9 things you need to know about COVID vaccines for kids
Kids aged 5-11 can now get a COVID-19 vaccine. That means the families of roughly 90,000 kids in that age group in Montana are deciding whether to get the shots.
Dr. Lauren Wilson is a pediatrician at Community Children’s at Community Medical Center in Missoula.
MTPR’s Freddy Monares asked Wilson questions about vaccines for kids.
Should I wait to vaccinate my kids?
Freddy Monares What do you tell parents who want to wait and see how the vaccine rollout for kids goes before getting their own child a shot?
Lauren Wilson Yeah, I think it's understandable when people are looking for more information because there's just a flood of information from various sources right now about the vaccine. So I understand when people are cautious and say they want to wait. But what I would say is I got my 8- and 10-year-olds vaccinated as soon as I possibly could, and the reason I did that is because there's still a lot of COVID circulating in our community. I don't want my boys to get it. The vast majority of kids do fine when they get it, but there are some that have pretty serious consequences, and I've seen those in my practice.
You know, we've got to look at the context, and for me, the evidence is really clear. This vaccine works really well. It seems to have fewer side effects in young kids than it does even in adults, and there's no real downside to getting it. And ultimately, you know, it's not a new thing. We've given millions of doses to adults and older people. So I think, you know, all in all, this has been one of the most well-studied medications or vaccines that I've seen in my career, and I feel confident that it's safe.
Data from the trials in the 5-11 age group show that the shots are about 91% effective at preventing symptomatic infection and similarly effective at preventing hospitalization.
Aren't kids unlikely to have serious COVID symptoms?
Monares Over 30,000 people under the age of 20 in Montana have contracted COVID-19, according to state data. None of them have died from the virus, and hospitalizations are uncommon. Why should kids get the vaccine when without it, they're unlikely to have serious symptoms?
Wilson We know that hospitalizations due to COVID are actually fairly high nationwide. We've had several thousand children who have been hospitalized and quite a few in Montana. Our data is not awesome for the state. In some cases, there are hospitalizations that are not being reported through health departments because the initial test happened before the hospitalization. So we're working on improving that data.
I am a pediatric hospitalist and I do see children in the hospital. That's my job. And I know that we have had some admissions of children due to COVID and due to sequelae [aftereffects of a disease, condition, or injury] of COVID. So there's more to it than just what the state data shows.
How well do the shots work for kids?
Monares Thanks for clarifying that. How well do the shots work at preventing COVID-19 in kids?
Wilson So, data from the trials in the 5-11 age group show that the shots are about 91% effective at preventing symptomatic infection and similarly effective at preventing hospitalization. And we know nationwide when we looked at the older kids, at kids 12-17 who've been able to get the vaccine for some time, that we have a 10 times higher risk of hospitalization in [the 5-11 age group] for children who are unvaccinated versus those who could get — who have gotten the vaccine.
What are the common side effects?
Monares And what are common side effects associated with the shot?
Wilson The most common things are arm soreness. We also see some fever, fatigue and sometimes chills. What's important is, we've heard about those sort of effects from adults, but in the trials, in the 5- to 11-year-old kids, they get a third of the dose that the adult dose is and they tend to have fewer of those side effects. So we're seeing less fever, we're seeing less of the fatigue and other systemic symptoms that you can get from the vaccine.
What about heart inflammation?
You know, I frequently get asked, for example, about the myocarditis risk for older teenagers. So, myocarditis is an inflammation of the heart, and we have a pretty robust vaccine monitoring system. We monitor vaccines three different ways after they've been given and after the trial's over. And so we picked up on this effect that was happening predominantly in older teenage boys after the second vaccine. But what we know is it's several cases per million that happen with vaccination.
But myocarditis is also an effect of COVID infection in kids and in that same demographic. So what we're seeing is if you get COVID, you have a much higher risk of getting myocarditis than you have from getting the vaccine. And so I think people are seeing that as a big, scary effect of the vaccine. But I can say in my clinical practice, I've seen more cases of myocarditis due to COVID infection by far than I have with the vaccine, and those associated with the vaccine tend to be milder. So I want to urge people, if you're worried about myocarditis, the best thing you can do is to get vaccinated.
What are the potential long-term impacts in children who get COVID?
Monares What's known about the potential long-term impacts of a child getting COVID, or what's known as "COVID long-haulers"?
Wilson Yeah. So the long haul, or 'long COVID' is something that we've been looking at in detail. We've seen a few patients with that and with some pretty severe symptoms in western Montana.
What that is, is after a COVID infection, even if it's a mild initial infection, people can get different symptoms that span different body systems, like neurologic symptoms like confusion or headaches or dizziness, GI symptoms like vomiting or difficulty eating, and a lot of fatigue or palpitations when someone does exercise or stands up.
Everyone's symptoms are slightly different, but they span a lot of different areas of the body. In kids, we think it's about 8% of kids who get COVID continue to have symptoms longer term. There are studies that show a little bit of a range. But that really speaks to what my experience has been here
What is multisystem inflammatory syndrome?
Monares There are reports of unvaccinated children who get COVID developing a serious complication called multisystem inflammatory syndrome. How common is that? And have you seen it in Montana?
Wilson Yeah, so multisystem inflammatory syndrome in children, or MIS-C, is a sequelae [aftereffects of a disease, condition, or injury] of COVID infection. It happens usually four to six weeks later. It's really unique to people under 21. It's rare above that age group and most frequently happens in kids around 8 or 9 years old.
It's something that I've admitted several children to the hospital with here, and some of them had an asymptomatic or really mildly symptomatic initial infection.
It consists of high fever for several days as well as other symptoms, and it's treated by giving IVIG. So it's an immune globulin — pooled immune globulin — and requires a several-day stay in the hospital. MIS-C is usually treated pretty well by that, but we have had kids who have been more severe and have needed to be transferred out of state for more advanced care.
If you get COVID, you have a much higher risk of getting myocarditis than you have from getting the vaccine. So I want to urge people, if you're worried about myocarditis, the best thing you can do is to get vaccinated.
Where can I get my kids vaccinated?
Monares And where can someone go to get a vaccine?
Wilson The best place to start is by calling your county health department or going to their website because they might have some information there. Also, vaccines.gov is a place where you can look for all sorts of people who have vaccines available, including retail pharmacy chains like CVS and Walgreens. In a lot of our smaller communities, those are the places that are offering vaccines if the county health department doesn't have a clinic.
Where can I learn more?
Monares For people who have more questions about the vaccine, where should they look for answers?
Wilson Healthychildren.org is one that the American Academy of Pediatrics puts out that has a lot of information and answers to common questions that parents might have about vaccines for their kids. The CDC website also has a ton of information on it and addresses some of the common questions that people have.
Monares Lauren Wilson is a pediatrician at Community Children's at Community Medical Center in Missoula. Thanks for taking our questions, Lauren.
Wilson Absolutely, any time.
Pediatricians with Community Children's at Community Medical Center are answering questions about the vaccine from 5-7 p.m. through November 18. You can reach a pediatrician at 406-327-4770.