OK, so it’s actually Thursday morning, Nov. 4, 2021. The world is in its 21st month of a global COVID-19 pandemic. So… what’s there to cheer about? This week, the CDC’s Advisory Committee on Immunization Practices and the CDC director officially approved emergency use of the Pfizer COVID-19 vaccine for children ages 5-11. Hooray!
I’ll admit I was a little obsessed with my social media this week (not pediatrician-recommended!). My Twitter feed was blowing up with post upon post and re-tweet upon re-tweet of joyous pediatricians and family practice doctors and nurse practitioners across the country celebrating this great news for children. The Instagram docs and TikTok docs were dancing. The COVID-19 Pediatrician Facebook Page was abuzz. My general pediatric clinic celebrated with cake! (Okay, it was for someone’s birthday, but it was serendipitous!) Some of my favorite social media quotes were, “So thrilled by this news today!! This is the best way to protect 5-to-11-year-olds from #COVID19.” “I’m not crying, YOU’RE crying!” and “OH HAPPY DAY.”
You may wonder why pediatricians are so ecstatic about the COVID-19 vaccine for 5-11-year-olds. Well, ever since the pandemic hit in the spring of 2020, pediatricians have been diligently donning (and doffing) PPE (personal protective equipment), reading, studying, attending webinars, fielding questions, testing, advocating, collaborating with schools and basically doing everything possible to prevent, test and/or treat pediatric COVID-19 infections. We want to keep children safe. And now we have a very effective new tool: the Pfizer COVID-19 vaccine for children.
The Pfizer vaccine has been available for health care workers since December 2020. Other high-risk groups began getting the vaccine shortly afterwards. In the spring of 2021, all adults were eligible to get the vaccine. In May 2021, children 12 and older were eligible for the Pfizer COVID-19 vaccine (another celebration for me as my 13-year-old got hers!). Spring of 2021 was full of hope for a return to normalcy. The availability of a safe and effective vaccine drastically reduced hospitalizations and community prevalence of SARS-CoV-2.
During the spring and summer of 2021, many teens and adults were vaccinated and had increased protection against serious illness from COVID-19. Unfortunately, our comfort dissipated as the COVID Delta variant swept across the nation. This, coupled with a drastic drop in masking, social distancing and other mitigation strategies, led to a steep surge in COVID-19 hospitalizations for both adults and children. In addition, parents had another worry—the 2021 school year. What to do? Parents were confused and concerned: Should I send my unvaccinated 6-year-old (or in my case, my 10-year-old) to school during a surge of a contagious and deadly virus? Iowa’s children went back to school. The majority of students were unmasked. Surges in pediatric infections and hospitalizations continued. Pediatric clinics, urgent cares, ERs and hospital wards were overflowing with sick children. Hospital staff were overworked and burned out. It was a bleak time for the world of pediatrics.
But now, finally, after months and months of waiting and worrying about how to keep children safe and healthy, the Pfizer COVID-19 vaccine has been approved for children 5-11 years old. My patients and families have a lot of questions about the vaccine. Here are some FAQ and my replies:
Isn’t COVID milder in children? Is my child at risk for serious infection?
In general, COVID-19 infection tends to be milder in children. But even completely healthy children can develop serious complications of COVID-19 including myocarditis (inflammation of heart muscles), MIS-C (the multisystem inflammatory syndrome in children), pneumonia and even death. As of today, 680 children have died of COVID-19, causing it to become one of the top 10 leading causes of death in children. So, the answer is, it could be a mild infection, but what if it isn’t? I’m not willing to take that risk for my child.
Is the COVID vaccine safe for kids? It feels too “new” for me…
Although it may seem like the vaccine was developed quickly, the RNA technology was created decades ago and has been thoroughly studied and tested. The COVID-19 vaccine itself has undergone rigorous testing. The data have been reviewed and approved by the FDA, the CDC and endorsed by the American Academy of Pediatrics. The studies of thousands of children showed no serious adverse events. Parents should always weigh risks and benefits for treatments. The risks of COVID-19 are potentially severe, and the risk of adverse events from the vaccine are low!
I’ve heard some people with the vaccine still got COVID, so why bother?
It’s true, some people are getting “breakthrough” COVID infections, but they are typically mild, self-limiting illnesses. Current data show that people who are fully vaccinated against COVID-19 are five times less likely to get COVID, more than 10 times less likely to be hospitalized, and more than 10 times less likely to die of COVID.
If my child has already had COVID, does he/she need the vaccine?
The answer is unequivocally “Yes.” Studies on older children and adults show a much more robust antibody response from the vaccine than from the illness, providing improved protection. It is unknown how long antibodies stick around after you’ve had COVID-19, so it doesn’t guarantee that you’ll be protected forever.
Does the vaccine work in children?
Yes, the data show it works great! The Pfizer vaccine for children has 90.7 percent efficacy in preventing severe illness or death in children.
Does the vaccine hurt?
Most childhood vaccines are delivered intramuscularly with a small needle. While that’s not fun for kids, it’s typically less painful than they expect. When parents discuss vaccines in a confident and positive way, it can help reduce a child’s anxiety around vaccines.
What does the COVID-19 vaccine for children mean for the future?
Pediatricians are hoping that getting children vaccinated can address many of the concerns created by the pandemic including educational struggles, mental health struggles and poor health habits as a result of isolation and social distancing. I’m hopeful that efforts to vaccinate children will keep our children safer at home, at school and in our communities. Increasing vaccination rates decreases the prevalence of SARS-CoV-2 in the community and can help return to a sense of normalcy.
So, if you are a parent of a child age 5-11 years (like me), I hope you will discuss the vaccine with your child’s health care provider and get your child vaccinated. Pediatricians are anticipating a rush of calls about appointments, and many clinics are still planning and organizing around this new vaccine, so please have patience with your health care workers as we roll out the new vaccine for kids. And don’t forget to celebrate!
Amy Shriver, M.D., FAAP, is a general pediatrician at Blank Pediatrics in Des Moines and assistant professor of specialty medicine at DMU.