What you should know about the Covid vaccine for young children
dr Rochelle Walensky, the director of the Centers for Disease Control and Prevention, has signed off on two Covid-19 vaccines for children over 6 months and under 5 years old.
Millions of US parents — including many of my friends with children under the age of 5 — crossed their fingers again this week in hopes that the vaccines would soon be available for younger age groups. An advisory panel to the Food and Drug Administration unanimously voted Wednesday to recommend that the agency approve the Pfizer-BioNTech and Moderna vaccines for use in very young children. On Friday and Saturday, CDC advisers met to discuss and voted unanimously yes.
After several delays in Pfizer’s vaccine review process, both vaccines are expected to be available early next week. The Pfizer vaccine will cover children aged 6 months to 4 years and the Moderna vaccine will cover children aged 6 months to 5 years.
Understandably, many parents of young children have questions about the vaccines and expected introduction. I spoke to three pediatric infectious disease doctors to get answers.
How are the Moderna and Pfizer vaccines different?
The Moderna vaccine is approved in two doses four weeks apart, said Dr. Debbie-Ann Shirley, Physician of Pediatric Infectious Diseases at the University of Virginia. Pfizer is approved as a three-dose series, with the first two injections given three weeks apart and the third injection given at least eight weeks later. (Pfizer’s third vaccine is not considered a booster vaccine. It’s likely that Moderna and Pfizer will eventually approve an additional booster vaccine for young children.) Both vaccines are dosed lower than the vaccines given to older children and adults.
Preliminary data released by Moderna in April suggests that two shots reduced symptomatic Covid-19 infection by 51 percent in children aged 6 months to 1 year and two shots in children aged 2 to 5 years 37 percent effectively prevent. Pfizer claimed that its three-dose series was 80 percent effective in preventing Covid-19 infection in children aged 6 months to 4 years, but that estimate was based on infections in just three children.
What are the side effects of vaccinations in young children?
The data so far suggests that side effects are milder in younger children than in older children, likely because a lower dose of the vaccine is given, said Dr. Shirley. In children under the age of 5, “the side effects were the kind of things that we might expect in children after receiving a vaccine,” she added, including increased excitement, drowsiness and pain at the injection site. When comparing the two vaccines, Pfizer’s resulted in fewer side effects overall, likely because it uses such a low dose.
No children in the vaccine studies developed heart problems such as myocarditis, a form of heart inflammation seen in a small number of older children who received the vaccine, said Dr. Shirley, but this could be because the studies weren’t large enough to identify rare side effects. It’s possible that there will be some cases once the vaccines are given to enough children, but experts don’t expect a significant number because myocarditis “is more common in teenagers and young adults than in younger children,” said Dr. Ibukun Kalu. an infectious disease pediatrician at Duke University School of Medicine. “I wouldn’t expect high rates of vaccine-related myocarditis in under-5s,” she added. dr Kalu also pointed out that the risk of myocarditis in children who contract Covid-19 is much higher than in those who receive the vaccine.
It’s important to note that the FDA didn’t approve the two-dose Pfizer vaccine in February because it didn’t work well enough, not because of safety issues. (And that’s ultimately why the vaccine now has a three-dose regimen.)
Should your child be vaccinated immediately if they recently had Covid-19?
According to the CDC, children who have recently had Covid can receive the vaccine once they are out of isolation and feeling better, said Dr. Kalu. But since “reinfection seems rare after the first few months of recovery from Covid infection,” added Dr. Adds Shirley, it is not unreasonable to wait up to 90 days after infection before getting vaccinated.
updated
Jun 18, 2022 3:15pm ET
Still, you might want to give them the shot sooner if cases are rising in your community, if you’re traveling to areas with high rates of Covid, or if your child is immunocompromised or has underlying risk factors, Dr. Shirley. If you’re not sure what to do, “contacting a trusted healthcare provider to discuss some of these issues is always a good way,” she added.
Can my child receive the Covid-19 vaccine and other vaccines on the same day?
Yes. According to the CDC, children can receive Covid-19 vaccines and other vaccinations, including flu vaccines, at the same time.
Covid-19 symptoms are often mild in young children, and they can get the virus even if they are vaccinated. So what is the point of vaccinating my young child?
It is true that Covid-19 is far less risky for children than for older ones. But more than 440 children under the age of 4 have died from Covid-19 since January 2020, and the infection is “one of the top 10 causes of death in children in the United States,” said Dr. Yvonne Maldonado, a pediatric infectious disease physician at Stanford Medicine, chairs the American Academy of Pediatrics’ Committee on Infectious Diseases. Also, Covid-related hospitalization rates are higher for children under the age of 4 than for older children, and more than half of pediatric hospitalizations in children aged six months to four years are in children with no known underlying risk factors. “I’ve had a number of healthcare friends whose children have ended up in the hospital, some were on oxygen in the intensive care unit and had no risk factors,” said Dr. Maldonado.
“Vaccines are the most effective way we as clinicians have to prevent patients from developing severe forms of Covid,” said Dr. Shirley – and that includes young children.
Will Covid come back for you?
Millions of people who have already had the coronavirus may be at risk of being infected again, and their immunity may not last as long as they would like. But there’s good news: Second and third infections are likely to be shorter and less severe than the first, and there are steps you can take to reduce your risk of getting infected again.
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Stay healthy!
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