Please Note

The Washington Post is providing this important information about the coronavirus for free. For more free coverage of the coronavirus pandemic, sign up for our Coronavirus Updates newsletter where all stories are free to read.

With nearly 17 million U.S. children eligible to receive a coronavirus vaccine, many health experts are urging parents and guardians to inoculate their children — especially now that the highly transmissible delta variant is the dominant strain in the United States.

Aside from protecting children against covid-19, the disease caused by the coronavirus, the vaccine “gives them a ticket to doing a lot of things they weren’t doing before, like hanging out indoors with friends without masks,” infectious-disease expert Sean O’Leary said.

But most families will have questions about the vaccines, so here are some answers.

Frequently Asked Questions

  • Should I consider vaccinating my child?
  • Is my child eligible?
  • Is this the same vaccine that is administered to older teens and adults?
  • Is it FDA-approved?
  • Is it safe for children?
  • Will vaccination be required to return to school?

Should I consider vaccinating my child?

The Centers for Disease Control and Prevention and the American Academy of Pediatrics recommend vaccinating children who are eligible. Currently, that means those 12 and older, but the shots are being studied in younger children.

It is true that covid-19 does not typically result in serious illness in children. But they are still at risk. Data shows that about 4 million children in the United States have been diagnosed since the pandemic started, resulting in tens of thousands of hospitalizations and at least 300 deaths, though some researchers estimate the actual number of fatalities could be twice as high.

In addition, more than 4,000 children have suffered a rare but serious condition called multisystem inflammatory syndrome (MIS-C), which is associated with covid-19 and can cause inflammation of the heart, lungs, kidneys, brain, eyes and other organs, according to the CDC.

Those numbers may not seem indicative of a significant problem for children when compared with the more than 33 million total cases and over 600,000 deaths across the United States, but health experts say that the virus is having an impact on youths.

To put it into perspective: 188 children died of influenza during the 2019-2020 season — mostly before the pandemic and precautionary measures such as social distancing. Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia, said covid-19 is “right up there among the vaccine-preventable diseases as one of the more likely killers.”

In fact, O’Leary, vice chair of the Committee on Infectious Diseases for the American Academy of Pediatrics, said because child fatalities are not common, the number of pediatric deaths related to covid-19 would put the virus in the top-10 causes of death among children.

But aside from protecting children themselves, vaccination makes sense for the greater good — to help reduce community transmission, get the country as close as possible to herd immunity and allow adults and children alike to get back to their pre-pandemic lives, health experts say.

“The more people we can vaccinate, the more lives we’re going to save,” O’Leary said.

Is my child eligible?

Currently, children 12 and older can take the Pfizer-BioNTech messenger RNA vaccine.

Older teens have been eligible for the coronavirus vaccines ever since Pfizer, Moderna and Johnson & Johnson were granted emergency use authorization from the Food and Drug Administration. The Pfizer vaccine was initially authorized for people 16 and older, while the Moderna and Johnson & Johnson shots were authorized for those who are at least 18.

The Pfizer vaccine was recently cleared for use in younger adolescents, and clinical trials are underway to determine the safety and efficacy of the shots in children ages 6 months to 11 years.

Moderna is studying its mRNA vaccine in children from 6 months old to 17 years old.

Anthony S. Fauci, the nation’s leading infectious-disease expert, said that it is likely that researchers will have enough health and safety data to start vaccinating children “of any age” by early next year.

Is this the same vaccine that is administered to older teens and adults?

It is. The Pfizer vaccine that has been cleared for children 12 and older is the same vaccine given at the exact same dose.

But based on safety, tolerability and immunogenicity data from the Phase 1 study, it will be administered at a lower dose for children younger than 12 when it becomes available to them, Pfizer said.

Moderna is likely to do the same.

Is it FDA-approved?

The Pfizer vaccine is authorized for emergency use in individuals 12 and older, and Moderna has submitted an application for authorization to offer the shots to adolescents. But neither has received full approval yet.

What does that mean?

Emergency use authorization is a way to use unapproved medical products, such as vaccines, during public health emergencies. It is a rigorous process, though, that requires comprehensive data from at least one large Phase 3 clinical trial.

For full FDA approval, the clinical trial participants must be tracked for at least six months to monitor for serious adverse reactions. Pfizer has applied for full regulatory approval to use the vaccine in people 16 and older and will submit supplemental materials for the 12-to-15 age group once the appropriate length of time has passed and enough data has been collected.

Is it safe for children?

Older teens have been getting vaccinated for months, and U.S. clinical trial data for the Pfizer vaccine showed “no safety concerns” for 12-to-15-year-olds — the most recent group to get the green light for inoculation.

The vaccine was also 100 percent effective at preventing symptomatic covid-19 infection. Out of nearly 2,300 adolescents, there were only 18 cases of covid-19 — all in the placebo group.

Trials are ongoing for those younger than 12. Offit said that once data is available for them, “then we’ll know whether or not the vaccines are shown to be safe and effective in those age groups.”

Will vaccination be required to return to school?

It is not yet clear whether vaccination will be required for school-age children in the fall. Those decisions are typically made at the state level and, at least so far, there hasn’t been a push from state lawmakers.

Dorit Reiss, a law professor focused on vaccine policy at the University of California Hastings College of Law, recently told The Washington Post it is unlikely that the shots would be required before the vaccines are granted full regulatory approval.

Dozens of colleges, meanwhile, have already announced plans to require coronavirus vaccines for their students.

Can the coronavirus vaccine be given at the same time as other shots?

Yes.

Both the Centers for Disease Control and Prevention and the American Academy of Pediatrics have stated that co-administration is acceptable.

Also, O’Leary stressed that regardless of whether families get their children inoculated against the coronavirus, they should make sure their children are caught up on other vaccinations. He said that during the pandemic, there was a drop in childhood vaccinations, and once children start socializing, those who are unvaccinated will be prone to other vaccine-preventable diseases — “some of which are much more severe in kids than covid-19.”

What are the side effects?

As with adults and older teens, younger adolescents may experience side effects from the vaccine, including pain and redness at the injection site, as well as tiredness, headache, muscle pain, fever and chills. Younger adolescents have experienced side effects more commonly than older teens, and the side effects may be more intense after the second injection, according to the CDC.

The CDC said side effects should subside within a few days.

Although such events are rare, those who experience a severe or immediate allergic reaction to the first dose should consult a doctor before the second.

What about myocarditis?

There have been rare instances of heart muscle inflammation in vaccinated adolescents and young adults.

The CDC and FDA have confirmed 674 reports of myocarditis (inflammation of the heart muscle) or pericarditis (inflammation of the outer lining of the heart) following vaccination in young people in the United States, though U.S. medical investigators are still assessing whether there is a relationship to the vaccines, the CDC said. Israel’s Health Ministry said researchers found a “probable link” to cases reported there.

Of the potential cases reported to the Vaccine Adverse Event Reporting System (VAERS), the majority occurred in males within a couple days after receiving the second dose of the mRNA vaccines. Symptoms include chest pain, shortness of breath and heart palpitations. But more than 80 percent recovered on their own, according to the data.

In June, the Advisory Committee on Immunization Practices, which makes vaccine recommendations to the CDC, reviewed the reported cases and determined the benefits of the mRNA vaccines outweigh the risks of myocarditis and pericarditis. Still, the FDA has added a warning about the potential risks to the Pfizer and Moderna fact sheets.

The CDC said there has not been “a similar reporting pattern” among those who received the Johnson & Johnson vaccine.

The Johnson & Johnson shot, which is an adenovirus vector vaccine, is currently not authorized for people younger than 18. Asked whether Johnson & Johnson plans to make the vaccine available for children, the company said in a statement that it is “moving forward with adolescent clinical trials and look forward to sharing this data with regulators in the future.” It is not clear whether or when the vaccine will be available to children in the United States.

All of that said, given that millions of teens and young adults have already taken at least one dose of the coronavirus vaccine in the United States, health experts said that if there is a link between the shots and the onset of myocarditis, it would be very small.

In fact, Offit said the incidence is about one in 20,000 to one in 50,000 people — meaning in a stadium of 100,000 people who took the vaccine, two to five of them might develop the condition (depending on their ages). The risk of developing myocarditis from covid-19 is much higher, he said.

A cohort study published in JAMA Cardiology looked at nearly 1,600 college athletes who underwent extensive cardiovascular testing after having covid-19 and found that 2.3 percent — or roughly one in 40 — had myocarditis.

And multisystem inflammatory syndrome, which is much more common and has been linked to the virus, can also cause heart inflammation.

“There are no risk-free choices; there are just choices that take different risks," Offit said. "The goal of a parent is to make the choice that puts the child at lesser risk. And the vaccine puts the child at lesser risk than not vaccinating the child, knowing that the delta variant is highly contagious.”

Where can I find additional information?

With so much misinformation about vaccines, O’Leary said, families should be careful to get information from a reputable source, such as the child’s pediatrician or authorities such as the CDC, American Academy of Pediatrics or the Immunization Action Coalition.

The vaccines are provided free. To find nearby vaccination centers, visit Vaccines.gov.

Read more: