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KIDS AND THE COVID-19 VACCINE: A PEDIATRICIAN ANSWERS SAFETY QUESTIONS

By Sandee LaMotte, CNN 5/13/2021

--------------------------------------------------------------------------------

'Eye-opening moment': City leaders, police departments push back over impending…
Ahmaud Arbery: Murder trial for the killing of 25-year-old Black man begins…

Teenagers between the ages of 12 and 15 years old can now be given the
Pfizer/BioNTech coronavirus vaccine, the US Centers for Disease Control and
Prevention said Wednesday.

© YURIY DYACHYSHYN/AFP/AFP via Getty Images A nurse administers a measles
vaccine to a teenager in the school of Lapaivka village near the western
Ukrainian city of Lviv on February 21, 2019.

"CDC now recommends that this vaccine be used among this population, and
providers may begin vaccinating them right away," CDC director Dr. Rochelle
Walensky said in a statement.

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The approval will allow another 5% of the population -- nearly 17 million teens
-- to be vaccinated, beginning immediately. A poll conducted during the first
week of April found just over half (52%) of parents said they would be willing
to vaccinate their children against Covid-19.

That still leaves many parents unsure of what to do, as misinformation campaigns
on vaccine safety spread on social media.

What are the facts? We asked Dr. Yvonne Maldonado, who chairs the American
Academy of Pediatrics Committee on Infectious Diseases, to answer questions
parents may have.

Maldonado is also chief of Stanford University School of Medicine's division of
pediatric infectious diseases and is currently leading vaccine trials in
children younger than 12.

The conversation has been lightly edited for clarity.

CNN: Some parents have had no issues getting vaccinated as adults but now find
themselves fretting over giving the vaccine to their children. What message do
you and the American Academy of Pediatrics have for these parents?

Yvonne Maldonado: The US Centers for Disease Control and Prevention, the US Food
and Drug Administration and the vaccine companies have been very open and
transparent with the American Academy of Pediatrics on all of the vaccine data,
because they know that we advocate for children and parents and families.

Not only are we pediatricians -- we are vaccine experts, and we have reviewed
the data ourselves on all the trials so far, and we will review the additional
data.

I personally am a liaison to the CDC's Advisory Committee on Immunization
Practices, representing the American Academy of Pediatrics, and have been
briefed on all the data. I was reassured by both the safety and efficacy data
regarding the Pfizer vaccine for all ages and especially for 12- to
15-year-olds.

As pediatricians, we would not agree with recommendations -- even if they came
from the federal government -- if we did not feel that they were safe and
effective given our vast experience with vaccinating children to keep them
healthy in this country.

CNN: How will administration of the Covid-19 vaccine fit into the back-to-school
vaccinations required for middle schoolers?

Maldonado: The American Academy of Pediatrics supports giving needed childhood
and adolescent immunizations at the same time as COVID-19 vaccines, particularly
for children and teens who are behind on their immunizations.

Because of the pandemic shutdown, many children haven't caught up with their
general vaccinations over the last year. There are national data suggesting the
11- to 12-year-old group is the one that is at the highest risk for being
delayed in their other vaccinations.

The AAP believes the benefits of co-administration and timely catch up on
vaccinations outweigh any theoretical risk. This belief is based on the
substantial data collected on the safety of COVID-19 vaccines -- and our
extensive experience with non-COVID-19 vaccines -- which show the immune
response and side effects are generally similar when non-COVID-19 vaccines are
given together as when they are administered alone.

If parents do have their teen vaccinated at a pharmacy or somewhere else other
than the doctor's office, they should let their pediatrician know right away so
their medical record can be updated.

CNN: Some parents are hearing on social media that the vaccine might have a
long-term impact on fertility. Since many kids reach puberty between the ages of
12 and 15, how can a parent be sure that the Covid-19 vaccine won't affect their
child's development?

Maldonado: Oh my goodness, people have been saying this about every vaccine
since I can remember! There's a whole group of people who have been talking
about what they call "primary ovarian insufficiency" and they've attributed that
to other vaccines in the past. I'm not surprised if they are doing the same with
the Covid-19 vaccine.

* CNN note: Primary ovarian insufficiency occurs when a woman's ovaries stop
releasing eggs. It's extremely rare -- with one case in 1,000 women under age
30. A 2018 study of almost 200,000 adolescent girls and women found no
connection between primary ovarian insufficiency and any of the vaccines
recommended for teens, including HPV, tetanus, diphtheria, pertussis
(whooping cough), meningococcal disease or inactivated flu vaccines.

Maldonado: There is no evidence at this point that this vaccine will affect
development or fertility. It is a mRNA vaccine platform -- it enters the cell
and serves as a template for development of the spike protein in the human cell
-- which then can stimulate antibody development.

The mRNA is made out of nucleic acids, which are basically the building blocks
of all our cells, and these aren't incorporated into anything. They just fall
apart and are eliminated. Bottom line: I think that's ridiculous.

CNN: What are expected side effects of the vaccine for children -- will they be
severe enough to cause a child to miss class and possibly endanger his or her
grades?

Maldonado: Just like any other vaccine, children may feel a little tired, but I
certainly don't think it's going to be a major reaction. More the type of things
we are typically seeing -- a sore arm, maybe some redness at the site of
injection and maybe a low grade flu-like illness, if there is any reaction at
all.

These symptoms should be all gone within 48 hours, but I think it may be a good
idea to at least be ready for that. If families are worried about children
missing school they could give the vaccines on a Friday or weekend.

I have no reason to believe that a child's schooling will be impacted. In fact,
I think this will be a great opportunity for people who have events planned for
the end of the school year. Getting their kids vaccinated as soon as possible
means that they're going to be protected that much faster.

CNN: What do we know about dosages for children? As one parent put it -- some of
these 12-year-olds weigh as little as 60 to 70 pounds -- so will they give the
same dosage that is given to a much larger adult?

Maldonado: The FDA approved the Pfizer vaccine for 12- to 15-year-olds at the
same dosage as that for adults. These dosages were well studied in a few
thousand children of all ages and weights between 12 and 15 years old. So they
will have looked at dosage very, very carefully to make sure that they are safe
and effective.

But obviously, what we need to think about is whether or not the dosage will be
different in children under 12, and that's what we're studying right now. There
may be differences in responses in the smaller children, primarily because
little kids are more likely to mount a higher fever in general than adults and
older kids.

It may be that we need a lower dosage for younger children because obviously
their immune system responses are much more robust. But those studies are still
going on right now for kids under 12 so we don't know yet.

We know from Pfizer's top line data on the 12- to 15-year olds that the immune
responses were more robust than the adults. And that's actually a good thing.

CNN: This stronger immune response that children have -- could it impact a child
in any serious way, such as setting them up for long-term reactions to the virus
that don't go away?

Maldonado: Again, the vaccine is not a live virus vaccine. It's not derived from
animals, humans or even other viruses. It is made from synthetic nucleic acids.

The immune response to the vaccine has been tracked exceedingly carefully to be
sure it doesn't trigger the inflammatory pathway that is similar to the one that
we see with long-term effects, and we haven't seen that happen in any of the
tens of millions of doses that have been given to adults or teens.

Not only have we not seen that happen, but the laboratory basis for that
inflammatory response has also not been documented to happen with the vaccine.

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