After almost two years of the pandemic, many parents with infants and toddlers have been waiting for a vaccine to lower the risk of contracting or spreading COVID.
But the possibility of swift approval was put on hold when the FDA announced Feb. 11 that it would wait for more data before weighing in.
Amid lackluster results for a two-shot vaccine for some children under 5, widespread misinformation and changing pandemic safety guidelines, even parents who have been vaccinated may feel hesitant about starting their young ones on a series of shots if approved.
So how can parents make sense of the delay and the flurry of information on vaccines for young children?
Dr. Michael Green, a professor and medical director of Infection Prevention and Antimicrobial Stewardship at UPMC Children’s Hospital of Pittsburgh, walked through the recent updates.
Green explained that the delay was imposed because additional information is needed to prove efficacy, not because of safety concerns. Trial data showed that two doses of the Pfizer-BioNTech vaccine seem to have minimal effects on participants between 2 and 5 years old. Children between 6 and 24 months developed antibodies, Green explained, but whether this would protect vaccine recipients was unclear. Study of the impact of the vaccine, including a third dose, is ongoing.
Dr. Andrew Nowalk, an associate professor of pediatrics at the University of Pittsburgh School of Medicine and clinical director of the Division of Infectious Diseases at UPMC Children’s Hospital of Pittsburgh, expressed similar confidence about the vaccine’s safety.
“The main things I hear from parents are: ‘This was rushed.’ ‘We didn’t know about this.’ ‘This is brand new technology.’ When I hear that, I will say to them, No. 1, this technology has been around for 25 years in one form or another … and it’s been used in coronavirus vaccines for a decade.”
As the authorization process unfolds, parents may be wondering where to find accurate information and what to make of the approval process. We’ve compiled key resources and asked Nowalk and Green to explain what parents should know about the vaccine’s safety.
Where to find updated information
Nowalk recommends parents refer to the National Institutes of Health and Centers for Disease Control and Prevention [CDC] for pandemic-related data. “Twitter,” he added, “is not a repository of scientific information.”
To address concerns from some parents, Dr. Edith Bracho-Sanchez unpacked the science of vaccines in an op-ed for CNN.
Bracho-Sanchez, a pediatrician at Columbia University Irving Medical Center, explained: “Following vaccination, immunity lasts in the body but the vaccine itself does not. Many parents have shared… concerns about the long-term effects of the vaccine on their kids’ development… I often explain the vaccine is a type of brief message to tell the body to make the protection against the virus, and once received and acted upon, the body destroys the message.”
The FDA advisory panel must endorse the vaccine for kids younger than 5 before the agency can authorize emergency use. The CDC would then decide whether to recommend the vaccine for the age group. NPR created an easy-to-follow timeline.
Resources to combat disinformation
Children are less likely than adults to experience serious symptoms, leading many to question why vaccinating this age group is necessary.
“It will save children’s lives, period,” Nowalk said, noting that the virus can be deadly for young people, even if it’s less common than for older patients. “Every time we vaccinate children, there’s a ripple out from them that protects the whole community.”
Children represent a very small proportion of total COVID-19 deaths nationwide, though Nowalk said the full scope is not yet known. The CDC reported that 970 U.S. children have died from virus complications, including 307 who were younger than 5.
Despite low mortality rates, Green said younger children are a source of community spread. Even if they don’t get too sick themselves, they can transmit the virus to vulnerable people like grandparents.
“To protect themselves from the acute infection and from the late post-infection complication and to limit them spreading it to other individuals who may also be at increased risk for worse outcomes, having the vaccine in this age group is a tremendous win,” Green explained.
Parents and health professionals have expressed concern about the unknown, erratic symptoms some children have manifested after testing positive. Long COVID and multisystem inflammatory syndrome in children (MIS-C) can have severe lasting effects, and Green said data for older children shows that the vaccine offers protection.
Data on the scope of these cases is limited. MIS-C, while serious, is uncommon, and the proportion of infected kids experiencing long COVID symptoms is yet to be determined.
In December, Pfizer and BioNTech reported results from their trial period showing that children between 6 and 24 months developed antibodies as expected. The vaccine in children between 2 and 5, however, did not produce a strong response. No negative side effects were observed in any age group.
During a Feb. 16 public briefing, County Health Director Dr. Debra Bogen noted that the FDA’s delay signals that the review process is working properly.
“I really appreciate the FDA’s caution in that matter,” Bogen said. “The vaccines they’ve approved to date have proven safe in all age groups that they’ve been approved for. And they need to do the same thing for the youngest infants.”
Parents curious about specific COVID-related questions can find official information on the CDC website. The site includes a page about youth vaccinations, which will be updated concurrently with the approval process. Localized information is offered by Pittsburgh Public Schools, which has numerous resources for parents to learn more about vaccinating their children.
For more digestible CDC content, parents and educators can refer to fact sheets, FAQ pages, and other resources tailored to younger audiences. The World Health Organization [WHO] also provides information on COVID-19 guidelines and vaccine efficacy.
Ways to promote youth vaccinations
Even if the vaccine is approved, parents with young children may still hesitate to schedule shots for their children, an ongoing issue for children older than age 5. Despite its approval in late October, the vaccine for 5-11 year olds has an uptake rate of about 28%. Comparatively, 74% of U.S. residents eligible for the vaccine have received at least one dose.
“I think it’s important for us to meet parents where they are, find out what they know … and then address this in a really respectful conversation that allows us to connect,” Nowalk said. “We always start from: We both want their child to be safe and healthy and thriving.”
Nowalk recommends that parents talk to their children about the vaccine the same as they do routine safety measures like car seats or bicycle helmets. While the shot might hurt, parents can reassure their kids the pain will be brief.
If the vaccine is approved, locations for parents to schedule appointments online include CVS and Rite Aid. Spanish-speaking families can use this form to schedule an appointment at CVS and this form for Rite Aid. Parents can also search for providers at vaccines.gov.
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