“Anxiously waiting for a vaccine” is not a vibe I thought I’d ever have in my life, but for most of 2020 and a huge chunk of 2021, it was the only vibe. And now, fully vaccinated thanks to science, I feel hopeful and overjoyed. Now my vibe is all about “anxiously waiting for life to return to normal.” The problem is my two young kids — 6 and 2, they won’t be vaccinated for some time, but even when a vaccine is approved for their age group, I know I’m not alone in having some questions.
Even for children over 12, some parents have concerns. It’s important to note that these are not anti-vaxxers asking these questions, not people who want to burn masks or refuse to comply with state mandates. Dr. Jan Bonhoeffer, professor of pediatrics, infectious diseases and vaccines at the University of Basel Children’s Hospital, Switzerland, understands the trepidation. “In most populations, children are not needed to reach the necessary herd immunity, if most adults get immunized. Given that children are comparatively poor transmitters, I can well understand if parents wish to see more robust safety data before immunizing anyone with a low risk of serious COVID,” he tells Romper.
I wanted to answer questions for concerned parents who are fully vaccinated and believe in science and mask-wearing, but still have some questions about what this all means for their children. Here’s what the experts have to say.
“My kids are low-risk for the virus. I’m vaccinated. I’m not excited about rushing them in to get a shot of a brand-new vaccine if they don’t desperately need it.”
One of the big debates about the COVID vaccine is if children under the age of 12 should even be first in line for the vaccine when it’s approved for them. In fact, in a recent Washington Post article, several pediatricians suggested that healthy children are at such a low risk of contracting COVID, that instead of vaccinating kids, America should send excess vaccines to other countries, like India, who are in need of the shots for their citizens most at risk.
But low risk is not no risk, says Dr. Hina Talib, pediatrician and adolescent medicine specialist at Children's Hospital at Montefiore. “Many kids have become very sick from COVID,” she says. “We are so fortunate to have a safe and effective vaccine, and all children, when eligible, deserve to have that protection, too.”
“Children have a lower risk of contracting COVID, but there are still rare cases of Multisystem Inflammatory Syndrome in Children — MIS-C — that can affect children several weeks after COVID infection that could be prevented by vaccination,” Dr. Zachary Hoy, MD, pediatric infectious disease specialist at Nashville Pediatric Infectious Disease, tells Romper. “Also, it can take up to two weeks to build up vaccine titers, so I would recommend children who are able to get vaccinated as soon as available in the local community.”
As Sejal Bhavsar, MD. and Kevin Slavin, MD., reported for Hackensack Meridian Health, MIS-C can affect multiple organs, including the heart. They also note that children have required hospitalization for treatment of COVID-19 pneumonia, while others suffer from what’s know as Long COVID, “with persistent symptoms for months after infection including extreme fatigue, ‘brain fog,’ breathing problems, and body aches.”
“The vaccines are so new. Should we wait to learn more before giving them to children?”
The Pfizer vaccine, the only one currently approved for children 12-16, is indeed new to the market, which can give parents pause. This isn’t like the MMR vaccine, which was developed in 1973. One important thing to note is that the technology being used both in the Pfizer and Moderna vaccines has been studied for decades. They are mRNA vaccines, which get into the cells and basically tell them what to look for if COVID ever enters the body so that they can illicit an immune response. They aren’t live viruses, and this same type of vaccine technology has been used in animal models of influenza, rabies, Zika, and even clinical cancer trials.
Ultimately, the CDC says, “COVID-19 vaccines have been used under the most intensive safety monitoring in U.S. history, which includes studies in adolescents.” Additionally, “in the clinical trial for children 12 through 15 years old, no safety concerns were identified with the Pfizer-BioNTech COVID-19 Vaccine.”
“My child is on immunosuppressant medication. Is the vaccine still effective for them?”
Dr. Bonhoeffer says there’s no simple answer to this, as it really depends on your child’s medication. “Please consult your trusted health care professional, ideally, the one prescribing the medication. She will understand your child’s condition and the medication well, and she will be able to advise on the benefits, risks and timing of immunizing your child.”
(When I ask Dr. Hoy if he believes there are certain times where children should remain fully masked, he cites places where immunocompromised children might be. “The CDC has special recommendations regarding children in medical settings, such as clinics or hospitals, and children who are more at risk, such as those on medications that suppress the immune system, to identify certain places where physical distancing and mask use needs to continue.” Even without the vaccine, masks can and do work.)
“I’m very worried about the vaccine affecting my child’s reproductive system.”
There are so many dangerous misconceptions out there about the COVID vaccine affecting reproductive systems; it’s one of the top concerns I’ve heard from my own family and friends. But vaccines affecting fertility is not a new myth — it’s associated with lots of well-established vaccines — and it has been debunked before. Dr. Hoy says this isn’t a concern.
“There have been several theoretical reports of how the COVID vaccine could affect reproductive system, but these reports are not true,” says Dr. Hoy. “COVID vaccines continue to be monitored, including pregnant women and children getting the vaccine. There has not been a link between COVID vaccination and reproductive systems being affected. If a parent or patient has specific concerns or reports about COVID vaccination, I would encourage them to bring those specific reports or questions into the physician's office to discuss those concerns. Many public health departments have medical professionals who would be happy to discuss vaccination-related questions.”
Dr. Lisa Egbert, a Dayton OB-GYN and president of the Ohio State Medical Association, said in a recent Ohio Department of Health press briefing that not only is there no evidence that the vaccine affects fertility, there’s not even a scientific way for the vaccine to work like that and alter your body. The vaccine just doesn’t work like that. The COVID vaccine is a mRNA vaccine, which teaches cells to make a protein or part of the protein that triggers an immune response. This response than creates the antibodies.
But Healthline reports that when the immune system has been activated, that genetic material is then discarded. It’s not sitting around in your body waiting to replicate or reproduce, and it doesn’t go anywhere near your DNA.
“Kids are so much smaller than adults. Will the vaccine dosage for children be the same? Will they need two shots?”
Luckily, this is what trials are for — to figure out just how much of the vaccine is effective in children. “This is part of the research trial that is underway now,” Dr. Talib says. “This is why we have research trials into vaccines so that we know what dose works the best for various age groups. Both Pfizer and Modera are studying a range of doses for children under 12 years of age.”
“Current trials are testing lower dosages in children younger than 12 years of age. Dosage has to be evaluated for safety and efficacy,” says Dr. Hoy.
“The vaccine really kicked my butt. If children are low-risk for serious COVID symptoms, are they also low-risk for side effects of the vaccine?”
I mean, really what parents are asking is, “Will I have to convince my young kid to get a shot, which is miserable, and then also have them feel miserable after... and then do it all over again?” But again — this is what research and trials are for.
Dr. Talib says this is something they look for in the studies, so parents will know more information once those results are revealed. “As a parent of young children myself, who thankfully have been spared the usual revolving door of winter viral infections this past year, I can understand how parents would worry or feel unprepared to encounter potential short term side effects,” she says.
Los Angeles-based physician Dr. Bita Nasseri previously told Romper that “just like any vaccine,” the COVID shot is expected to cause minor symptoms of a viral infection, including low-grade fever, fatigue, body aches, and muscle soreness. It’s important to note this is not because you're being injected with any kind of live virus, but because there is a shot site where muscle soreness can occur, and because there is also some research that suggests your immune system is reacting to the vaccine, which may cause these side effects.
Looking at how teenagers have been experiencing side effects might help put your mind at ease when it comes to younger kids. Dr. Talib says in her experience, “some adolescents had no short-term side effects, and some had similar side effects to adults, like headache, fever, body aches, and fatigue. These side effects usually go away in the first few days.”
When it comes to more serious side effects, like the occurrence of myocarditis — heart inflammation — following the Covid vaccination in “relatively few” adolescents, the CDC still recommends that kids ages 12 and up receive the vaccine.
“If vaccines aren’t 100% protective, will my kid getting the vaccine help cut down on any potential long-term COVID side effects?”
There have been cases of people contracting COVID after being vaccinated, but the difference is, those people do not have symptoms as severe as they would without the vaccine. As the CDC points out, “no vaccines are 100% effective at preventing illness in vaccinated people.” Dr. Bonhoeffer says that, most likely, the vaccine can cut down on any potential long-term COVID side effects if your child contracts the virus after immunization. “As the disease is effectively prevented, the serious consequences are. That is the primary reason for immunization,” he says. “Today, there is no indication that the long-term effects after COVID are occurring after immunization. However, this will certainly be monitored for in the next years.”
“Is there a time frame for vaccines for infants or children under 2?”
Both Pfizer and Moderna have claimed that shots for children between the ages of 5 and 11 should be available this fall, but for children under 2, there’s still not a lot of info.
“My young child still needs routine immunizations. I’m worried the COVID vaccine will mess up their other scheduled shots that feel more important.”
Another common fear: how this vaccine could affect the efficacy and protection of other vaccines children receive. “Right now, for teens and young adults ages 12 and older, the recommendation is that the COVID vaccine can be given at the same time as other vaccines,” says Dr. Talib. “This is actually really important when we consider just how many teens have missed other routine immunizations this past year during the pandemic — far too many. A perfect time to get all caught up. For little kids, infectious disease doctors and pediatricians will offer us guidance after the trial data is shared about timing of the shots.”
There are so many questions and concerns for parents regarding COVID. We’ve worried about masks, we’ve worried about school, about playgrounds, about their mental health — and now, we even worry about the light at the end of the tunnel. Until then, maybe this helps: “Vaccines do make diseases go away, they work like a controlled infection. We know who wins,” Dr. Bonhoeffer says. “The current vaccines have demonstrated that they are effective. When there is something unique like a new vaccine being given to everyone, many health events will continue to occur in immunized individuals whether causally related just coincidental. This is the challenging task of vaccine safety professionals to sort out what is coincidence and what is truly causal.”
Dr. Jan Bonhoeffer, professor of pediatrics, infectious diseases and vaccines at the University of Basel Children’s Hospital, Switzerland
Dr. Hina Talib, pediatrician and adolescent medicine specialist at Children's Hospital at Montefiore
Dr. Zachary Hoy, MD, pediatric infectious disease specialist at Nashville Pediatric Infectious Disease