COVID-19 Vaccines and Children: Stanford University Pediatrician Answers Questions

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Dr Maldonado

Interview with Dr. Maldonado

May 16, 2022

Parents want to do what’s best for their children’s health. That means asking questions and getting reliable and clear answers from experts about the COVID-19 vaccine. To get those answers, we talked to Dr. Yvonne Maldonado, a pediatrician and chief of the Division of Pediatric Infectious Diseases at Stanford University School of Medicine. 

Why did it take so long to have an approved vaccine for our youngest children? 

The process of approving vaccines is long and very detailed because we must ensure their efficacy, safety, and lack of serious side effects. The sequence we follow to minimize risks is conducting clinical trials for adults first, followed by teens, then children, and finally babies. In other words, the age of those participating in clinical trials is lowered only when safety and efficacy is proven in an older pool of volunteers. That is why babies are the last to have an approved vaccine.

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Dr Maldonado

What, if any, side effects could my child experience? 

The available COVID-19 vaccines result in very good immunity against severe symptoms, complications, and death. There can be some short-term side effects such as headache, low fever, and generalized flu-like feeling. These side effects usually disappear within the first 24 hours of receiving the vaccine, and after that the person will enjoy protection against severe illness.

Can kids get the COVID-19 vaccine at the same time they’re getting their other childhood vaccines and the flu shot?

Yes! It is possible to get more than one vaccine in the same medical appointment, just not all in the same arm.

Kids don’t seem to get as sick from COVID-19 as adults – especially adults with underlying conditions.  Why should kids get vaccinated?

COVID-19 is presently among the 10 leading causes of death in children under 18 and among the top 3 in adults in the United States. It is true that most cases of severe complications and death are in adults over 50. However, children get COVID-19 infections too. There have been more than 1,000 registered U.S. deaths of children due to COVID-19 infections and thousands of child hospitalizations. Right now, we are still seeing children under 18 hospitalized with bad cases of COVID-19. It is very important to vaccinate children because it is impossible to predict who will have no symptoms, who will need hospitalization, who will have long COVID complications, and who will die. For instance, almost 50% of the children who must be hospitalized due to COVID-19 have no pre-existing medical conditions.

What do we know about myocarditis (inflammation of the heart) as a rare side effect of the COVID-19 vaccine?

The vaccines are very safe. Around the world there have been more than 11 billion vaccines given to adults over 18 years of age and tens of millions of doses given to children under 18 years of age.  Myocarditis is an inflammation of the heart that can be triggered by some viral infections, including COVID-19, and very rarely by some vaccines. It is a rare side effect observed in 11 cases per million vaccinations in male patients over 12 years of age. This is observed even more rarely in children under 12. For reasons not well understood, most of the cases are in males between 12 and 29 years of age. To minimize the risk of this very rare side effect, males within those ages receive the two doses 6-8 weeks apart instead of the standard 4 weeks apart.

Will kids need a booster shot?

Immunity against COVID-19 acquired by either infection or vaccination does not last forever. After a few months, immunity fades and everybody eventually needs a booster shot to maintain a good immune response. In order to be protected against severe infection, everyone ages 5 and older should get a booster shot at least five months after completing their primary series of shots.

What do you tell parents who are nervous about vaccinating their child?  

Remember that the objective of the vaccination is not to prevent infection, or a simple case of COVID-19. The objective is to prevent hospitalization and/or death. The vaccine’s development was preceded by many years of basic investigation. It has been given to millions of adults over 18 around the world with good results. We know that it is also effective and safe in children under 18. The American Academy of Pediatrics, with 67,000 pediatrician members, strongly recommends that all eligible children receive COVID-19 vaccines. Yet only 28% of children between the ages of 5 and 11 and 68% of children between the ages of 12 and 17 have received their vaccinations. Please protect your children. If you have additional questions or concerns, please talk to your pediatrician.

Yvonne Maldonado, M.D., is Professor of Pediatrics and of Epidemiology and Population Health, and Chief of the Division of Pediatric Infectious Diseases at Stanford University School of Medicine. 

For real-time tracking of the progress in vaccinating U.S. children, check the summary of data as reported by the American Academy of Pediatrics.