This story appeared in the U of M Health Blog. Read more here.
The country recently reached a highly anticipated milestone when adolescents and younger teens became eligible for Pfizer’s COVID-19 vaccine.
And more than half a million kids aged 12 to 15 have already received COVID vaccine shots since the May 10 authorization, according to the Centers for Disease Control and Prevention. Moderna just announced that its vaccine is also safe and effective in ages 12-17 and is expected to begin offering it to adolescents this summer as well.
Two Michigan Medicine experts recently responded to parents’ top questions about COVID-19 vaccines for kids during a live Q & A, ranging from expected side effects and concerns about kids and teens with allergies to myths and misconceptions about the vaccine.
Family physician and immunization expert Pamela Rockwell, D.O., and Sharon Kileny, M.D., a pediatrician at University of Michigan Health C.S. Mott Children’s Hospital, answer frequently asked questions below.
Expert FAQ: COVID vaccines for children and teens
1. Do kids ages 12-15 get the same vaccine and dose that has been offered to adults and are there any differences in administering the vaccine to younger ages?
Yes. This is the same Pfizer vaccine and dose previously offered to ages 16 and older with two shots 21 days apart. There aren’t any differences.
2. What can you tell us about clinical trials involving this age group as far as safety and efficacy?
More than 2,000 adolescents ages 12-15 were part of Pfizer’s phase three clinical trial, which found 100% efficacy in protection against COVID-19 and robust antibody responses – exceeding those recorded earlier in vaccinated participants aged 16 to 25 years old.
Kids were monitored for two months with no serious adverse effects.
3. We’ve heard that in adults, younger people sometimes experience worse side effects from the COVID vaccine than older people. What can parents expect for side effects among adolescents and younger teens? Should families be planning for kids to be out of school or other activities for a few days afterwards?
Side effects were also similar to those in the 16-25 age group. Just as in people ages 16 and over, the first shot triggered fewer side effects than the second for younger kids.
If kids have an important event coming up, like a big sports game for example, parents may consider spacing out a vaccine a couple of days in advance to leave time for side effects to ware off, Rockwell suggests.
“About 90% of kids will have side effects that are considered mild,” Rockwell says. These may range from a sore arm and headache to a fever or muscle aches and usually last one to two days.
“That is a smaller price to pay than the potential of (severe disease), getting hospitalized or being responsible for making somebody else very ill in society.”
4. Are there any caveats for the COVID vaccine in children with food allergies, those who use an epi-pen or experience anaphylaxis?
There are no food or latex allergens in the vaccines, and the vaccine is completely safe for kids with these types of allergies, Kileny says.
The CDC recommends that people get vaccinated even if they have a history of severe allergic reactions not related to vaccines or injectable medications. However, if your child has had an immediate allergic reaction to a vaccine or injectable therapy, they should consult with their health provider.
People who are allergic to polyethylene glycol should also speak with a doctor before getting the shot because it’s closely related to polysorbate, an ingredient in the mRNA vaccines.
Doctors advise anybody with a history of any severe allergic reaction or anaphylaxis to bring an Epi-pen and Benadryl and wait at least 30 minutes instead of the usual 15 after their shot to go home.
However, allergic reactions to the COVID vaccine remain rare.
“As a parent of a child with a food allergy I can tell you my daughter is getting her shot,” Kileny says. “But if you have any hesitancy at all reach out to your specialist.”
5. How do you know if the COVID vaccine is safe for kids long term?
Vaccine development is based on decades of research, and scientists and federal agencies have done a rigorous review of all available data before approving it for adolescents and younger teens. While long term studies aren’t available, there are no biological reasons to believe this vaccine, compared to others, would have any long term adverse effects, Rockwell says.
Children in these trials will also continue to be monitored for years.
“With any vaccine and any medication you take you always have to weigh the risks versus the benefits,” Kileny says. “All data points to benefits far outweighing risks with the COVID vaccine.”
6. Is there any reason that hormones related to puberty may change the immune response or side effects in kids?
Younger people are expected to have a stronger immune response because of their more robust immune systems. But this doesn’t have any connection to hormones.
7. Can the COVID vaccine impact my child’s fertility in the future?
This is a myth that appears to have circulated on social media based on a false report.
Truth: the mRNA is the code or message to duplicate a spike protein that helps the body react more quickly if exposed to COVID-19, which has that specific spike protein on it.
The false report claimed that the spike protein on the coronavirus was the same as another spike protein involved with placenta growth during pregnancy.
But the two spike proteins are completely different and distinct, Rockwell and Kileny say.
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And mRNA vaccines don’t incorporate into the genetic material of someone getting a vaccine, so there’d be no genetic reason an egg or a sperm would be affected by the vaccine.
In fact, among adults, many unintended pregnancies were reported during the vaccine trial, Rockwell notes.
“There’s been so much mistruth and miscommunication,” Rockwell says.
8. Where can I find reliable information about COVID vaccines in kids?
Rockwell and Kileny encourage parents to seek credible “.org” sites and sources for fact checking news about the vaccine, such as the Centers for Disease Control and Prevention and the American Academy of Pediatrics.
9. Are there any differences in vaccine recommendations for kids who have congenital heart conditions, have had transplants or are otherwise immunocompromised?
No, there aren’t any recommended changes in dosing or timing of getting the vaccine.
“In fact these are young adults we need to get vaccinated because they’re more at risk of having a severe COVID infection,” Rockwell says.
10. If my child has recently had the HPV vaccine, should there be a waiting period before getting the COVID vaccine?
The Advisory Committee on Immunization Practices, also known as ACIP, determined that there’s no need to wait between vaccines. Your child can get the COVID-19 vaccine at same time as other routine vaccines.
11. Where can my child receive a COVID vaccine?
Families can make vaccine appointments through the state health department, community pharmacies and a select group of private providers may also offer vaccines through an office visit. Families interested in a vaccine appointment at Michigan Medicine may learn more about how to get one here.
In Michigan, a parent or guardian must provide consent for any patient under the age of 18 to receive a vaccine, including the COVID-19 vaccine.
12. Do kids this young really need the COVID vaccine since their rates of infection seem so much lower?
As of May, 2021, there have been more than 3.9 million cases of COVID in children in the U.S. and nearly 13,000 hospitalizations – higher pediatric hospitalization rates than what was reported during the HIN1 “swine flu” outbreak in 2009, Kileny notes.
With many people over 65 vaccinated, hospitalizations for older people with COVID are leveling off. But there’s been an uptick in COVID-related hospitalizations for younger, unvaccinated groups, including adolescents and kids who are out in the community more at a time when a more contagious COVID variant is dominant.
“It’s not just for your child’s health,” Rockwell says. “Although it’s less likely that they will be super sick, they could also be responsible for spreading COVID to others who are unable to get vaccinated or are immunocompromised (and may be more vulnerable even with the vaccine).”
13. Which kids are at risk of severe disease from COVID?
While most children with COVID-19 have mild symptoms, about 1.3% of children have been hospitalized and 0.01% have died. Babies under age one as well as kids with certain underlying conditions, including heart disease, diabetes and asthma, are at higher risk of severe illness.
But a small subset of previously healthy children have also developed a rare, but life threatening, COVID-linked condition called multi-system inflammatory syndrome, or MIS-C, which causes severe inflammation in vital organs and tissues.
Other previously healthy children have also developed long haul COVID, experiencing respiratory issues, fatigue and other lingering symptoms months after a mild COVID infection. Mott recently opened the Pediatric Post-COVID Syndrome Clinic specifically to serve these kids.
“It’s an indiscriminate virus,” Rockwell says. “You just don’t know which person it will pick to have these (serious) conditions.”
14. If my child already had COVID or MIS-C, should they wait to get the vaccine?
People who have been infected with COVID are believed to have some immunity from another COVID infection for an unknown period of time. But there’s no reason to wait to get vaccinated after recovery, Rockwell and Kileny say.
15. How will pediatric COVID vaccines contribute to ending the pandemic?
Children make up more than a fifth of the population, so pediatric vaccines are believed to play an important role in helping communities get closer to the 75-80% vaccination goal and ultimately achieve herd immunity.
“We need to think of this pandemic as something we all, together have to do our best to bring down,” Rockwell says. “The fall will look much more normal if the majority of children can get vaccinated.”
16. What if my child can’t their second get dose 21 days later because of camp or travel? Should they wait to get the first dose?
No, as long as the second dose can be given within a couple of weeks of the 21-day recommended period between doses, doctors don’t suggest postponing the first shot.
17. What’s the timeline for other vaccines to be offered to this age group?
Moderna has announced that its vaccine is also safe and highly effective in children ages 12 to 17 and plans to submit findings to the FDA in early June for authorization. The company’s trial involved more than 3,700 participants in this age group.
18. When will COVID vaccines be available for children under age 12?
Both Pfizer and Moderna are running clinical trials for children between six months and 11 years old. Neither is expected to file for FDA authorization until at least fall. The hope is that COVID-19 vaccines will be available to younger kids in September, Rockwell says.
19. Do you expect that children will need to continue getting regular COVID vaccines, just like the flu shot?
Research is still ongoing in this area, Rockwell says.
“I think there is a pretty good expectation that we may need booster shots especially as the pandemic continues and more mutations develop … some of those mutations may become smarter than our vaccines,” Rockwell says. “But so far our vaccines are holding up to all mutations that are in existence in the U.S.”
20. What kinds of things can kids do after they’re vaccinated against COVID-19?
Currently an exposure to COVID could lead to a child being quarantined for two weeks from school, sports and other activities, Kileny notes. If they’re vaccinated, however, they can resume as normal and just self-monitor for symptoms.
“That’s huge. I can’t tell you how many parents and children I’ve seen over the past year that had an exposure, and now parents can’t work … kids can’t go to school. It’s a burden,” Kileny says. “It’s been very difficult on our families. It’s been very difficult on our kids. The rules do change when you get the vaccine.”
Once kids are two weeks out from their second shot, families may also consider safely resuming pre-pandemic activities like sleepovers, going to the movies, attending summer camps and traveling with some more “peace of mind that your family is protected,” Kileny says.
“This is really the only way for our kids to get back to what life was like before March 2020,” Kileny says. “Every step gets us closer back to normal.”