Seasonal Allergies and Treatment
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COVID-19 Vaccine for Children: FAQ's
While Pediatric Associates is still in the planning stages to hopefully be able to offer the COVID-19 vaccine to children 5-11 years, we do not yet know for certain when/if this will happen. The logistical aspects are far more challenging than the flu vaccine clinics that we have done for many years. The government requires an extensive registration process for every patient and dose of vaccine administered. When and if PAA is able to administer this vaccine, we will let our families know. In the meantime, we recommend those 5 years and older receive the COVID-19 vaccine at a local pharmacy.
Q: Why do you recommend the COVID-19 Vaccine for kids?
A: We look at from a few perspectives. From the perspective of the child, it could be argued that because COVID-19 tends to make children less ill than adults, a vaccine isn’t really important. Though in general, healthy children do tend to handle the COVID-19 illness well, it can still result in severe illness, MIS-C (multisystem inflammatory syndrome), “long COVID” where symptoms last for months, and death. Even though this risk is small, we don’t want this to happen to any child, especially when easily avoided with a vaccine.
Also, potentially of more importance, we look at this pandemic from the perspective of those individuals who have a higher chance of severe illness or death with COVID-19 illness. These individuals could be your immunocompromised aunt, your elderly mom, your obese nephew, or even your healthy 45 year old husband. These are all people who, if unvaccinated, have a thousand fold greater chance of severe illness or death compared to a child with COVID-19 illness. The COVID-19 vaccine for kids can be thought of similarly to the routine childhood vaccines Haemophilus Influenza B (Hib) and Pneumococcal Conjugate (Prevnar), which are given to protect the child, but more so to keep the child from contracting the illness and giving it to an adult who could have much greater complications from the illness.
Vaccinating kids (and everyone) against COVID-19 will help protect those of us likely to weather the illness well, as well as those most vulnerable to severe complications and death. We recommend the vaccine because it not only helps protect the recipient, but also our family, friends, and loved ones.
Q: How does the vaccine work?
A: If you have not watched it yet, Dr. Mirrop created a great video on this exact topic. Watch it here: Dr. Mirrop discusses the COVID vaccine. As always, his explanation is thorough and easily understandable. Our favorite key take home messages are that the vaccine is safe, and that it cannot give a person COVID.
Q: This vaccine was created so fast, should I be worried about its safety?
A: “The COVID vaccine is safe. Pfizer’s vaccine was the first to be authorized for emergency use by the FDA it was tested on 44,000 people... and, Moderna’s vaccine, which is also authorized for emergency use, was tested on 30,000 people.” These vaccines are 94-95% effective at preventing COVID-19 illness, including serious disease and death. For those 12-15 years, >7 million in this age group “have been fully vaccinated with Pfizer-BioNTech COVID-19 Vaccine in the United States and in the general population there has been no safety concerns associated with vaccination.”
Q: Which COVID-19 vaccines have been approved for children and teens in the US?
A: “In the U.S., COVID-19 vaccines are available to children by age group:
Q: When will there be a COVID-19 vaccine available for those 4 years and younger?
A: We don’t yet know when the vaccine will be approved for this age group but studies in this age group are ongoing and have had great results so far.
Q: Should pregnant and breastfeeding mothers get the COVID-19 vaccine?
A: “Although pregnant and breastfeeding women were not enrolled in the Covid-19 vaccine trials and as a result there are limited data about safety, the CDC advises that pregnant and lactating women should be offered the vaccine and may choose to be vaccinated. This view is shared by the American College of Obstetricians and Gynecologists and the Society for Maternal–Fetal Medicine. It’s nice when all these groups agree! There is no theoretical reason why mRNA vaccines would be harmful to the mother during pregnancy, to a developing fetus, or to a breastfeeding infant. Also reassuring is that gestating rats receiving the Moderna vaccine did not demonstrate any safety concerns related to fetal or embryonal development.” We recommend discussing with your OB/GYN whether or not the vaccine is right for you.
Q: For children aged 11/12 who are 11 years at first dose and 12 at second dose, what dosage should they receive?
A: “They should receive 10 micrograms for the first dose and 30 micrograms for the second dose. However, if they mistakenly get a 10-microgram dose for the second shot, they are considered fully vaccinated and do not need to receive a 30-microgram dose, under the Food and Drug Administration’s (FDA’s) emergency use authorization.”
Q: What dosage is indicated if my child’s weight is comparable to that of a teen or adult?
A: “Children should receive the age-appropriate vaccine formulation regardless of their size or weight.”
Q: Can COVID vaccine be co-administered with other vaccines?
A: Yes. “If more than two vaccines are injected in a single limb, the vastus lateralis muscle of the anterolateral thigh is the preferred site because of greater muscle mass.”
Q: What are the contraindications to receiving the COVID-19 vaccine?
A: “Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a component of the COVID-19 vaccine or known diagnosed allergy to a component of the COVID-19 vaccine.”
Q: Should those who have been infected with COVID-19 be vaccinated?
A: Yes. Studies have shown that the immunity from the vaccine is longer lasting than immunity from previous illness. Those with “current SARS-CoV-2 infection should wait to be vaccinated at least until they have recovered from the acute illness (if symptomatic) AND they have met criteria to discontinue isolation (typically 10 days after positive test if asymptomatic or 10 days after symptom onset and after resolution of fever for at least 24 hours).” Patients treated with monoclonal antibodies or convalescent plasma should wait 90 days after treatment, before being vaccinated against COVID-19.
Q: How do we sign up to receive the COVID-19 vaccine?
A: As we mentioned above, PAA is not yet able to offer the COVID-19 vaccine to children 5-11 years and we don’t know for certain when/if this will happen. The logistical aspects are significantly more challenging than the flu vaccine clinics that we have done for many years. The government requires an extensive registration process for every patient and dose of vaccine administered. When and if PAA is able to administer this vaccine from our office, we will let our families know. We recommend all children and adults 5 years and older receive the COVID-19 vaccine at a local pharmacy. Most local pharmacies allow you to schedule online. The pharmacy with which we are most familiar for pediatric vaccine administration is Tarrytown pharmacy. You can schedule online at Tarrytown Pharmacy@ https://www.tarrytownpharmacy.com/pages/covid-vaccine
Q: Are there specific side effects to watch for and if seen, how do I report them?
A: Per the information available online from the vaccine manufactures, the most common reported side effects are very short lived and include muscle soreness and/or swelling at the vaccine site, low-grade fever, chills, fatigue, and headache. Our office staffs’ personal experiences have been similar to those reported above and side effects did not appear to vary dramatically between the Pfizer and Moderna groups. More specific information about COVID-19 vaccine side effects can be found here: Pfizer Vaccine Fact Sheet 5-11 years OR Pfizer Vaccine Fact Sheet 12 and up
“Anticipated side effects do not need to be reported unless they are so severe that they trigger hospitalization, or an emergency department visit.” If parents wish to report side effects, they can do so on their v-safe account or to VAERS (Vaccine Adverse Event Reporting System)
Q: What about myocarditis and the COVID-19 vaccine; I’m worried about this!
A: Myocarditis (inflammation of the heart muscle) has very rarely been reported as a side effect of the COVID-19 vaccine. It occurs at significantly higher rates in those who contract COVID-19 illness than in those who receive the vaccine. “In the clinical trials of more than 3,000 children aged 5 to 11, there were no reports of myocarditis from the vaccine. The reports of myocarditis after COVID-19 vaccination were seen mostly in adolescents and young-adult males, especially those 16 years of age and older, more often in males than females, more often following dose 2 than dose 1, and typically within 4 days after vaccination.” “The known risks of COVID-19 illness and its related, possibly severe complications, such as long-term health problems, hospitalization, and even death, far outweigh the potential risks of having a rare adverse reaction to vaccination, including the possible risk of myocarditis or pericarditis.”
Though this risk is very small, it does still exist and rightfully worries many parents. Please feel free to discuss your concerns with your child’s PCP. Our goal is not to pressure you, but to educate and help you as the parent feel good about the choices you’re making for your child.
Q: What about taking medication such as Tylenol (acetaminophen) or Advil (Ibuprofen) for side effects?
A: It is not advised to take these medications before getting the vaccine to preemptively help with anticipated side effects; “theoretically they could also blunt immune response and make the vaccines less effective… They are useful, however, in diminishing side effects once they occur. Acetaminophen is preferred for pregnant women.”
If you still have questions about the COVID-19 vaccine, there are numerous references listed below. You can also discuss your concerns at your child’s next well-check exam.
References:
https://states.aarp.org/texas/covid-19-vaccine-distribution
https://www.dshs.state.tx.us/coronavirus/immunize/vaccine.aspx
http://www.austintexas.gov/covid19-vaccines
https://www.cdc.gov/coronavirus/2019-ncov/vaccines/expect/after.html
https://www.happiestbaby.com/blogs/parents/covid-vaccine
https://www.nejm.org/covid-vaccine/faq
https://publications.aap.org/aapnews/news/17965?autologincheck=redirected
https://publications.aap.org/aapnews/news/15461/Answers-to-lingering-questions-about-vaccinating-5
https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2021-11-2-3/07-COVID-Woodworth-508.pdf
https://www.cdc.gov/media/releases/2021/s1102-PediatricCOVID-19Vaccine.html
https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/myocarditis.html
