Hope for a better tomorrow: Expanding COVID-19 vaccine to children 5 to 11 years old

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Photo courtesy of Texas Children's Hospital

COVID-19 has certainly been a marathon and not a sprint – 19 months and counting. As a daughter of elderly parents, a wife, and mother of three, the pandemic has been filled with many disappointments – illness and death of loved ones, social isolation and missed birthday parties. But, it has also offered silver linings – spending time with immediate family, watching fantastic TV shows, and allowing extra time for hobbies and outdoor activities.

As a pediatrician, the pandemic has been a period of constant change. We’ve learned to wear personal protective equipment, figured out how to prevent glasses from fogging under goggles, familiarized ourselves with the ins and outs of telemedicine, and most importantly – managed COVID-19 testing and treatment on a daily basis. Thankfully, the light at the end of the tunnel is shining brightly. Nearly 85 percent of persons 65 years of age and older are vaccinated, and the fourth wave caused by Delta variant is on the sharp decline. Medical personnel are fully vaccinated including a booster, and nearly 68 percent of U.S. adolescents and adults ages 12 years and older are also fully vaccinated.  

Despite the progress towards ending the pandemic, children less than 12 years of age have been left on the sidelines, without an opportunity to get vaccinated. These unvaccinated school-aged children returned to school leaving their parents in a quandary with tons of questions: Should my children attend in-person school? What should I do if my child’s school district doesn’t require masks? Is the indoor birthday party safe? Does every runny nose merit another COVID-19 test? 

Thankfully, the opportunity to vaccinate children ages 5 to 11 years is here. On Nov. 2, the Pfizer and BioNTech vaccine was fully recommended for this age group. While we know many parents will rush to vaccinate their children, national polls suggest at least one third of parents may choose to delay or refuse COVID-19 vaccination all together. Are you a parent who is asking yourself, “Does my child really need this vaccine?” As a pediatrician who has seen the effects of COVID-19 in children firsthand, the answer is absolutely yes – kids need the COVID-19 vaccine too.  

Even though COVID-19 disease in children has received less media attention than adults, so far 791 children in the U.S. have died of COVID-19 since the pandemic began. Of these deaths, 172 were children 5 to 11 years old.  Put another way, COVID-19 has killed more children than would fill 26 full classrooms or 16 full school buses. Like adults, children can develop COVID-19 pneumonia and respiratory failure from acute COVID-19 disease. More than 5,000 kids in the U.S. have experienced multisystem inflammatory syndrome in children (MIS-C), a serious and sometimes deadly condition occurring weeks after initial COVID-19 infection. Like adults, children can also experience long-term effects of COVID-19 disease, including persistent fatigue, shortness of breath, chest pain, brain fog, sleep problems, gastrointestinal symptoms, anxiety and depression. These symptoms can last for several months. 

While we know there are some parents who are still hesitant about getting the COVID-19 vaccine for their children, extensive research demonstrates the safety and effectiveness of the COVID-19 vaccine. These vaccines continue to be remarkably effective in reducing the risk of severe disease, hospitalization and death, even against the widely circulating Delta variant. Choosing to vaccinate your child against this virus is one way we can ensure we are able to reach some sense of normalcy – in-person school for all, unmasked school days, indoor playdates – sooner rather than later.

As a pediatrician, I want parents to feel comfortable choosing to vaccinate their young children. So, I have provided answers to several commonly asked questions from parents about the pediatric COVID-19 vaccine.

How effective is the Pfizer-BioNTech COVID-19 vaccine for 5 to 11 year olds? 

Pfizer conducted a study of 2,268 children 5 to 11 years of age; one group of children were given a 10 mcg dose (1/3 of the dose given to persons 12+ years) of the Pfizer-BioNTech mRNA vaccine and was compared to an unvaccinated group of children. This study demonstrated that the vaccine was over 90 percent effective in preventing COVID-19. These school-aged children experienced similar mild side effects as compared to older adolescents and young adults such as fever, fatigue, headache and muscle soreness. Serious side effects did not occur.  

What percentage of the adult dose is given to this age group?

The dose for 5 to 11 year olds is 10 micrograms, which is one-third of the current adult dose of 30 micrograms. Two doses of the vaccine are given three weeks apart. 

What side effects could my child experience after vaccination?

We know COVID-19 vaccines are safe and effective. From preliminary data, we know that mild side effects are common and may occur after any vaccine. These include pain, redness and swelling at the injection site, headache, muscle pain and chills. Although uncomfortable, these side effects are a sign that your child’s immune system is responding to the vaccine and is learning to recognize the virus for the future.

How long will the COVID-19 vaccine work?

As clinical trials progress, we’ll know more about how long immunity lasts and if booster doses will be necessary. While we’re still in a global pandemic, it is important for us to remain vigilant to the practices which have proven successful to mitigate COVID-19 – wear a mask in all settings, wash your hands frequently, maintain social distancing and avoid large gatherings.

Can a COVID-19 shot make me sick with COVID-19?

No. The vaccine only contains the genetic instructions to make a protein of the virus. It does not contain a whole virus that can replicate inside of your body. So, the vaccine cannot make your child sick with COVID-19.

How long after a COVID-19 infection should you wait to vaccinate children?

The CDC recommends that individuals with COVID-19 infection should wait until they have recovered from their illness and their isolation period has ended. Children who have had prior COVID-19 infection should still be vaccinated. Research has shown that unvaccinated people who already had COVID-19 are much more likely than fully vaccinated people to get COVID-19 again.

Why is it important for children to get the COVID-19 vaccine?

My colleagues and I who work at Texas Children’s Hospital know just how dangerous COVID-19 can be for children. We see the short and long term effects of COVID-19 including problems with the lungs, heart and other organ systems. We don’t want your child to be at risk from these serious medical issues. It’s also important to vaccinate your child to prevent the spread of this disease to other children and adults. There is an astounding amount of misinformation being spread by social media. Please follow trusted sources such as the CDC and the American Academy of Pediatrics. Trusting the science and getting all adults and children vaccinated will help us all return to life as we knew it pre-COVID-19.

To learn more about COVID-19 vaccines and Texas Children’s equitable vaccination efforts, please visit Texas Children’s COVID-19 Vaccine Hub. For more information about Texas Children’s Hospital, visit www.texaschildrens.org.