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Health

Cincinnati Children's on what you need to know about the Pfizer COVID-19 vaccine for kids 5 to 11

A young girl in a colorful mask looks away as she receives a shot in her arm.
Courtesy
/
Cincinnati Children's
Amirah, age 7, participated in the clinical trial for the Pfizer-BioNTech COVID-19 vaccine.

An announcement is expected soon to approve the Pfizer-BioNTech COVID-19 vaccine for children ages 5 to 11 years old. A Food and Drug Administration advisory panel Tuesday recommended approval and the FDA is expected to make a decision in the coming days. A panel advising the Centers for Disease Control and Prevention could then make its recommendation next week.

Robert Frenck, MD, director of the Gamble Vaccine Research Center at Cincinnati Children’s, expects children could begin getting the vaccine by "the first week in November, certainly before Thanksgiving."

Cincinnati Children's was among the first sites in the U.S. to initiate vaccine clinical trials last year. Researchers there began studying dosage of the Pfizer vaccine in kids 5 to 11 in March 2021.

On safety

Mary Carol Burkhardt, MD, associate division director for primary care at Cincinnati Children’s and medical director of the hospital’s Hopple Street Health Center, points out the FDA panel's recommendation indicates "the evidence really has been looked at and studied and weighed, and there's good evidence to proceed and consider this vaccination for your child."

Burkardt is optimistic because there's confidence in recommending the vaccine. She also notes the benefits far outweigh the risks of side effects.

Is the kids vaccine weaker or different?

Cincinnati Children's was one of five sites to study the Pfizer vaccine in children. The vaccine is the same for children and adults, the difference is the dosage amount. Adults and children over 12 receive a full 30 microgram dose, while the dose for kids 5 to 11 is 10 micrograms. As with adults, children will receive a second dose (of the smaller dosage) 21 days later.

"It's not that it's a weaker dose or a lesser dose, it's all that the children needed to make the same immune response as the adolescents and young adults," Frenck says.

My child is 11, do I vaccinate or wait?

Frenck and Burkardt agree you should not delay in getting the vaccine. Frenck says the 10 microgram dose for an 11-year-old who is about to turn 12 should be sufficient. Researchers theorize the lower dose is likely sufficient for slightly older kids, too, but there's no data on that yet. Those studies are expected to begin soon, he says.

If your child will turn 12 between the two shots, he advises sticking with the lower dose for both as it should be sufficient.

I prefer my kids get their immunity naturally

Burkardt says she often hears from parents/guardians who want their children to build their immunity naturally. She points out there are a lot of diseases, illness and developmental delays that can't be prevented. COVID-19 is something people can do something about.

"Children are still going to develop fine; they are still going to build immunity because there's things that they're going to have to build natural immunity for, but when we have one that we can prevent that we know has as serious consequences as COVID, that's when I think parents can be reassured that this is an important one to do."

She says parents/guardians can be confident in getting their kids vaccinated against COVID.

"We have good science ... and I think parents need to look to that good, quality information to have the reassurance that this one is safe. We don't need to worry about the affects that it's going to have on the child's development. What we want is the child to be healthy so they can develop. That's what's most important here."

But wasn't this vaccine developed for an old strain?

Both doctors note the mRNA vaccines are shown to be effective against the current delta variant as well as other strains. This should not deter parents.

But my kid hates shots

Okay, no one loves getting a shot, right? However, Frenck says you might be surprised about how excited your child is to get vaccinated. He remembers one small child in the study who was grinning broadly and eager for the shot. He says she proudly wore her "I'm Vaccinated" sticker out of the office.

Burkhardt says the best advice is to be factual and brief. Kids will follow their parents' lead.

"They want to get on with life; they want to play sports; they want to go to school," she says. "(Don't) prepare your kids weeks and weeks in advance that a vaccine is coming. Tell them the day of (that) 'We're going to do this. You're strong, you can handle this. This is going to keep you healthy and it's important that we do it."

What about younger kids?

Children's continues to study the vaccine and is enrolling children as young as six months of age in various studies.

What about blood clots or myocarditis?

Of all the studies done on COVID vaccines, Frenck notes only two side effects have emerged after approval and both are very rare.

"We've now given this vaccine, literally, hundreds of millions of doses of vaccine and only two things have shown up that didn't show up in clinical trials."

One is evidence of low platelet count in women who received the Janssen Johnson & Johnson or Astrazeneca vaccines, "but that's incredibly rare, about 1 in 500,000."

The other is a swelling of the heart muscle called myocarditis, mostly in teenage boys and young men. That's also very rare, Frenck notes, with an incidence of only about 3 or 4 per 100,000.

More importantly, he points out, the likelihood of getting myocarditis from COVID is six to seven times higher.

"The virus itself is much more likely to give you myocarditis than the vaccine."

Myocarditis in general has been a minor symptom with people being treated at home with medicines like Motrin ibuprofen. "We have not seen any long-term side effects."