Answering Questions About Children and the COVID-19 Vaccine

With multiple choices now on the market, the COVID-19 vaccine is becoming more widely available. “We owe thanks to the adult volunteers who were willing to test the COVID-19 vaccines and confirm their safety before the vaccines were administered to the general population,” Pediatrician Afif El-Hasan, M.D., FAAP, said. But while each day millions of adults are getting vaccinated, children are still waiting for their turn for the vaccine. 

The authorized COVID-19 vaccines are not currently offered to children because the vaccines have not yet been evaluated in a clinical trial. But many companies are beginning clinical trials to expand their research to include children, starting with those 12 and over. As a pediatrician Dr. Afif El-Hasan has a unique view into the importance of vaccinations, especially for children. “I have been doing this long enough that I can remember a time before certain vaccines were developed and given. I remember it was not unusual for me to do a spinal tap in clinic because a child came in with meningitis. I have not done a spinal tap in clinic for at least 16 years. So, vaccines do work, and people don't remember the world we were in before we had them.” 

At this time, the only COVID-19 vaccine approved for use in children is the Pfizer vaccine, which may be used for children 16 and above. Pfizer and Moderna are both leading clinical trials for children 12 to 16, and Moderna has begun pediatric trials for 6 months to 11 years. “We hope to have the data on the testing by the end of summer. There is a good chance that the age 12-16 group will be vaccinated in the fall. Over time, we will progress with testing and administration of the vaccine in the younger children, but we will need to wait for the final research to be concluded on dosing.” Dr. El-Hasan explained. 

But he is encouraged by the way these trials are being conducted. “There is a measured, methodical and careful approach to confirming the safety of the vaccine in younger children. We are extremely careful. We don’t want to give vaccines to children until we are sure that they are safe for adults, so testing and use of vaccines in the pediatric population will lag behind authorization for adults.” 

A main concern for many adults who have received the vaccine is the possibility of side effects. Common side effects include pain at the injection site, redness and swelling. Some people also experience a fever, headache, muscle pain, nausea or fatigue. “We need to remember that the vaccine cannot give a person COVID-19 though there may be other side effects. These side effects are  very often an immunological reaction to what's in the vaccine and means that the vaccine is working. We're hoping when we get the results of the trials, we'll have a good idea of what kind of side effects the pediatric patients are going to have so there shouldn't be any surprises for the parents.” This isn’t to say that you shouldn’t report side effects or keep your doctor informed if you are concerned. “There is an app you can use to report side effects. We are going to keep a very close eye on reporting of side effects, especially in children.” 

Once a vaccine is found to be safe and effective for kids and available, physicians agree that it will be an important step in not only keeping children safe but maintaining herd immunity. “Vaccinating children is an important component of controlling COVID-19 in our country. While children in general tend to deal with COVID-19 better than adults, some children do get very sick and this needs to be prevented. Also, a child may show minimal or no symptoms of COVID-19, but could still be contagious, as can adults, so achieving herd immunity will only be accomplished after the majority act on the opportunity to be vaccinated.” 

Decline in current COVID-19 rates suggest that schools will probably open back up, or will remain open, before the vaccine is approved for children. Social distancing, wearing masks and maintaining good hygiene will be the key to keeping the classrooms safe. “The COVID-19 pandemic has been a good lesson to children (and adults) that hand washing and good general hygiene practices are important in keeping us healthy. Eating well, finding time to exercise and cherishing time with the important people in our lives is not only a great way to live, but also an important way to keep our bodies strong to fight disease. The pandemic has also highlighted the need to address mental health issues. Depression and other psychiatric issues are shedding their social stigma and people are seeking help to heal their emotional and mental well-being.” 

Children are often very likely to be in large groups, either at school or with friends. So, they need immunity against COVID-19 not just to protect themselves but also to protect those around them. “Children deserve a safe environment to go to school, play sports and participate in other social activities. While much of this can be accomplished with masking, social distancing and hand washing, the vaccine will take them to a higher level of protection and safety. As long as appropriate safety measures are in place, I think it's very important for children's development that they have the interactions at school. Children are not supposed to be sitting at a computer screen all day long. This is also why, when a safe and effective vaccine becomes available for any specific group age group, I strongly recommend getting it.”