Children age 5 to 11 receive COVID-19 vaccines in Louisville

The COVID-19 vaccine and kids. Your questions answered

Children ages 5-11 are the latest group in the United States to be eligible for coronavirus vaccines, joining nearly a quarter billion people aged 12 and up who have had at least one dose so far. In the first week of availability, an estimated 900,000 kids in the new age range will have already gotten shots, the White House announced Wednesday. But not everyone is rushing to book an appointment — many parents are waiting to see how things go with early adopters.

Medical experts say widespread vaccination is crucial for stifling the COVID-19 pandemic. Clinical trial data suggest that Pfizer’s vaccine, authorized for emergency use among children ages 5-11, is more than 90 percent effective at preventing severe cases of coronavirus infection, hospitalization and death. And looking across this pandemic, people who remain unvaccinated make up the overwhelming majority of people who have suffered the most — signaling the protective and preventive power of getting vaccinated.

Yet older children, who have been eligible since the spring, have been slower to get their shots compared to adults, and some families with younger kids might be similarly hesitant. According to a survey from the Kaiser Family Foundation from late September, a minority of parents with children ages 5-11 — about three out of 10 — said they would get their children immunized against the virus as soon as possible. Rigorous clinical trials and hundreds of millions of shots suggest these vaccines are safe and effective. Yet the top worry of parents in this survey was that they might cause unknown potential long-term side effects. Other concerns included not knowing whether a parent would have to pay for the vaccines (the vaccines are free), and other issues of access, like not having reliable transportation.

The bottom line, according to medical experts, is when in doubt, ask a trusted health care provider, such as your child’s pediatrician. We’ve been taking your questions to multiple public health and pediatric experts, who have laid out what we know about the vaccines and protecting young children against this deadly virus.

We’re compiling their answers below. Do you have a question you want answered? Leave it here.

How does the vaccine work?

For children as well as adults, the Pfizer-BioNTech vaccine requires two doses delivered three weeks apart, and a person is considered fully vaccinated two weeks after their second dose in the series.

After that time, most people will have developed sufficient antibodies against COVID-19 to protect against severe illness, hospitalization and death.

How is the kids’ vaccine different from the one given to adults?

For children ages 5 to 11, the doses are a third of the size of those administered to adults. These doses can also be stored in a conventional refrigerator for up to 10 weeks, unlike adult doses, which need to be used or tossed after a month of normal refrigeration. That innovation makes distribution easier than during earlier phases of the U.S. vaccine rollout.

Are there side effects?

Side effects of vaccinating young children against COVID-19 are mild and consistent with what parents and pediatricians see after immunizing children against the flu, such as initial pain and swelling at the injection site, fever, chills, headache and fatigue.

If you notice any side effects, report them to the Centers for Disease Control and Prevention’s v-safe database. Through this smartphone app, people who have been vaccinated can report how they are feeling after receiving their dose, to help researchers who are collecting and analyzing vaccine safety information in near real time.

Is the vaccine safe?

Vaccinating a child against COVID-19 is safe, and the benefits of doing so far outweigh the risks of waiting and potentially getting sick with the coronavirus, the CDC has stated after extensive clinical trials. Health experts also say it is safe to get vaccinated against COVID and the flu at the same time. And it is not possible to get COVID-19 from the vaccine itself.

After the authorization of Pfizer’s vaccine for children ages 5 to 11, researchers are continuing to monitor data for safety and effectiveness. Dr. Paul Offit, a member of the Food and Drug Administration’s Vaccines and Related Biological Products Advisory Committee, shared this guidance before casting his Oct. 26 vote in support of authorizing COVID vaccine use among young children: “You never know everything. The question is whether you know enough.”

Could my child develop heart inflammation, or myocarditis, after getting vaccinated?

In rare cases, young people who have gotten vaccinated have developed an inflammation of the heart muscle or lining that can result in chest pain, shortness of breath and pounding heart, especially after the second dose. An FDA analysis of Optum health insurance claims found 180 cases per million fully vaccinated boys ages 12-15 developed myocarditis.

But these cases were relatively mild compared to what happens after COVID-19 infection, which brings a 15-fold increase in risk of myocarditis. And the Centers for Disease Control and Prevention say that most cases “responded well to medicine and rest and felt better quickly.” These side effects should be reported to the CDC’s Vaccine Adverse Event Reporting System, or VAERS database, according to experts who advised the CDC on this matter.

Will getting vaccinated against COVID affect my child’s fertility?

There is no evidence that any vaccine causes fertility problems, the CDC notes, and that includes COVID vaccines. However, using fertility as a talking point is a common strategy of anti-vaccination advocates.

READ MORE: There’s no evidence COVID-19 vaccines hurt fertility. Here’s what’s fueling the myth

My child already had COVID. Should they get vaccinated?

It is unclear how much durable and long-lasting protection a COVID-19 infection offers children, so public health experts recommend that children get vaccinated even if they have been sick with or tested positive for the virus. Evidence presented during the CDC’s Nov. 2 meeting of experts suggested that vaccination after recovering from a COVID-19 infection provides good protection against the virus.

A child’s immune system can handle COVID better than an adult’s. Why bother?

Throughout the pandemic, children appear to be statistically less likely to get really sick from COVID-19 compared to adults. Federal data suggests four out of 10 children have been infected with COVID-19. Of those aged 5-11, more than 8,000 were hospitalized, a third of whom had no known medical conditions that would predispose them to severe COVID-19 outcomes. Dozens of these school-aged children have died — CDC lists COVID-19 as a top 10 cause of death for this age group. “Children are not supposed to die,” said Dr. Smriti Khare, president of Children’s Wisconsin-Primary Care. The risk to children may be smaller, but it is not zero.

My child recently was diagnosed with COVID. Should they get vaccinated?

Children who recently have been sick should get vaccinated, but there are some notable caveats.

If your child is still sick with COVID-19, you need to follow guidelines around isolation to protect others from getting infected, said Dr. Claire Boogaard, who serves as medical director for the COVID-19 Vaccine Program at Children’s National Hospital.

And if your child’s infection was treated with monoclonal antibodies, Boogaard says you need to wait 90 days from the end of that regimen before getting your child vaccinated. “Your body won’t get a strong immune response because it already has those things floating around,” she said.

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