This week, the Centers for Disease Control and Prevention signed off on using Pfizer-BioNTech's COVID-19 vaccine for children ages 5 to 11. The approval came days after the U.S. Food and Drug Administration authorized it for emergency use.
As vaccinations begin across the country, many parents have lingering questions about how to proceed.
Since the start of the pandemic almost 6.4 million children have tested positive for COVID-19, with the number of newly-diagnosed cases in recent weeks remaining “extremely high,” the American Academy of Pediatrics reported at the end of October. Thankfully, severe illness, hospitalization and death due to COVID-19 were uncommon among kids, it noted.
Most families seemed ready to have their young kids vaccinated.
Two-thirds of parents with children ages 5 to 11 years old said they were likely to have them get the shot once a vaccine was authorized, according to a survey released in mid-October by the COVID-19 Vaccine Education and Equity Project and the National Association of School Nurses.
Another poll, by the Kaiser Family Foundation, showed about a third of parents would vaccinate their 5-to-11-year-old child “right away” once a vaccine was authorized, with another one-third noting they would “wait and see” how the vaccine was working. Almost a quarter of parents, 24%, said they definitely wouldn’t get their 5-to-11-year-old vaccinated.
Meanwhile, 60% of parents of kids ages 5 to 18 supported schools requiring children to get a vaccine to attend school in person, according to an Ipsos poll.
What should families know as the shot becomes available?
TODAY asked Dr. Claire McCarthy, a pediatrician at Boston Children's Hospital and an assistant professor of pediatrics at Harvard Medical School; and Dr. Angela Myers, director of the infectious diseases division at Children's Mercy Hospital in Kansas City and an assistant professor of pediatrics at the University of Kansas School of Medicine.
Does my young child really need to get vaccinated?
It’s true that for the most part, children seem to have a milder illness than adults when they get COVID-19, both experts said.
“But the ‘for the most part’ is important because some children do get very sick. And some of them get MIS-C, a complication of COVID, and some of them could end up with long-haul COVID,” McCarthy noted.
“So the argument that there isn’t any point in vaccinating them because they won’t have problems with COVID doesn’t work for me.”
It’s also true that long-term effects of COVID-19 are less common in children, but “you don't know up front if that's going to be your child or not,” Myers added.
“Just like you don't know when your child gets infected from COVID, if they're going to have severe disease or not,” she said. “We’ve seen plenty of children in our hospital who have severe disease and are otherwise healthy. They're not obese, they don't have severe asthma, they don't have underlying immune compromising conditions."
More than 700 children and teens under 18 have died since the start of the pandemic, according to the Centers for Disease Control and Prevention.
Adults’ experience with the vaccine shows getting the shot makes a big difference when it comes to preventing hospitalization and severe disease. “Certainly, we want that for our children, too,” McCarthy said.
Will it make a difference in ending the pandemic?
Vaccinating school-age children is a key part of getting back to normal since they can transmit the virus to other people, Myers said.
“When you immunize a child against an infection or virus, you're automatically providing protection for the adults in that child's life,” she noted.
Kids aren’t always the best at keeping distance and washing their hands, so even if a child has mild symptoms or none at all, they could spread the illness to others who are high-risk and who could get very sick or die, McCarthy added.
“Vaccinating children helps keep all of us safe,” she said. “Vaccination is literally our only way out of this pandemic. As long as there are unvaccinated people, the virus will keep spreading and mutating. Vaccination is a safe and effective way to get our lives back.”
Is the vaccine safe for kids 5 to 11 years old?
Hundreds of millions of doses have been given across the country and worldwide, and the vaccine has been shown to be safe, Myers said.
The version for children 5 to 11 years old is to be given in two doses administered 21 days apart, with the dosage one-third of that given to adolescents and adults. Young kids don't need as high a dose of the vaccine to develop a similar immune response as adults do, she noted.
In Pfizer’s trial of children, the vaccine caused similar side effects to those seen in adults, which include arm soreness and fatigue. There is a small risk of myocarditis, an inflammation of the heart muscle, especially in adolescent boys and young men, but the condition remains rare and most cases are mild and get better with treatment.
Meanwhile, the risk of myocarditis for children who’ve had COVID-19 is 37 times higher than for those who weren’t infected.
“There is always the possibility of a side effect from the vaccine — that’s true of any vaccine,” McCarthy said.
“Lots of people don’t feel great for a couple of days, but they get better. The risks of a more serious side effect are very small. The risks of having something bad happen from a COVID infection are much higher.”
Children with cancer or other conditions that weaken their immune system should also get the vaccine, Myers said.
Can a child receive too much of the COVID-19 vaccine?
Dr. Ashish Jha, dean of Brown University's School of Public Health, joined TODAY earlier this week to answer common questions parents might have. TODAY's Hoda Kotb wondered if her almost 5-year-old daughter, who weighs about 40 pounds, was too small to receive the same vaccine as a large 11-year-old.
“The clinical trials have shown that the benefit and the side effects to 5- and 11-year-olds are actually comparable even though they are going to be pretty different in sizes,” Jha said. “If you have a particularly small 12-year-old or a particularly large 11-year-old, talk to your pediatrician about this. The recommendations are staying with your age group, but you can always have that conversation with your doctor and sort out what’s the best path for you.”
The vaccine has been studied carefully in children, with the data reviewed by the U.S. Food and Drug Administration, the CDC and the expert panels that work with them, McCarthy noted. Every pediatrician she knows and the American Academy of Pediatrics think vaccinating children as soon as they are eligible is a good idea.
“It appears that the vaccines are safe and effective in children, just as they are in adults,” she said.
“It’s important to know that these studies have been done thoroughly and appropriately — when it comes to children and medical treatment, we don’t take chances. We take their health and well-being very seriously.”
This story was updated on Nov. 4, 2021.