It seems that the longer we wait for a COVID-19 vaccine to be approved for certain age groups, the less likely children in those age groups are to get vaccinated.
The Food and Drug Administration cleared the vaccine for emergency use in children ages 5 to 11 in late October, but nine months later only 30% of children in that age group have been fully vaccinated. The Pfizer-BioNTech and Moderna vaccines were authorized in June for children aged 6 months to 4 years, but only 4% of children of these ages received a first dose.
That number is expected to remain low, as a Kaiser Family Foundation (KFF) COVID-19 Vaccine Monitor survey released on Tuesday found that 43% of parents of children 6 months to 4 years old will “definitely” not get them vaccinated. And enthusiasm for the vaccine only increases marginally from there: an additional 13% say they will only vaccinate their child if it is necessary for school or daycare, and 27% said they wanted to “wait and see how the vaccine works for others”. young children.” The remaining parents, who have already vaccinated or plan to do so “right away”, represent only 17% of the 471 parents of children under 5 surveyed.
The survey also asked parents to explain their reluctance to have their children vaccinated. We presented some of their most common concerns to medical experts to see how they would address them with parents. Here’s what they had to say:
Concern: The vaccine is “too new”.
The No. 1 concern raised by vaccine-hesitant parents in the KFF survey was that the vaccine is “too new” or has not been researched or tested enough.
“The vaccine is not new. It’s been around for a while,” said Dr. Amesh Adalja, senior researcher at the John Hopkins Center for Health Security.
Dr. Ruth Kanthula, pediatric infectious disease specialist at MedStar Health, explained several factors that led to the relatively rapid development of the COVID vaccine. Although you may not have heard of it before the pandemic, the mRNA technology used by scientists to create the vaccine was discovered in the 1960s.
“During the COVID-19 pandemic, there has been a major injection of funds to support clinical trials of COVID-19 mRNA vaccines,” Kanthula said.
“The increased funding has allowed research programs to hire more staff to work at multiple sites and to help manufacture the vaccines. In addition, clinical trials have been able to recruit large numbers of study participants, including children, in a short time. This allowed data on vaccine safety and effectiveness to be examined earlier than earlier vaccine trials. »
Adalja also pointed out that novelty is not a reliable indicator of danger. “Just because something’s new doesn’t mean it’s unsafe,” he said, adding that we don’t hesitate to buy the latest version of iPhone for security reasons. .
“At one time, every piece of technology that improved human life was new,” Adalja said.
Concern: I worry about side effects.
No one wants to see their child suffer or be embarrassed, but side effects like fever and pain at the injection site are quite common after many vaccines. These can occur with the COVID-19 vaccine and tend to pass quickly.
Parents may also worry about scarier side effects they’ve heard about or seen on social media. Last year, for example, cases of myocarditis and pericarditis (inflammation of the heart muscle and the lining surrounding the heart, respectively) were reported, mostly in young men after their second dose of the vaccine. It sounds scary, but most patients recovered quickly and the incidence was very low: the highest rate, in males aged 16-17, was 105.9 cases per 1 million doses of the Pfizer vaccine. -BioNTech. That’s a 0.0001% risk, much lower than the risk of complications from COVID-19.
Concern: COVID-19 is generally mild in young children.
Fortunately, it is true that COVID-19 infections in children are usually mild. Infections rarely cause the type of symptoms that would land a child in the hospital. But Adalja asks this question: “Why not minimize any risk with a safe vaccine?”
He explained that diseases such as rotovirus and chickenpox rarely cause serious illnesses, but we regularly vaccinate against these diseases.
And just because cases are usually mild doesn’t mean problems can’t occur. When infections with the omicron variant increased last winter, so did pediatric hospitalizations. Nine out of 10 children aged 5 to 11 who were hospitalized during the omicron wave were not vaccinated, meaning their hospitalization was likely preventable.
“Yes, children tend to get milder infections,” Kanthula said. “However, children are still at risk of serious infection requiring hospitalization, supplemental oxygen and possible intubation – the placement of a breathing tube.”
Additionally, “paediatricians are limited in what drugs we can use to treat COVID-19 infection in children,” Kanthula added. Treatments such as Paxlovid and monoclonal antibodies are only approved for ages 12 and older.
There’s also the small but real threat of MISC-C, a condition in which COVID-19 infection precedes an immune response in the body that causes inflammation of the heart, lungs, kidneys or other organs. Vaccination offers protection against this serious complication.
A recent study found that 6% of children seen in emergency departments who tested positive for COVID-19 reported 90 days later that they had long COVID symptoms such as fatigue, lethargy and cough. Children so sick they were hospitalized were more likely to report long COVID symptoms. By preventing serious illnesses, the vaccine protects children against the long COVID.
Concern: The vaccine is not very effective.
You have heard a lot about people talking about their vaccinated children getting infected with COVID-19. While it’s true that a child or adult can still test positive for COVID after being vaccinated, that’s not the most important measure of a vaccine’s effectiveness.
Vaccination offers strong protection against serious diseases and complications. If your vaccinated child gets COVID-19, Adalja said, “they’re unlikely to need hospitalization.” That, he noted, is the real goal of vaccination.
“What we’re really trying to prevent is serious illness,” he said.
Concern: My child has already had COVID-19.
At this point in the pandemic, the majority of children have had COVID-19. The Centers for Disease Control and Prevention reported that in February 2022, 75% of children and adolescents had antibodies, indicating previous infection.
As the infection provides temporary protection against the disease, parents may wonder if it is still worth having their children vaccinated. Experts say yes.
“Hybrid immunity,” meaning both from previous infection and vaccination, is “the best kind of immunity to have,” offering the most protection against multiple variants of the disease, Adalja said.
Concern: I don’t understand the dosage.
Some parents are confused about the varying dosage of childhood vaccines. The Pfizer-BioNTech vaccine, for example, is given in two doses of 10 micrograms to children 5 to 11 years old and in three doses of 3 micrograms to children 6 months to 4 years old. A 4-year-old and a 5-year-old child are not very different in size, however, and a parent may wonder, for example, whether they should wait until their child is 5 years old to receive the higher dose.
But the dosage does not depend on the weight of the child. “The dosage is based on the minimum amount of vaccine dose needed to get a sufficient immune response,” said Adalja, who noted that it “took so long for children 5 to 11 years old because they were trying to ‘get the right dosage’ to minimize side effects.
“As a pediatrician,” Kanthula said, “I know that children are not small adults and one dose of vaccine is not right for everyone. Children have different physiological and immune responses depending on their age.
For some, there are other barriers to vaccinating their children.
One of the biggest predictors of whether or not a child is vaccinated has nothing to do with their health. The KFF survey found parents who identified as Republican or Republican-leaning were the most likely to say they “definitely did not” intend to have their children vaccinated.
Other parents’ concerns were less ideological and more financial or logistical. The survey found that 44% of black parents with children aged 6 months to 4 years worry about having to take time off work to have their child vaccinated or care for them if they have side effects . And 45% of Hispanic parents with children the same age said they were worried about not being able to have their child vaccinated in “a place they trust”.
A potentially encouraging finding is that 70% of parents of children aged 6 months to 4 years said they had not yet spoken to their pediatrician about their child’s vaccination, meaning that health care providers may have an opening to ease families’ concerns in person when they bring children in for checkups. But there is no need to wait for your annual visit. If you have any questions about the vaccine, call your pediatrician and make an appointment to discuss them.