What a pediatrician wants concerned parents to know about COVID vaccine

November 01, 2021
Girl getting a vaccine.
The Food and Drug Administration has authorized the emergency use of the Pfizer COVID vaccine in children 5 and up. iStock

Most moms and dads will do anything to keep their children safe. So when it comes to giving COVID vaccines to kids, some parents are understandably cautious.

Elizabeth Mack, M.D., is cautious, too. It’s her job as a pediatric critical care doctor to protect and take care of children. That means she not only treats kids in the MUSC Shawn Jenkins Children’s Hospital but also scrutinizes research on issues that affect them.

Here, Mack, a spokeswoman for the American Academy of Pediatrics, with a Master of Science degree in addition to her medical degree, tackles some of parents’ top concerns about COVID shots.

“You’re trying to experiment on our kids.”

Mack hears from a lot of parents who worry that the vaccines are being approved too quickly. They’re used to it taking years for vaccines to be developed.

“But the difference here is that mRNA vaccine technology is not new,” she said, referring to the way the Pfizer and Moderna vaccines work.

Dr. Elizabeth Mack 
Dr. Elizabeth Mack

Scientists at the National Institutes of Health have been working since well before the pandemic on ways to fight coronaviruses. They created a vaccine that could be customized. So when COVID-19 emerged, researchers were able to develop new shots quickly.

Right now, children 12 years and up can get the Pfizer vaccine. Younger kids may be able to get it soon, too. Last week, the Food and Drug Administration authorized emergency use of the Pfizer vaccine in 5- to 11-year-olds. This week, a panel of experts at the Centers for Disease Control and Prevention will give its assessment.

Mack said the data are also being looked at closely by pediatricians and epidemiologists. “There are a lot of calls and healthy discussion about the data, like how much do we trust them? How inclusive are they? So it's not just a given that everything gets approved. I hope that folks understand that.” 

“Do the vaccines affect puberty and future fertility?”

“We get asked that a lot,” Mack said. “That has been studied, and it does not disrupt puberty, and it has not disrupted fertility. In fact, vaccination is recommended for women who are of childbearing age and/or are pregnant.”

The North American Society for Pediatric and Adolescent Gynecology issued a statement addressing the pediatric concerns: “There is no plausible biological mechanism or evidence to support concerns that puberty or growth would be altered by COVID-19 vaccines.” Other scientists have made similar statements, noting that the vaccines do not enter the nucleus of cells, so they can't alter a child's DNA or affect adolescent development.

“There are no long-term studies on the impact of the COVID vaccine on kids.”

“I appreciate the concern about long-term data, but COVID hasn’t been around long enough for that yet. But we do know the short-term danger of COVID and MIS-C.” MIS-C stands for multisystem inflammatory syndrome in children. “We have lost a number of children to those things,” Mack said.

“In the 5- to 11-year-old age group, about 1.9 million children, approximately 9% of cases in the U.S., have been infected with COVID-19. Approximately 8,300 children have been hospitalized with COVID-19. And at least 94 have died.”

“The vaccine can cause heart problems.”

“There's been a lot of press about vaccine-associated myocarditis and that sort of thing. And I think that it's important to remember that any and everything can be reported to VAERS,” the Vaccine Adverse Event Reporting System, Mack said.

The Centers for Disease Control and Prevention is keeping track of those VAERS reports. But it says the benefits of getting vaccinated – preventing COVID-19 and its complications, including long-term problems, hospitalization and in rare cases, death – far outweigh the potential risks for most people. 

Mack said the myocarditis cases she sees aren’t from vaccination but from MIS-C and COVID. “We are routinely caring for children in our ICUs unvaccinated against COVID-19 with COVID-associated myocarditis. This is a very real, immediate risk.”

“Kids aren’t at risk of getting really sick with COVID.”

“That has changed with Delta,” Mack said.

Delta, the highly infectious variant, helped the coronavirus spread more easily. More kids got sick, leading to more children ending up in the hospital. At the MUSC Shawn Jenkins Children’s Hospital, some young COVID patients got so sick they had to go on a last-resort form of life support called extracorporeal membrane oxygenation, or ECMO

“We are currently in the midst of a MIS-C surge, which predictably follows our COVID surges by one to two months,” Mack said.

While South Carolina’s COVID numbers have come way down from our recent peak in what one scientist called part of a two-month cycle, there’s worry that we’ll see another surge of COVID cases this winter. 

“Children are having bad reactions to the vaccine.”

“That certainly is something that we monitor. All recipients should be observed for a period of time. But we've seen zero of that leading to hospitalizations the entire course of the pandemic,” Mack said. “At the end of the day, in the ICU, we’re seeing kids with COVID and kids with MIS-C, not kids who are vaccinated.”

In the more than 3,000 5- to 11-year-old children in the vaccine trials, none had anaphylaxis or myocarditis. The most common reactions were pain at the injection site, fatigue and headache. 

The CDC is monitoring VAERS for reports of serious problems following vaccination but calls them rare. Mack said minor, short-term reactions are what parents should prepare for. “Having site pain is very common with an injection. You can also have a fever, fatigue, things like that for a brief time.”

Her big worry is that parents’ reluctance will mean too few children get vaccinated, leaving them at risk of getting COVID. “A lot of people assume that there will be quick uptake in 5- to 11-year-olds. I anticipate it will be even less than what we currently have in the older kids. We're still sitting at 30% of our 12- to 19-year-olds who are fully vaccinated against COVID in this state.”

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