Weighing the benefits, risks of the COVID vaccine for children

“And he yelled out in the middle of the store, ‘I want to get the vaccine,’” Bailey said. “And I had to tell him, ‘Honey you can’t get it yet.’ Ever since we got ours, he’s wanted to have his.”

Parents like Bailey have eagerly waited for the day they could protect their kids against this dangerous and deadly virus. That day came this past week when Pfizer’s COVID-19 vaccine received emergency authorization for use in children ages 5 to 11.

But some parents of young children are still on the fence about getting their child vaccinated, and others are convinced the shot is not right for their child.

So the Dayton Daily News asked local pediatricians and examined the data to answer parents’ most common questions about the benefits and the risks of the COVID vaccine for children.

Dayton Children’s Hospital is planning for about 40% of families in the area with children ages 5 to 11 to get the Pfizer vaccine right away. And that’s being optimistic, said Dr. Adam Mezoff, chief medical officer at Dayton Children’s.

According to polling by the Kaiser Family Foundation in September and October, about one-third of parents nationally say they will get their child between the ages 5 to 11 vaccinated right away, one-third say they will wait and see, and another third say they will definitely not get their child vaccinated.

Kyle Kettering of Xenia said he and his wife won’t vaccinate their three kids. “If you can’t promise me that my child isn’t going to have an adverse reaction to something, then I don’t really want to give it to them,” he said.

Pediatricians and health experts nationwide say the benefits of the coronavirus vaccine for young children outweigh the extremely rare and mild risks of the shot. It is also crucial children are vaccinated widely to protect them, reach herd immunity and get their lives back to normal, experts say.

Here are answers to the questions readers sent us about the vaccines for children.

Q: How much of a risk does COVID-19 pose to children?

While COVID-19 poses less of a threat to children than to adults, experts say it is more worthwhile to compare the risk it poses to children with other risks children face. COVID-19 is now the eighth-leading cause of death in the 5-to-11 age group.

“Right now, we’re seeing more kids hospitalized from COVID infections than we do from pneumonia, for meningitis,” Dr. Alonzo Patterson III, a pediatrician with PriMed Physicians in Dayton, said. “Even amongst the pediatric population, it’s happening. It’s causing more of a problem than common childhood illnesses.”

The Delta variant has also turned COVID-19 into a much more dangerous virus for children.

“There has been a huge uptick in the number of cases that we see in children,” Mezoff said. “In fact, if you look at the data from June to July and compare it to August and September, the number of cases went up by more than 400%. Clearly, the Delta variant was a game-changer for children.”

Here are some quick figures about the impact COVID-19 has had on the 5-to-11 age group nationally:

All these numbers might have been higher had pandemic mitigation efforts like masking and social distancing not been implemented, experts say.

Children have also paid a unique price during this pandemic: Their school, activities and social lives have been disrupted during their formative years.

Q: What are the risks of the coronavirus vaccine for children?

In the Pfizer coronavirus vaccine trial of over 2,500 children ages 5 to 11, no serious side effects were detected. Some kids experienced fatigue (39%), headaches (28%) and muscle pain (12%), but those mostly resolved within one to two days.

There were no cases of MIS-C or myocarditis (heart inflammation), allergic reactions or deaths in the trial.

Scientists expect there will be some cases of vaccine-induced MIS-C in the wider population, but they expect it will be rare and mild.

In addition to the trial, over 400 million doses of coronavirus vaccines have been administered nationally and 7 billion doses have been given out worldwide. There have been few reports of serious side effects and no deaths linked to the Pfizer vaccines.

“If we haven’t seen anything with the hundreds of millions of doses, we’re not going to see anything — so I think parents should feel comfortable that this vaccine has been given to hundreds of millions of people, and that it continues to show a very good safety profile,” said Dr. Robert Frenck, the director of vaccine research at Cincinnati Children’s. He oversees the Pfizer coronavirus vaccine trials in kids there.

Q: What is the risk of heart problems from the vaccine? And what is the risk of heart problems from COVID-19?

Multisystem inflammatory syndrome in children (MIS-C) is a condition involving inflammation around the heart (myocarditis or pericarditis), lungs, kidneys, brain, skin, eyes or gastrointestinal organs. It is sometimes caused by coronavirus, and less often caused by the coronavirus vaccine.

“What’s important to remember is that you are more likely to have a severe case of myocarditis if you contract COVID than the kind that you would get from the vaccine — (from the vaccine), it tends to be mild, self-limited and goes away in a few weeks,” Mezoff said.

There have been 877 reported cases of vaccine-induced MIS-C in Americans ages 12 to 29, or less than 0.0009% of those in the age group who received a coronavirus vaccine. No vaccine-induced MIS-C cases have resulted in death.

“So it’s about twice the chance of getting hit by lightning,” Frenck said. “So pretty rare.”

Kids usually bounce back quickly from vaccine-induced MIS-C. One preprint study found adolescents fully recovered from symptoms within 35 days.

Meanwhile, MIS-C occurs about seven times more often in kids who contract COVID-19 compared with kids who get it from the vaccine, and infection-induced MIS-C is more severe. More than 5,000 children have developed MIS-C from catching COVID-19 and over 46 kids have died from it.

Incidences of MIS-C have been estimated as one case for every 3,200 COVID-19 infections in the 5-to-11 age group.

Q: How can we be sure the vaccine won’t cause a harmful side effect years later?

The FDA required two months of safety data because vaccines can’t cause problems years later.

Frenck said he has gotten this question a lot, and at first it puzzled him.

“Because it’s not a question I usually hear with vaccines,” he said. “And then I thought about it, and I think this is what is prompting that question: When you take, say you have diabetes, or you have asthma or you have high blood pressure, something like that, a medicine that you’re taking every day, it’s possible that over time that you do get an accumulation of the medication so that you can have side effects that start months or years maybe down the line. But that’s not what we see with a vaccine.”

Frenck explained that vaccines (coronavirus and others) cannot cause side effects years later. Unlike medicines we take daily, vaccines don’t stay in our bodies long. In the case of the Pfizer vaccine for coronavirus, the mRNA it contains is broken down by enzymes within days. Therefore, if somebody is going to have a negative reaction, not just a coronavirus vaccine, it’s going to happen soon after getting the shot.

“If you’re going to have a side effect, it’s going to happen within the first six to eight weeks,” Frenck said. “You don’t get symptoms that start two, six or 12 months down the line. If there’s going to be things with the vaccine, they happen early on.”

That is why experts believe it is safe to give a shot without safety data spanning several years.

Q: Will the vaccine cause infertility issues?

Claims about the coronavirus vaccine possibly causing infertility issues is not based on facts, according to Frenck and other pediatricians.

“People that have been against the vaccine have found that fertility has been a pressure point that raises a lot of anxiety in a lot of people,” he said. “That’s not a factual thing. There’s nothing in the animal or human studies that would suggest infertility.”

Frenck pointed out that when the coronavirus vaccines were first studied in adults, trial participants were told not to get pregnant during the study, but hundreds of women got pregnant anyway.

Q: What are the benefits of the coronavirus vaccine for my child?

“I will tell you that I believe it’s a good idea and an important thing to do, and I would put reasons why into three broad categories,” Mezoff said. “The first and most important is protecting your child. It is always important to prevent a disease that can be prevented.”

Experts estimated based on recent pandemic trends that for every 1 million COVID-19 vaccines given to children ages 5 to 11, it could prevent over 58,000 cases, 226 hospitalizations, 132 MIS-C cases and 72 ICU admissions.

Mezoff also encouraged parents to consider vaccinating their child to protect their family and their community, and to help get kids’ lives back to normal.

“Remember that by limiting the amount of COVID in children, we limit the amount that gets to siblings who may have chronic illnesses, grandparents, cancer survivors, even teachers they may come in contact with, so it does protect your family and extended family and again, extending that further, the community as your extended family,” he said. “It not only helps get us back to normal quicker, but the better we do in vaccinating, the less likely we will develop more variants down the road.”

Pediatricians and health experts nationwide agree that the benefits of the coronavirus vaccine for children outweigh the risks. That’s why the FDA and the CDC advisory panels voted unanimously to authorize the vaccine for children.

“Coronavirus deaths and severe outcomes may not be as frequent as it is in adults,” Patterson said. “But isn’t it important to take care of our children as best we can?”

Q: My kid had COVID-19. Do they still need the vaccine?

CDC Director Rochelle Walensky said this week that the agency “absolutely” recommends all children, even those who have had the disease, get vaccinated.

A recently published CDC study found the Pfizer and Moderna vaccines better protect against coronavirus than prior infection. Unvaccinated people who had COVID-19 previously were about five times as likely to test positive for the virus again than people who had received both doses of the mRNA shots and had no previous infection.

Q: Where can I get my child vaccinated?

Note that the coronavirus vaccine is free for all U.S. residents. You can find locations offering the Pfizer vaccine for young kids and register for an appointment at gettheshot.coronavirus.ohio.gov.

Dayton Children’s Hospital will offer vaccination clinics for children 5 years and older at the following places and times starting Monday. Appointments are required and can be made at gettheshot.coronavirus.ohio.gov.

Five Rivers Health Centers will offer the vaccine. Call 937-503-5664 to make an appointment (preferred) or walk in from 8 a.m. to 4 p.m. at one of two locations:

At the Champaign County Health District, children ages 5 to 11 can get vaccinated by appointment. Parents can call the district at 937-484-1605 or email health@champaignhd.com to schedule.

At the Clark County Combined Health District, children ages 5 to 11 will be able to receive vaccines at the district’s 110 W. Leffel Lane vaccine center in Springfield by appointment. To schedule an appointment, call 937-717-2439.

Greene County Public Health is hosting clinics on select dates at 360 Wilson Dr., Xenia. Register for an appointment at gettheshot.coronavirus.ohio.gov

Miami County Public Health will host vaccine clinics for children at 510 W. Water St. Suite 130, Troy. The first dose clinic will be on Saturday, Nov. 13 and the second dose will be on Saturday, Dev. 4. Register online at miamicountyhealth.net/vaccine-registration. Call 937-573-3500 if you need assistance.

Public Health-Dayton & Montgomery County will administer the vaccine to young kids by appointment only at its immunization clinic in the Reibold Building. Find more information and schedule an appointment online at phdmc.org/coronavirus-updates or call 937-225-6217.

Warren County Health District is administering the shot on select days at 416 S. East St., Lebanon. Register for an appointment at gettheshot.coronavirus.ohio.gov.

CVS Pharmacy: visit cvs.com/immunizations/covid-19-vaccine or call your local pharmacy.

Kroger Pharmacy: visit Kroger.com/ohiocovidvaccine or call 866-211-5320.

Meijer Pharmacy: visit clinic.meijer.com, text COVID to 75049 or call your local pharmacy.

Rite Aid Pharmacy: visit riteaid.com/pharmacy/scheduler

Walgreens Pharmacy: visit walgreens.com/findcare/vaccination/covid/19

Walmart Pharmacy: visit walmart.com/cp/flu-shots-immunizations/1228302

Have questions about COVID-19, face masks, vaccines, testing, quarantining or anything else pandemic-related? Send them to jordan.laird@coxinc.com. Answers will be published regularly in print and online.