COVID-19 Vaccines for Young Children: Are they Safe and Effective?

July 26, 2022

anderson-evan_.pngA conversation with Emory Professor of Pediatrics and Medicine Dr. Evan J. Anderson, an infectious disease pediatrician at Children’s Healthcare of Atlanta who was involved in the clinical trials testing COVID-19 vaccines for children ages six months to 11 years at Emory and Children’s.

In June, the Centers for Disease Control and Prevention (CDC) recommended that all children six months through 5 years should receive a COVID vaccine, joining the agency’s previous recommendation for children 5 and older. “These vaccines have been well studied and thousands of children have been involved in the clinical trials that provided data to support their approval,” Anderson says.

The Partnership: EYP has designed multiple projects for Emory University and Emory Healthcare, including the Winship Cancer Research Institute, the Oxford Science Building, and research labs across campus. EYP has also partnered with Children’s Healthcare of Atlanta on projects on its Egleston campus, Scottish Rite campus, Center for Advanced Pediatrics and new Arthur M. Blank Children’s Hospital.

Three Things to Know about COVID-19 Vaccines for Children:

1. Although it is rare for children to become seriously ill from COVID-19, tens of thousands have. About 1,300 youth 18 years of age and younger have died from COVID-19 in the U.S., and more than 40,000 have been hospitalized with the virus. Additionally, more than 8,500 children have developed COVID-related multisystem inflammatory syndrome in children (MIS-C), which causes inflammation of internal organs and can be fatal.

2. These vaccines have been well studied and have proven to be safe and effective. “We have a wealth of experience from children 5 years of age and older, as well as in adults, related to COVID-19 vaccines,” Anderson says. “It’s a unique situation as hundreds of millions of doses have been given in the U.S. This should provide additional reassurance to parents.”

3. Side effects are almost always mild and easily controlled. The most common side effects of the COVID vaccine are fever, chills and generally not feeling well. Local symptoms include pain, redness, soreness and tenderness at the site of the vaccination. “In general, most of these vaccine side effects are less pronounced in children than in adults,” Anderson says. “Most of these side effect symptoms can be easily controlled with medications like Tylenol or Ibuprofen.”

A Deeper Dive

Evan Anderson isn’t just a pediatrician, he’s also a father. And he didn’t hesitate to have his own children vaccinated for COVID-19 as soon as possible.

“I’ve got four kids and all of them got COVID-19 vaccines on the day that vaccinations became available in their age range,” he says. “I trust in the clinical trial process and the scientific method, which is driven by data.”

He hopes to reassure parents by sharing his knowledge and91558883-56a6fd185f9b58b7d0e5de19.jpg providing straightforward information. To that end, he addresses parents’ concerns from his expertise as a doctor, scientist, and researcher.

COVID vaccines for children are important

A substantial number of COVID-19 infections occur in young children. “We saw relatively large numbers of hospitalizations in children who were not vaccine eligible, and a relatively large number of deaths occurred in infants and children less than 5 years of age,” Anderson says.

Influenza is a useful marker against which to gauge the burden of disease, he says. “When we compare COVID-19 with influenza, the number of deaths seen with COVID-19 each calendar year since the beginning of pandemic are similar to or greater than the burden of seasonal flu that we observed before the pandemic,” he says. “And that is despite all the social interventions we’ve undertaken trying to prevent transmission to our youngest children. There were far fewer deaths of children from influenza during the past flu season than deaths of children from COVID-19 in the past year.”

Children from newborn to six months

When a pregnant mother receives a COVID-19 vaccine, it’s been determined that this provides protection against severe COVID-19 outcomes in the baby in the first six months of life, according to data that partly came out of Children’s Healthcare of Atlanta and Emory.

“This is probably due to antibody transfer through the placenta, and it also helps the mother by protecting her against COVID-19 and the risk of transmitting it to her baby as well,” he says.

Anderson recommends that children and family members in households with new babies also should be vaccinated for COVID to protect the youngest infants.

Clearing up the differences

Children receive smaller doses of the vaccine than are given to the adults, but also require multiple shots.

Experts say that young children need two doses of the Moderna vaccine and three doses of the Pfizer vaccine. The difference, Anderson explains, is that the vaccines are licensed based upon the ability of the vaccine to stimulate a similar immune response as that seen in young adults enrolled in Phase 3 clinical trials.

The Moderna vaccine, in children six months to 5 years, generated a similar immune response to that of adults with the two-dose series. With Pfizer, three doses were needed in these infants and young children to generate a similar immune response.

Another difference: the Pfizer vaccine has been approved for children six months through 4 years, and the Moderna vaccine for ages six months through 5 years.

This is due to how the clinical trials were designed, which then impacted the FDA approval of the vaccines. For Pfizer, says Anderson, the clinical trial age ranges for the doses were set for six months through 4 years, while Moderna was six months through 5 years. Five-year-olds, he says, have been able to get the Pfizer vaccine at a higher dose since late October 2021.

Children who have had COVID still need the vaccine

Children who have had COVID-19 previously are somewhat protected from serious illness if they get the virus again, says Anderson.

“But the immune response and breadth of immune response appear less robust in such cases than what is observed after two doses of COVID-19 vaccination. As such,” he says, “vaccination is likely to decrease risk of recurrent infection and may provide better cross-protection against current and future variants.”

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