injection site. Some may also get swollen lymph nodes under their armpit, which is a good sign that the immune system is responding well.
Some adolescents may also experience systemic symptoms like tiredness, a fever, body aches or headaches. This is most common after the second dose, usually lasts a day or two, and goes away on its own.
Side effects for younger kids ages 5-11 are expected to be similar.
Keeping a child’s schedule light the day after their second shot may be helpful in case they experience any of these mild symptoms that make them feel like being less active, Lloyd says.
Concern: Can my child get the COVID-19 vaccine at the same time as other vaccinations, such as the flu shot or HPV?
Truth: Yes, there are no reasons to space out the COVID vaccine with other vaccinations, including the flu shot or HPV.
Families are encouraged to get vaccinations their children are eligible for at the same time instead of delaying them, Lloyd said. Flu shots will especially be important heading into winter months and as the pandemic continues.
Simultaneous peaks of flu and COVID-19 (as well as a virus called RSV, which is also circulating at high levels right now) could overwhelm the health care system and potentially reduce the ability to catch and treat these respiratory illnesses effectively, she said.
Concern: Why would I put my child through the side effects of the vaccine if they’re healthy and their risk of getting severely sick from COVID is low?
Truth: Children now make up more than a fourth of new COVID cases in the United States as the Delta variant affects more kids than previous strains.
While it’s true that children and teens mostly have mild symptoms, pediatric hospitalizations from COVID hit a peak during the Delta wave along with rising cases of a rare, but serious and potentially life -threatening condition called multi-system inflammatory syndrome, or MIS-C.
As of October 2021, there were over 500 pediatric deaths related to COVID and over 40 additional deaths due to MIS-C, according to theCDC.. This made COVID-19 one of the top 10 causes of death for children of all ages over the last year.
The Pfizer vaccine is 93% effective in preventing Covid-19 hospitalization among adolescents ages 12 to 18, according to a recent CDC study.
“We know kids in general are at less risk but certainly we see kids who need to be hospitalized and we do see children die from COVID infections. These are complications and deaths that could be preventable,” Lloyd said.
“We can’t predict which children and teens will experience more severe COVID infections or have lingering symptoms that will prevent them from participating in their usual activities,” Lloyd said.
“The vaccine will not only protect your child, but protect others around them who may be more vulnerable,” she added.
Vaccinating young people will also help slow community infection rates and the creation of new variants, which could be more resistant to current COVID vaccines and lengthen the pandemic, she noted.
With more kids protected from COVID and less risk of disruptive quarantines, schools will also be more likely to stay open and continue operating sports and other activities.
“Being in school and doing regular activities are especially important to kids and their social and emotional development and growth,” Lloyd said. “The more kids we vaccinate, coupled with masking and other mitigation measures, the less risk of disruptions to our daily lives that not only affect kids but their whole family.”