It seems that the longer we wait for approval of a COVID-19 vaccine for certain age groups, the less likely it is that children in those age groups will eventually be vaccinated.
The Food and Drug Administration approved the vaccine’s use in children ages 5-11 in late October, but nine months later, only 30% of children in that age group have been fully vaccinated. The Pfizer-BioNTech and Moderna vaccines were approved in June for ages 6 months to 4 years, but only 4% of children that age have received a first dose.
That number is likely to remain low as a Kaiser Family Foundation (KFF) COVID-19 Vaccine Monitor survey released Tuesday found that 43% of parents of children 6 months to 4 years old “definitely don’t” give them. will be vaccinated. And enthusiasm for the vaccine has grown only marginally from then on: another 13% say they will only vaccinate their child if necessary for school or childcare, and 27% said they wanted to “wait and see how the vaccine works for others.” young children.” The other parents, who have already vaccinated or plan to do so ‘immediately’, make up only 17% of the 471 surveyed parents of children under 5 years old.
The survey also asked parents to explain their reluctance to have their children vaccinated. We presented some of their most common concerns to medical experts to see how they would address them with parents. Here’s what they had to say:
Concern: The vaccine is “too new.”
The main concern raised by parents hesitant about the vaccine in the KFF survey was that the vaccine is “too new” or has not undergone enough research or testing.
“The vaccine is not new. This has been around for a while,” says Dr. Amesh Adalja, senior scientist at the John Hopkins Center for Health Security.
dr. Ruth Kanthula, a pediatric infectious disease specialist at MedStar Health, explained several factors that led to the relatively rapid development of the COVID vaccine. While you may not have heard of it before the pandemic, the mRNA technology scientists used to create the vaccine were discovered in the 1960s.
“During the COVID-19 pandemic, there was a major infusion of funds to support clinical trials for the mRNA COVID-19 vaccines,” Kanthula said.
“The increased funding has allowed research programs to hire more staff to work in multiple locations and help produce the vaccines. In addition, clinical trials were able to recruit a large number of study participants, including children, within a short period of time. This allowed data on vaccine safety and efficacy to be reviewed earlier than previous vaccine studies.”
Adalja also pointed out that novelty is not a reliable proxy for danger. “Just because something is new doesn’t prove it’s unsafe,” he said, adding that we don’t hesitate to buy the latest version of the iPhone due to security concerns.
“At one point, every piece of technology that improved human life was new,” Adalja said.
Concern: I’m concerned about side effects.
No one wants their child to be in pain or discomfort, but side effects such as fever and pain at the injection site are quite common after many vaccines. These can happen with the COVID-19 injection and tend to pass quickly.
Parents may also be concerned about more terrifying side effects that they’ve heard people talk about or seen on social media. For example, last year there were reports of myocarditis and pericarditis (inflammation of the heart muscle and the mucous membrane around the heart, respectively), mainly in young men after their second dose of the vaccine. This sounds scary, but most patients recovered quickly and the incidence was very low: the highest rate, among 16-17 year old males, was 105.9 cases per 1 million doses of the Pfizer-BioNTech vaccine. That’s a 0.0001% risk – much lower than the risk of complications from COVID-19.
Care: COVID-19 is usually mild in young children.
Fortunately, it is true that the COVID-19 infections in children are generally mild. Infections rarely result in the kinds of symptoms that would land a child in the hospital. But Adalja asks this question: “Why not minimize the risk with a safe vaccine?”
He explained that diseases such as rotovirus and chickenpox also rarely cause serious illness, yet we routinely vaccinate against these diseases.
And just because the cases are generally mild doesn’t mean that problems can’t arise. When infections with the ommicron variant increased sharply last winter, the children’s hospitals also increased. Nine out of 10 children aged 5-11 who were hospitalized during the ommicron wave had not been vaccinated, meaning their hospitalizations were likely preventable.
“Yes, kids tend to get milder infections,” Kanthula said. “However, children are still at risk for a serious infection that requires hospitalization, oxygen supplements, and possible intubation — placement of a breathing tube.”
In addition, “pediatricians are limited regarding the drugs we can use to treat COVID-19 infection in children,” Kanthula added. Treatments such as Paxlovid and monoclonal antibodies are only approved for children 12 years and older.
There is also the small but real threat of MISC-C, a condition in which COVID-19 infection precedes an immune response in the body that causes inflammation of the heart, lungs, kidneys or other organs. Vaccination protects against this serious complication.
A recent survey found that 6% of children seen in the emergency room who tested positive for COVID-19 90 days later reported experiencing symptoms of prolonged COVID-19, such as fatigue, lethargy and coughing. Children who were so sick that they were hospitalized were more likely to report long-term COVID symptoms. By preventing serious illness, the vaccine protects children from long-term COVID.
Care: The vaccine is not very effective.
Many have heard people talk about their vaccinated children becoming infected with COVID-19. While it is true that a child or adult can still test positive for COVID after being vaccinated, this is not the primary measure of a vaccine’s effectiveness.
Vaccination offers strong protection against serious diseases and complications. If your vaccinated child gets COVID-19, Adalja said, “they are unlikely to need to be hospitalized.” That, he noted, is the true purpose of vaccination.
“What we’re really trying to prevent is serious illness,” he said.
Care: My child already had COVID-19.
At this point in the pandemic, a majority of children have had COVID-19. The Centers for Disease Control and Prevention reported that by February 2022, 75% of children and adolescents had antibodies, indicating a previous infection.
Because infection offers temporary protection against the disease, parents may wonder whether it is still worth having their children vaccinated. Experts emphasize yes.
“Hybrid immunity,” meaning from both prior infection and vaccination, is “the best type of immunity to have,” and provides the most protection against multiple variants of the disease, Adalja said.
Concern: I am confused about the dosage.
Some parents are confused about the varied dosage of childhood vaccines. For example, the Pfizer-BioNTech vaccine is given in two doses of 10 micrograms to children aged 5-11 years and in three doses of 3 micrograms to children aged 6 months to 4 years. However, a 4-year-old and a 5-year-old are not very different in size, and a parent may wonder, for example, if they should wait until their child turns 5 to get the higher dose.
But dosage does not depend on a child’s weight. “The dosage is based on the minimum dose of vaccine needed to get a sufficient immune response,” said Adalja, noting that it “took so long for 5- to 11-year-olds because they were trying to get the right dosage” to avoid side effects. to minimize.
“As a pediatrician,” Kanthula said, “I know that children are not small adults and that one vaccine dose is not right for everyone. Children have different physiological and immune responses depending on their age.”
For some, there are other barriers to getting the vaccine for their children.
One of the biggest predictors of whether or not a child will be vaccinated has nothing to do with their health. The KFF survey found that parents who identified as Republican or Republican were most likely to say they “definitely did not intend” to vaccinate their children.
Other parents’ concerns were less ideological and more financial or logistical. The survey found that 44% of black parents with children aged 6 months to 4 years are concerned about having to take time off work to vaccinate or care for their child if they have side effects. And 45% of Spanish parents with children of the same age said they were concerned that they could not get their child vaccinated in “a place they trust”.
A potentially hopeful finding is that 70% of parents of children aged 6 months to 4 years said they had not yet spoken to their pediatrician about vaccinating their child, meaning caregivers have an opportunity to address families’ concerns in person. to take when they bring children in for checkups. But you don’t have to wait for your annual visit. If you have any questions about the vaccine, call your pediatrician and make an appointment to discuss them.