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Opinion Real-world data on the safety of covid shots for young children is just weeks away

Dr. Marc Lashley gives brothers Aaru Diaz, left, and Taylan De Gal their covid-19 vaccines with assistance from Hofstra medical student Dan Bastardi at Valley Stream Pediatrics in Valley Stream, N.Y., on Nov. 3. (Jackie Molloy for The Washington Post)
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Rachel M. Pearson is an assistant professor of pediatrics at the University of Texas Health Science Center at San Antonio.

A recent poll shows a third of parents of 5-to-11-year-olds are waiting to see more data on the coronavirus vaccine before choosing to vaccinate their children. Such parents won’t need to wait long: With the White House projecting that 900,000 kids in this age group will have their first vaccine this week, we will soon have enough information to detect even very rare vaccine side effects.

Unvaccinated kids remain at risk of hospitalization and death from covid, so I want all my pediatric patients to get vaccinated as soon as possible. But if you are a “wait and see” parent, you should have the information you need by February.

Here’s the timeline: The kids joining the ranks of the vaccinated this week should get their second dose three weeks later. After that, there’s a six-week window when we can expect any adverse effects to show up.

Hesitant parents worry about “long-term effects,” but decades of data from vaccinating billions of people against all kinds of infections have shown that side effects generally occur shortly after the injection, when induced antibody levels are at their highest. The same has been true with the coronavirus vaccines thus far.

Should any serious side effects be found, it could take a little more time to review them. For example, the vaccine was authorized for children between 12 and 15 in May. By the end of June, the CDC had reviewed the data on vaccine-induced myocarditis — an inflammation of the heart muscle — in this cohort. Because this treatable complication affects only about 1 in every 50,000 vaccinated, the agency recommended that vaccination continue. Similarly, the Johnson & Johnson single-shot coronavirus vaccine was authorized for adults on Feb. 27; just two months later, health officials detected an extremely rare clotting side effect and briefly paused vaccination.

Hesitant parents also point to the fact that the initial Pfizer studies on younger children, performed over the past year, were small — a total of about 3,100 who got the vaccine, and 1,500 who got a placebo. The most common side effects were headache and fatigue. Only 1 in 15 kids had fevers after the vaccine, and most of those were low-grade. Now, with hundreds of thousands of newly vaccinated, and more every day, parents can be reassured by the much larger real-world sample.

While big data accumulates, parents of unvaccinated 5- to 11-year-olds will begin to see personal and anecdotal evidence supporting vaccination. They will see their kids’ friends and cousins get the vaccine and do just fine. They will see vaccinated kids able to participate more fully in education and after-school activities. They will talk to many parents relieved at the assurance that their vaccinated child won’t be hospitalized with, or die of, covid.

As the mother of a 15-month-old, I am watching those families with envy. Normal toddler life still feels perilous for my son. Without the vaccine, the only thing standing between him and covid infection is us: the precautions we take as parents, and the degree of vaccination in our overall community. Quite frankly, I want him vaccinated so that his father and I can relax.

Parents often ask me if their child who already had covid should get the vaccine — or would they be likely to have a “bad reaction”? The data so far is reassuring: 133 kids vaccinated in the first arm of the study already had antibodies to SARS-CoV-2 in their blood, indicating they’d been infected before. And those children were slightly less likely than others to have vaccine side effects.

In general, vaccine-hesitant parents are trying to figure out whether the vaccine is right for their specific kid. Is it okay for kids with asthma, for kids with diabetes or for kids with heart disease? From a public health perspective, the answer is almost always yes. But your pediatrician is a key resource here: If you need to know if the vaccine is right for your child, ask the doctor who is sworn to protect and help that child.

With the third winter of this pandemic upon us, unvaccinated children will remain at risk of serious illness and death from coronavirus infection, as well as post-covid complications such as multisystem inflammatory syndrome in children (MIS-C).

So if you are among the parents who hope to wait and see before vaccinating your eligible child, please don’t wait too long. In every population group that has been vaccinated or come eligible for vaccination, covid hospitalizations and deaths have dropped dramatically. Finally, elementary-aged kids can get this same protection.

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