COVID-19 vaccines and children: What you need to know

Millions of children over five across America have been vaccinated against the coronavirus – advancing the fight against the pandemic. Still, parents have concerns about potential side effects and possible booster shots. Dr. Sallie Permar, pediatrician-in-chief at New York Presbyterian hospital and chair of the pediatric department at Weill-Cornell Medical Center joins.

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  • Michael Hill:

    Covid vaccinations are now available for children as young as five.

    Adding children to those who can receive covid vaccines is a step forward in protecting everyone, but parents still have questions.

    Before the Thanksgiving holiday, Hari Sreenivasan spoke with Dr. Sallie Permar pediatrician-in-chief at New York Presbyterian Hospital and chair of the department of pediatrics at Weill Cornell Medical Center.

  • Hari Sreenivasan:

    Dr. Permar, how many children have had vaccinations now and what have we learned about the process?

  • Dr. Sallie Permar:

    Yeah. So it's exciting that mRNA vaccines for COVID have become available down to age five, the five to 11 year olds only recently. Of our adolescents there have been over 15 million in the U.S. have been vaccinated. And in that five to 11 year old group that have only just started becoming vaccinated in the last two weeks, we know that almost two million at least have gotten their first dose.

  • Hari Sreenivasan:

    And I think most parents, the kind of immediate concern that a lot of them have is have there been any adverse reactions? I'm kind of in the wait and see camp. Should I wait for those news stories to come out? Tell us, put this vaccine in context.

  • Dr. Sallie Permar:

    Yeah. So this is one of the most scrutinized vaccine processes that we've ever seen roll out in all of history. And because of that, we actually know it's one of the safest vaccines that we've ever had available to us and the most effective vaccine. One of the most effective. And we know that because this has been a very public process from the original producing of the vaccine all the way through giving it in all of the trials. And then since then, because we are watching literally millions of people get vaccinated, collecting the data on what is going on with individuals after they get vaccinated.

    And of course, I think parents all have heard that in our young adults and adolescents, there was a very rare side effect that was picked up from all of this scrutiny, and it was myocarditis or inflammation around the heart that occurred very rarely, maybe 20 to 40 in a million doses. And it did occur more often in males than females in that age group.

    But one thing that as a pediatric infectious disease doctor I think is quite notable about the vaccine associated myocarditis is that it was extremely mild when you compare it to the virus associated myocarditis, both from COVID or from other viruses. So with a virus associated myocarditis, it requires lifesaving intervention, sometimes heart lung bypass, and creates a lot of heart damage that children then have to live with. But the vaccine associated myocarditis, these were very mild, treated with just ibuprofen, and children walk out of the hospital the next day without any evidence that there's any long term issue that's going to arise. And we have not seen myocarditis at all in the younger age group that five to 11 age group. And so we have good reason to think that it won't even occur.

  • Hari Sreenivasan:

    Are children going to have to have booster shots similar to the adults in their lives that are perhaps lining up now?

  • Dr. Sallie Permar:

    Yeah, so that's a great question that we don't know the answer to yet. But being a vaccine scientist myself for children, I know that the pediatric immune system is very different than the adult immune system. And in fact, it's very good at responding to this type of vaccine, the mRNA vaccine. And in fact, we saw that occur when scientists doing the trials in this five to 11 age group noted that they were able to go to a lower dose of the vaccine to achieve the same level of immunity as adults were seeing and we know now is protective. And so we know that our children will respond very well to these vaccines and it's possible that their immunity will last longer than for adults. And so we don't yet know if children will need a booster or when they will need a booster.

    I do predict it will be different than what we're seeing in adults, and in the long term, I think this vaccine will live as a standard pediatric vaccine that we already know, we get multiple boosters of most of those vaccines already. And so I imagine it'll be a similar pattern with this vaccine.

  • Hari Sreenivasan:

    How do school districts and parents and teachers think about this virus being part of school life?

  • Dr. Sallie Permar:

    When we do have widespread vaccine immunity and we don't have pockets of unvaccinated people who are all congregating together, then we can think about what of all the interventions we had to put in place to really keep our kids in school this year. Which ones can we cut back on? And of course, we should never give up washing our hands. That's always a good one. Sneezing into our elbows and not into our hands. But, you know, the masking would be great for all of our kids to not have to wear a mask to, you know, for them to be able to see the teachers, what they're saying and when they're smiling, et cetera.

    But I think we can start to talk about that once most school kids are vaccinated. And maybe even that we have some policies around requiring vaccination in order to, you know, enroll kids in schools with some ability to have exemptions when it's medically necessary. But I think that only now and only when we get most kids vaccinated can we start to think about pulling back.

  • Hari Sreenivasan:

    You know, here we are kind of heading into this holiday season, and it's always a tense time for family members who might not see eye to eye on lots of things. But now there's this sort of compounded layer of what relatives of mine are going to meet, what are their views on the vaccine? Do I want to put my children around them before they have the vaccine or wait until after? It just sort of makes sometimes a complicated time of the year, even more so.

  • Dr. Sallie Permar:

    I agree. It has been a political challenge, this coming to a place where we can all feel comfortable with vaccine immunity and an understanding that the vaccine is the safer choice across the board, then getting the virus itself, which has has been true of all the data that we've been seeing. However, not everyone is on board with that point of view. And so that does raise some interesting questions around the Thanksgiving table.

    I think that it is important to still think about our children when we're bringing to this population because there's not a single five to 11 year old who's going to be fully vaccinated by Thanksgiving Day. They will at best have one dose so far, or maybe just recently gotten a second dose. So we do have to think about in small gatherings or family gatherings where we're going to be eating is to think about how can reduce the risk to avoid your child becoming infected just as they're at the precipice of gaining vaccine immunity.

    So thinking about if your family members want to test before getting together, that's one opportunity. And, you know, even potentially using the opportunity to talk about vaccines to have your child talk about why they are excited to be able to access the vaccine, you know, some of the data shows that those one on one conversations from someone who really cares about you can make a difference in someone's choice to get vaccinated. And so Thanksgiving might be a time to initiate some of those questions.

  • Hari Sreenivasan:

    Dr. Sallie Permar from Weill Cornell, New York Presbyterian. Thanks so much.

  • Dr. Sallie Permar:

    Thank you.

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