On June 18th, the CDC approved COVID-19 vaccinations for kids six months and older. Pfizer’s vaccine was approved for ages 6 months through 4 years as a three-dose series. Moderna’s vaccine was approved for ages 6 months through 5 years as a two-dose series. These vaccines are becoming available to patients as I write this. I know I take care of families who have been anxiously awaiting this news for a long time. I also take care of families who have questions or concerns about their child receiving this vaccine. Does it work? Is it safe? Should I vaccinate my child? Here is the breakdown of what we know.
These vaccines are given at a fraction of the dose adults receive with a comparable antibody response. Side effects have been similar to what we have seen in older children and adults. In 6-23 month old kids, the most common side effects were irritability and drowsiness. For 2-5 year old kids, pain at the injection site and fatigue were the most common symptoms. One in four kids had a fever, more commonly after the second dose. There were no serious side effects. No cases of myocardidtis (inflammation of the heart) were seen although the studies were too small to pick up such a rare side effect. Ongoing monitoring of all side effects will continue as we move forward.
At first glance, the effectiveness of these two vaccines seems quite different. This is not as straight forward as it looks so follow closely as I explain. The Moderna vaccine had 37-46% efficacy against any illness in 2-5 year olds and 31-51% efficacy in 6-23 month olds after two doses. Pfizer had 80% efficacy after three doses. While it initially seems like Pfizer would be the better option, let’s explore some key details. When a study is conducted, a certain number of both participants and cases need to be included to be sure that the estimates of efficacy are correct. Pfizer needed to have 21 cases of COVID in their study to have confidence in their efficacy numbers. They only had 10. While that doesn’t mean there is no efficacy in their vaccine, it does mean that their 80% could be wildly off base. Moderna’s protection, while lower, came after only two doses of vaccine. Pfizer had almost zero protection after two doses. They are currently studying adding a third dose to the Moderna series that is Omicron specific and would likely come out later this summer. This means that your child can get protection in half the time with the Moderna vaccine with a strong possibility of even better protection with a third dose coming soon.
The data up to this point do not tell us about decreased risk of hospitalization, serious illness, or death. The numbers of vaccinated patients in this age group isn’t high enough to tell us that information yet. However, vaccination has drastically improved these things in every other age group and it is anticipated to help our youngest as well.
So why vaccinate? Deaths in this age group have been low at 0.32%. While rare, no parent should risk this outcome when a safe vaccine is available. I found the following statistics very compelling and interesting. COVID has had 442 deaths in this age group through the pandemic. This is the HIGHEST death rate, aside from measles, for a virus for which we have developed a vaccine. Per year, COVID can kill 74-221 kids between the ages of 0 and 4. Influenza would kill 68-87, chickenpox about 50, rotavirus 20-60, rubella 17, and hepatitis A would kill 3. Except for flu, those are deaths prior to vaccines becoming available for those illnesses. This new age group eligible for the COVID vaccine had the highest hospitalization rate compared to other pediatric groups during the Omicron surge. One in four ended up in the ICU. These are our hardest patients to mask. Not to mention that COVID has caused continued disruption to care and schooling for kids and families.
Many families have gone through COVID already and wonder if vaccinating is necessary if their child already had COVID. Recent studies showed that 32% of kids who had COVID failed to make antibodies after the infection. Studies have also show that you significantly increase your antibodies from infection if you receive the vaccine. In short, even if your kids have had COVID, get them the vaccine. Aside from waiting to be out of your quarantine period when you are sick, there is no waiting period between having COVID and receiving the vaccine.
South Lake Pediatrics is planning on offering the Moderna vaccine. We are in the process of planning our vaccine clinics and will get the information out shortly. We hope you will vaccinate your child against COVID and, as always, we are here to answer your questions.