Pediatric COVID vaccine is ‘our path toward normalcy’

November 03, 2021
closeup image of two vials and a box of the Pfizer pediatric covid vaccine
MUSC Health is preparing to distribute COVID vaccines to children ages 5 to 11. Photos by Sarah Pack

Across South Carolina and the nation, parents of elementary school kids can now choose to have their children vaccinated against COVID-19.

With so many competing voices out there and rampant misinformation, it’s a choice that can feel scary for some. But for at least one mom, it’s an option that couldn’t come soon enough.

“We’ve been waiting for a year for this,” said Allison Eckard, M.D., director of the Division of Pediatric Infectious Diseases in the MUSC College of Medicine and mother of two young children. “This is our path toward normalcy.”

The Centers for Disease Control and Prevention approved the Pfizer BioNTech COVID vaccine for children age 5 to 11 after an all-day session on Tuesday. MUSC Health will begin offering the children’s vaccine on Thursday.

Eckard realizes she has a perspective that most don’t. She’s seen children admitted to the intensive care unit at MUSC Shawn Jenkins Children’s Hospital because of COVID or MIS-C, a rare condition that sometimes follows a COVID infection, and she’s seen how sick they can get. Last week, an unvaccinated teenaged patient died.

“That's the perspective that we as pediatricians have, as we get to see the whole spectrum of the pandemic from kids who do fine to kids who don’t. Not everybody in the community has that perspective,” she said.

And although death is the marker most often used in public discussion to gauge the seriousness of COVID, it’s not the only outcome that should be considered, Eckard said. Hospitalization, lingering symptoms and missed school are all serious negative effects. Long-term effects from COVID-19 are also possible but currently unknown.

The vaccine, on the other hand, has been shown to be safe and effective. The side effects most likely to be reported in the 5- to 11-year-old trial group are injection site pain, fatigue and headache. Myocarditis, the side effect that seems to concern parents the most, was not reported in that group. When it does occur, it’s more likely among males in late adolescence or early adulthood, Eckard said, but even then, it is usually mild and gets better quickly. She expects this side effect to be even more rare in the younger age group.

And, she noted, it’s important to remember that COVID itself can also cause complications like myocarditis, which occurs more commonly and tends to be much more severe. Earlier in the pandemic, when kids were home and masking and social distancing were more stringently observed, it was easier to avoid COVID. Now, with Delta circulating and community transmission rated as “substantial” by the CDC, it’s more of a matter of “when” rather than “if” the unvaccinated will get COVID, she said.

“I think ‘wait and see’ is not the right approach because as you wait, there’s a good chance your child will get infected,” Eckard said. “I think it’s not a good gamble.”

MUSC Pharmacy manager Aaron Steele, PharmD, holds the Pfizer’s pediatric covid-19 vaccine vials.  
MUSC Pharmacy manager Aaron Steele, PharmD, holds the Pfizer pediatric COVID-19 vaccine vials. 

None of the children admitted to MUSC Shawn Jenkins Children’s Hospital because of COVID, from the beginning of the pandemic to now, were fully vaccinated, she pointed out.

Serious COVID remains relatively rare in the 5 to 11 age group, she said. But children that age are just as susceptible to COVID and just as likely to transmit it as adults – something that wasn’t clear at the beginning of the pandemic, when children were kept close to home.

And CDC data shows that 32% of children age 5 to 11 who were hospitalized for COVID-19 had no underlying or preexisting conditions.

“I’ve said from the beginning, you've got to have a healthy respect for this virus,” Eckard said. “There’s so much we don’t know about it. This is not a common cold. This is not even influenza. This is different. This is something we have never seen before. We don’t know a lot about it; it's very serious, and it has the potential for long-term effects.”

Eckard encouraged parents who have questions to speak with their child’s pediatrician. And she reminded parents that another spike in cases is expected around the holidays, which are now just weeks away. To celebrate safely with family members of all ages, it’s best to vaccinate everyone who is eligible, she said.

Preparation for rollout

To prepare for the pediatric vaccine rollout, all providers tasked with giving vaccines, whether they typically see adults or children, must complete an online training, said Ali Worthy, director of administrative operations for the pandemic response team at MUSC Health. Providers who usually care for adults will then receive further in-person oversight and training from clinicians with pediatric experience.

The pediatric vaccine is exactly the same as what is given to teens and adults with one significant difference – children will receive 10 micrograms, compared with 30 micrograms for teens and adults. The needle itself will be smaller for children, and there will be more doses per vial for the children’s version.

The most visible change will be to the packaging – the vials with the vaccine for children will have an orange cap to differentiate it from the adult vials. The current vials for adults have a purple cap.

However, just like adults, children will get two doses, scheduled three weeks apart. People are considered fully vaccinated two weeks after the second dose. Some children with certain immune system conditions may require a 3rd dose.

Worthy said that MUSC Health is staggering its opening of vaccine clinics, beginning with the former DMV site at 180 Lockwood Blvd., on the peninsula. It will then open vaccine clinics at MUSC Children’s Health R. Keith Summey Medical Pavilion and Charleston International Airport. Two of the pharmacies on the peninsular Charleston MUSC campus will also have the vaccine.

As those sites get underway, MUSC Health will begin offering the vaccine at its four pediatrics practices in North Charleston and Moncks Corner. It is also working with the Charleston County School District to offer after-school clinics throughout the district.

Parents are encouraged to make appointments at this time. As of Wednesday, MUSC Health had ordered almost 4,000 doses for the Charleston Division, some of which will be shared with the Midlands Division; 900 for the Florence Division and 600 for the Lancaster Division.


Beginning Thursday, Nov. 4  180 Lockwood Blvd., 7 a.m. to 7 p.m. Monday through Friday and 7 a.m. to 4 p.m. Saturdays. 
  ART Pharmacy, 9 a.m. to 4 p.m. Monday through Friday.
  Rutledge Tower Pharmacy, 8 a.m. to 5 p.m. Mondays, Tuesdays, Thursdays and Fridays, 

and 7:30 a.m. to 7:30 p.m. Wednesdays, Saturdays and Sundays.
Beginning Friday, Nov. 5 Summey Medical Pavilion tents, 3-8 p.m. Monday through Friday and 7 a.m. to 4 p.m. Saturdays. 
Beginning Monday, Nov. 8 Charleston International Airport, 3-8 p.m. Mondays, Tuesdays and Thursdays.