AHA News: What Parents Should Know About the COVID-19 Vaccine For 5- to 11-Year-Olds

A COVID-19 vaccine has finally arrived for children ages 5 to 11 – and with it, some important questions from parents.

Many are wondering about safety, said Dr. Donna Curtis, a pediatric infectious disease specialist at Children's Hospital Colorado in Aurora. Others are asking whether the coronavirus is enough of a threat to their child to require a vaccine.

Here are answers that might help.

What is the vaccine, and where can I get it?

It's one-third of the dose of the Pfizer vaccine that has been given to adults since December 2020 and adolescents 12 and up since May. Tens of millions of Americans have received Pfizer's vaccine, and it's considered very safe.

Data presented to the Food and Drug Administration showed the new dose was 90.7% effective at preventing symptomatic COVID-19 in 5- to 11-year-olds.

The vaccine is being distributed through pediatricians, pharmacies and others, with plans to scale up to full capacity starting Nov. 8, according to a Centers for Disease Control and Prevention news release. Locations are listed at vaccines.gov. As with adults and adolescents, young children will need a second dose three weeks later.

Does my child even need a vaccine for COVID-19?

"We don't think of children as the highest-risk group," said Curtis, who has done research on vaccines in immunocompromised children. However, according to data reviewed by the CDC's advisory panel on vaccines, as of Oct. 10, almost 2 million 5- to 11-year-olds have gotten ill from COVID-19, and 94 have died.

COVID-19 also has been linked to multisystem inflammatory syndrome in children, or MIS-C, a condition that causes swelling of the heart, brain and other organs. As of early October, more than 5,200 children had been diagnosed with MIS-C, and 46 died, according to CDC data.

A vaccine goes beyond giving protection to the child who receives it, Curtis said. It can stop the spread of the disease to nearby children and family members, some of whom might have conditions that put them at higher risk for severe illness from COVID-19. Those conditions include obesity, diabetes, weakened immune systems and congenital heart defects.

The chance that a child will develop severe COVID-19 that requires hospitalization or develop MIS-C remains low, "but still the risk is too high and too devastating to our children, and far higher than for many other diseases for which we vaccinate children," CDC Director Dr. Rochelle P. Walensky told the agency's advisory panel before it reviewed safety data on Tuesday.

What are possible side effects from the vaccine?

Common side effects include pain, redness and swelling at the injection site. Some children had fevers, fatigue, body aches, headaches, chills or swollen lymph nodes – similar to what happens in adults.

Among the 3,109 children in the clinical trial that evaluated the Pfizer vaccine in this age group, there were no serious side effects, the FDA said in granting emergency use authorization.

What about the risk of heart issues, such as myocarditis and pericarditis?

Although no cases were seen in the clinical trial, myocarditis and pericarditis – swelling of the heart muscle or its lining – has been a rare side effect in other groups, particularly in adolescent and young men who got the Pfizer or Moderna vaccines.

That problem affected a small percentage of people who were vaccinated, Curtis said. The FDA used statistical modeling to predict the risks of heart inflammation in 5- to 11-year-olds and concluded the overall benefits of getting vaccinated far outweighed the risk.

As a parent, Curtis said she understands heart inflammation sounds scary. "But generally, these are mild to moderate illnesses," she said. Patients are hospitalized, given ibuprofen or a similar drug, and go home in a few days, generally with no long-term issues.

The risk of myocarditis from COVID-19 itself, she said, is much higher.

My child already had COVID-19. Is vaccination still needed?

"The recommendation is yes," Curtis said. Immunity can wane with time. "We hear about it more when we talk about vaccines, but we've seen the exact thing with coronavirus infection." A vaccine can boost their immune response and help prevent future infections.

Most of my child's classmates are getting vaccinated. Can I just count on herd immunity?

"I don't think that is a safe thing to assume," Curtis said. Vaccinated people are less likely to get sick, are protected from serious illness and seem less likely to spread the disease. But they can still get infected, and they can still be contagious.

Also, an unvaccinated child would be at risk for catching the coronavirus from an adult outside of school, Curtis said. "So I think the only way to maximally protect your child is to get them vaccinated."

What can I do to protect my children who are too young to be vaccinated?

"You can protect them by getting everyone in the household vaccinated," Curtis said, and by making sure their caregivers are vaccinated, too. It's called "cocooning," she said – surrounding the people who can't be vaccinated with people who are.

In the meantime, people also should continue measures such as social distancing, wearing masks indoors in public for those ages 2 and older, washing hands and avoiding higher-risk areas.

What other factors should I be weighing?

By protecting a child from being sick, a vaccine protects an entire family's well-being, Curtis said. "We are preventing the parent from having to take time off from work, the child from missing school. We're preventing them from potential hospitalization" and long-term problems such as the sometimes debilitating symptoms that come with "long COVID."

Children can easily spread diseases to adults, Curtis said. "So the benefit to vaccinating children is huge."

The CDC advisory panel was told that vaccinating children in this age group would help prevent roughly 600,000 COVID-19 cases between November and next March.

How can I prepare my child for their vaccination?

The American Academy of Pediatrics has a page full of tips such as talking about the experience in positive terms and reminding children that vaccines keep people healthy.

Should a parent feel anxious right now? Or happy?

"This is something that I've been waiting for, for a very long time," said Curtis, who has two children, ages 9 and 11. "And I'm very excited about it."

COVID-19 can be severe in this age group, she said. "For me, the choice is clear that the vaccine is so much safer than my children getting the coronavirus. And it's also a way that I can help protect their friends and help protect other people in our family."

American Heart Association News covers heart and brain health. Not all views expressed in this story reflect the official position of the American Heart Association. Copyright is owned or held by the American Heart Association, Inc., and all rights are reserved. If you have questions or comments about this story, please email editor@heart.org.

By Michael Merschel