Ask Dr. Mom: Should I Vaccinate My Child Against COVID-19?

We have been in this pandemic for almost two years. As a pediatrician and mother, the decision-making has been tiring at times. It's been 24 months of weighing risk and benefit for our families, and now deciding if we should vaccinate our children with the COVID-19 vaccine. In November 2021, the Pfizer vaccine became available for kids 5 years old and up, leaving parents (much like myself) feeling happy to have added protection for their children.

For most of the pandemic, the focus in the media has largely been on adults and older, immunocompromised individuals, Much of the recommendations seemed to exclude children and families and this has left many families frustrated and confused on how to proceed. Are kids impacted by COVID-19? Are they high-risk? Do we need to vaccinate them?

There has been a lot of misinformation surrounding COVID-19 and kids and the vaccine so it's important to separate fact from fiction.

Fact: The COVID-19 pandemic has impacted children in many ways. Ahead, some stats and facts that support this claim. Once we go over the data, I will discuss the topic many of the parents of my patients ask: Should my child get the COVID-19 vaccine? I will share both the medical advice I offer, and what I plan to do in my own life as a mom.

The Loss of Caregivers to COVID-19

More than 140,000 children have lost a primary caregiver in the United States from COVID-19. Overall, the study shows that approximately 1 out of 500 children in the U.S. has experienced COVID-19-associated orphanhood or death of a grandparent caregiver.

Children Are Being Hospitalized

Children are being hospitalized with COVID-19, and 30% of those cases include kids who have no underlying medical conditions.

When it comes to the 5 to 11 age group, there have been 8,300 children have been hospitalized since the start of the pandemic. These are healthy children, who are missing school to recover from this virus in a hospital setting.

Although outcomes have been good in that children do get discharged from the hospital, hospitalizations can lead to high costs for families, the stress of admission into hospital, and time away from family, friends, and school/daycare.

Kids Can Get Long COVID

Some children also do experience symptoms of COVID-19 beyond their initial infection. The U.K. Office for National Statistics's latest report estimates that 12.9% of UK children aged 2 to 11, and 14.5% of children aged 12 to 16, still have symptoms five weeks after their first infection. Almost 500,000 UK children have tested positive for COVID-19 since March 2020.

This data is important as it does show that children (like adults) can experience symptoms of COVID-19 that lingers. Symptoms may include brain fog, fatigue, difficulty concentrating, muscle and joint pain, headache, insomnia, respiratory problems, and heart palpitations. Although long COVID is not life-threatening, it can be debilitating, leading to missed school and interactions with loved ones.

MIS-C Can Be a COVID-19 Complication

MIS-C (Multisystem Inflammatory Syndrome in Children) is a rare, but serious complication of COVID-19. This is something I myself have seen in clinical practice in healthy children.

This is an inflammatory condition from a prior COVID-19 infection that leads to inflammation in major organs, including blood vessels and the heart. As of January 3, 2022, 6,431 children in the U.S. have had MIS-C. As of that time, there have been 55 deaths associated with MIS-C. Vaccination can prevent this risk and subsequent hospitalization.

There Have Been Child Deaths Due to COVID-19

In the U.S., over 700 children under the age of 18 have died from COVID-19. It's important to note that almost 9.5 million children in the U.S. have tested positive for COVID-19.

We need to do everything we can to reduce deaths and hospitalization in children due to COVID-19. Any child lost to a virus is something to prevent. This pandemic is impacting children and thus finding preventative measures, such as vaccines and treatments, is important.

Should I Vaccinate My Child Against COVID-19?

This is an important question every parent should ask themselves. When deciding on anything we put into our bodies or our child's bodies, it's understandable to ask ourselves these types of questions. Why vaccinate my child against this virus if hospitalization and deaths are low compared to adults? Can I trust this vaccine? Do the benefits outweigh the risks?

When deciding to vaccinate, we are taking the benefit of vaccination over the risk of vaccination. It's understanding the very, very small risk of side effects from a vaccine versus the complications from getting COVID-19. Clinical trials and the effective administration of the COVID-19 vaccine to the global population confirm that the shot is safe. Safety means that the benefit of getting the vaccine outweighs any risk.

While there are low risks of vaccination (similar to having an allergic reaction to antibiotics and/or food), we in the medical community and public health community look at the benefit this vaccine will provide. It can reduce the chance of getting COVID-19, experiencing complications, and spreading the virus. (If you have any concerns about getting the COVID-19 vaccine, speak to your child's clinician.)

It is why this vaccine is recommended by the AAP and CDC to all children 5 and up.

Many families ask if the vaccine is recommended if their child has an underlying medical condition, and the answer is still yes. The only contraindication to the COVID-19 vaccine is a prior allergic reaction to the vaccine. For example, if you or your child has an allergic reaction to dose one, they would not get dose two, according to the CDC.

The Doctor Answer

So how do you know that the vaccine is safe for kids 5 and up? It comes down to research studies.

In November, when the CDC and FDA both authorized the vaccine for 5 to 11-year-olds, they met to discuss the data from the Pfizer study. In summary, the study showed that the vaccine was 90.9% effective in protecting an individual from getting COVID-19.

There were no deaths in trial participants, there were no serious adverse side effects, and participants had only common side effects (with arm soreness being the most common).

Recently, more research came out supporting the safety and efficacy of the vaccine in the 12-15-year-old age group. The vaccine was 100% effective in preventing COVID-19 in this age group.

Parents are also concerned about myocarditis after vaccination. The reality is myocarditis is more common after COVID-19 infection or other viruses like flu or enterovirus, and the risk is lower when vaccinated. At the Pfizer authorization meeting, they confirmed that no child between the ages of 5-11 had myocarditis after vaccination in the trials. We have not had any cases in the over 2 million children who have received the vaccine.

The Mom Answer

One of the hardest things as a parent is knowing if there would be long-term side effects of a vaccine. Science has come a long way and long-term side effects of any vaccine are uncommon. Most side effects—albeit rare—would occur the day of vaccination (for example, allergic reaction) or within a week (for example, myocarditis).

When parents in my office ask me about the chance of long-term side effects, I remind families that we don't know for sure. With newer treatments and interventions, we don't know 100% of any long-term effects.

However, what we do know is that COVID-19 illness can have the potential for harm. So, when deciding to vaccinate we are taking the low, low risk of a rare side effect from a vaccine versus the very real possibility of getting COVID-19 and experincing a complication. I will trust science given the remarkable advancements in vaccine research.

It's also why I will vaccinate my own son with the COVID-19 vaccine when his time comes. He is almost 2 years old and likely will not be authorized to get the vaccine until late winter 2022. We are choosing to vaccinate him because, first, we want to provide him the most protection possible against this virus. Second, we want to give him better chances and outcomes if, in fact, he does get COVID-19. (Remember no vaccine is always 100% against preventing illness, but it can prevent severe illness, hospitalization, and death.)

And finally, we want to protect other people he may come in contact with. Vaccines not only protect the person receiving them but also the people you come across. Unvaccinated individuals continue to primary spreaders due to higher viral loads and potential of transmission.

Vaccinating him will also help reduce the chances of mutation formation. Mutations (or variants) are formed when the virus infects an unvaccinated host and mutates to become stronger. Vaccinating children can help to reduce the formation of more variants in the future.

Until our son is eligible to get the vaccine, we continue to take precautions to reduce his risk of contracting the virus. Avoiding a virus is not always 100% possible, but we do our best. My husband and I are both vaccinated, as are our close family and friends, who we see on a regular basis. We also continue to mask in indoor public places to reduce our chances of spreading and contracting respiratory viruses, including COVID-19.

The Takeaway

The decision to vaccinate is sometimes a challenging one. Both as a pediatrician and mother, I support the evidence and science surrounding the COVID-19 vaccination for kids. According to the data, vaccination has saved so many lives, reduced transmission, and reduced severe complications of COVID-19.

If you are still unsure about getting your kid the shot, I encourage you to seek education from scientific resources that discuss benefits and risks. Misinformation is rampant and parents deserve evidence-based discussions when deciding on health interventions and preventative measures.

You can always speak to your child's healthcare provider for more guidance to make the best choice for you and your family.

Mona Amin, DO

Pediatrician

Dr. Mona Amin is a board-certified pediatrician with five years of experience in private practice. She has written for multiple renowned parenting journals and has been a speaker at multiple conferences. She shares information and education about children's health and wellness, namely how to navigate the first few years to set a healthy parenting foundation for the rest of a child's life.

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