At last, COVID-19 vaccines for younger children are ready for little arms.
On Tuesday, an advisory committee of the US Centers for Disease Control and Prevention's (CDC) unanimously recommended the Pfizer-BioNTech COVID vaccine for US kids ages 5 to 11. And CDC Director Rochelle Walensky, MD, accepted the panel's recommendation, meaning health care providers may begin to administer those shots to the 28 million US children in that age group.
The 14-0 vote by the CDC's Advisory Committee on Immunization Practices (ACIP) followed the US Food and Drug Administration's (FDA) decision on October 29 to authorize emergency use of the Pfizer vaccine for that same age group. Parents clearly have a lot of questions about what that means for their kiddos.
Parents clearly have a lot of questions about what that means for their kiddos. Here, experts put concerns over the kids' COVID vaccine to rest.
The vaccine dosage for children ages 5 to 11 is one-third of the adult dose, or 10 micrograms, compared to 30 micrograms.
However, like adults, children will need two doses given approximately three weeks apart to achieve the full 90.7% efficacy rate found in Pfizer's clinical trials.
Doses are not adjusted based on height or weight. That's because, unlike Tylenol, for example, vaccine dosage is based on the type of immune system response someone mounts, not the amount of fat in their body, Bhakti Hansoti, MD, director of Center for Global Emergency Care at John's Hopkins Medicine, tells Health.
Children in this age group tend to experience fewer side effects than adolescents or adults, CDC's Kate Russell Woodworth, MD, pointed out during a presentation to the ACIP panel of experts.
According to Pfizer data, the most common side effect was pain at the injection site, followed by fatigue and headaches. Other potential side effects include redness and swelling at the injection site, fever, chills, vomiting, diarrhea, and muscle or joint pain.
"Fever is often brought up as a common side effect of COVID vaccination, but among this age group, it really wasn't much of a factor at all," Fatma Levent, MD, a pediatric infectious disease specialist at AdventHealth in Orlando, tells Health. "Kids actually tolerate vaccines really well."
Dr. Levent adds that if a child develops a fever due to their immune response to the vaccine, it's not going to cause any harm.
While there is no data thus far on potential long-term side effects of the COVID vaccine in children, Daniel Ganjian, MD, a pediatrician and member of the American Academy of Pediatrics tells Health he has few concerns. "The mRNA COVID vaccine is kind of like an email. You read it, you learn the data, and then you delete it. It trains your immune system how to fight COVID, but it doesn't stay in the body."
While children 5 to 11 receive a smaller dose of the Pfizer vaccine, those over the age of 12 receive an adult dose. Many parents may be wondering if they should wait until their child is 12 to receive the vaccine.
However, Dr. Hansoti advises against this. "Please have your children get their first dose as soon as possible. The pandemic is here, and we need to protect our children as soon as we possibly can," she says.
She recommends parents stick to the dose recommended for their child's age group. For example, if your child is 11 at the time of their first shot, they should have the 10-microgram dose. Then, if they turn 12 before their second shot, they should have the 30-microgram dose.
However, the Pfizer trial found the smaller dose to be just as effective for children who turned 12 at the time of their second dose. Therefore, the FDA guidelines on vaccination in children allow parents to choose which dose their child will receive if they turn 12 before their second shot.
Most children should be able to get vaccinated at their pediatricians, where they may feel more comfortable, Dr. Ganjian says.
"However, if your child's pediatrician does not offer the Pfizer vaccine, other vaccination sites for children include pharmacies, school-located vaccination clinics, some children's hospitals, and temporary community clinics," the CDC's Kevin Chatham-Stephens, MD, said during a presentation to the CDC advisory committee.
"You could and should have your child get any vaccine that is needed as soon as possible. There is no need to space them out," says Dr. Ganjin.
Multiple vaccines at once should not impact the severity of side effects since the vaccine themselves don't cause fever or body aches, Dr. Ganjin explains. Instead, it's the immune response to the vaccines—which is activated whether it's one shot or two— that causes the side effects.
No cases of myocarditis, or inflammation of the heart muscle, were seen among the 3,000-plus children involved in Pfizer's clinical trial of the COVID vaccine for 5- to 11- years-olds, CDC Epidemiologist Sara Oliver, MD, noted during her presentation to the CDC advisory panel.
Matthew Oster, MD, a pediatric oncologist and medical officer at the CDC's National Center on Birth Defects and Developmental Disabilities, pointed out during his presentation that getting COVID poses a much greater risk to the heart than getting vaccinated.
In fact, a September 2021 study in Morbidity and Mortality Weekly Report found people of all ages with COVID-19 had a nearly 16-times greater risk of developing myocarditis than people without COVID.
"The bottom line is that getting COVID is much riskier to the heart than getting the vaccine regardless of age or gender," Dr. Oster told the advisory pane;. He even recommends that children with congenital heart defects get the vaccine since they are more likely to have severe outcomes if they contract COVID.
Since the start of the pandemic, 1.9 million COVID cases, 8,300 hospitalizations, and 94 deaths have been reported in children between the ages of 5 and 11, according to a presentation given by the CDC's Senior Investigator Matthew Daley, MD. Therefore, parents should not wait to have their children vaccinated.
Diego Hijano, MD, a pediatric infectious disease specialist at St. Jude Children's Research Hospital, tells Health that the messaging around kids and COVID vaccines needs to change. "With Delta we saw a lot of healthy kids get hospitalized and get complications, and while the Delta surge is coming down [in terms of daily cases], we still have a lot of new COVID-19 in children."
Additionally, children are the age group most affected by multiple inflammatory syndrome in children (MIS-C), with 44% of cases occurring in children between the ages of 5 and 11, Jefferson Jones, MD, a CDC medical officer, told the advisory panel. MIS-C is a potentially life-threatening illness that occurs two to six weeks after COVID infection. It causes symptoms like fever, rashes, and red eyes, and can affect the heart, lungs, and blood vessels according to Johns Hopkins Medicine.
"As of this point right now, the benefits of vaccination greatly outweigh the risks. The problem with waiting too long is that you're putting your child at risk, and the disease has much more effects than the vaccine. The vaccine is much safer than getting COVID," says Dr. Ganjian.