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What Parents Need to Know About the COVID-19 Vaccine for Children 5 and Older
Dr. Mobeen Rathore explores questions that parents may have about the COVID-19 vaccine that has been approved for children 5 and older and what they need to know about it.
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Learn more about Mobeen Rathore, MD
Mobeen Rathore, MD
As chair of the infection prevention and control committee for five hospitals in northeast Florida, Dr. Rathore has found the coronavirus disease 2019 (COVID-19) pandemic to be a constant concern that will continue to demand his attention for the foreseeable future. He has been at the front lines fighting many diseases, but he has never seen a virus as commanding as this one.Learn more about Mobeen Rathore, MD
Transcription:
Prakash Chandran: This COVID-19 Baptist Health Radio podcast was recorded on November 16th, 2021.
Welcome to Baptist Health Radio. As the most preferred healthcare provider in Northeast Florida, we are here to help you stay informed with the latest news, views and resources for your health and well-being.
Children continue to account for a quarter of COVID-19 infections in the United States. Those who get the virus are able to spread it to other children, including babies and toddlers who are too young to be vaccinated and adults who might be at higher risk for severe illness. With holiday gatherings on the horizon, it is critical to get children vaccinated now to prevent a new surge of COVID-19.
Joining us today to help answer the most common questions about the COVID-19 vaccine for children is Dr. Mobeen Rathore, Chief of Pediatric Infectious Disease and Immunology at Wolfson Children's Hospital. This is Baptist Health Radio, the podcast from Baptist Health of Northeast Florida. My name is Prakash Chandran.
So Dr. Rathore, really great to have you here today. I wanted to start by asking, is the vaccine approved and effective in younger children?
Mobeen Rathore, MD: Well, Prakash, thank you so much for doing a podcast on this important topic. Yes, the vaccine is in fact approved by the FDA under EUA for children five years of age and older. And yes, the vaccine is effective. It's the same vaccine that we use in adults. So there's no reason why it would be effective in adults and not in children.
Prakash Chandran: Okay, understood. And in terms of the types of vaccines, you know, I guess in adults, we have like Moderna, Pfizer, Johnson & Johnson. Is that all of the same types of vaccines for children as well?
Mobeen Rathore, MD: Well, the vaccines are a little bit different. Moderna and Johnson & Johnson are different types of vaccines. Moderna is messenger RNA and Johnson & Johnson is an adenovirus vector vaccine. The vaccine that's approved for children five years of age and older is the Pfizer vaccine. And that is also a messenger RNA vaccine. So vaccines are slightly different platforms.
Prakash Chandran: Okay, understood. What about the dosage? Will younger children get the same dosage as adults?
Mobeen Rathore, MD: Yeah, thank you very much. That's an important question. Yes, the vaccine is similar, but the dose is one-third of what the adults get. So the study that was done found that the one-third of the dose is as immunogenic, and what we mean, the body's response is as good as the full dose that is given to older children and adults. So same vaccine, smaller dose.
Prakash Chandran: And what about how the dose is administered? Because it's a third of the adult dose, do you still need two shots or is a single shot enough?
Mobeen Rathore, MD: No, this is also two doses. So they still need two doses at least 21 days apart. And once they get their second dose, we consider them protected two weeks after that. So in five weeks, you can get your child protected and safe and try to get their lives back to normal.
Prakash Chandran: And after that second shot, I remember there was just a little bit more of an immunoresponse as my body got used to the vaccine. Is it going to be similar for children? Can parents expect that second shot might cause a little bit more of an immunoresponse in the child?
Mobeen Rathore, MD: Yeah, that's the reason we need two shots. The first shot gets your body prime and the second shot gives the body's antibody response a boost so you're protected for a longer period of time.
Prakash Chandran: Okay, understood. And, you know, you mentioned earlier the EUA, which is the emergency use authorization. Talk at a very high level about what was done in order to get that authorization, you know, like studies or research, just to make sure it's safe for our younger children.
Mobeen Rathore, MD: Oh, yeah, absolutely. I think these vaccines, the way it was studied was very similar as you would study other vaccines. They did a study which is basically showing that the vaccine is not inferior to what is used for the adults and older children and it had 3000 children in this study and they found that the first vaccine was safe in this children. It was also found to be very effective and the response was as good as the response in adults, even with one-third the dose.
I think there's some misconception that EUA for some reason is not as robust. It's just that they do this very quickly. The evaluation of medications under the EUA is similar to what you have in the regular approval. And it is fully expected that this vaccine will also get full approval just as the vaccine has got full approval in the adults.
Prakash Chandran: And I remember when the initial vaccines first came out for adults, the efficacy was I think ninety plus percent depending on the type of vaccine. Do you have statistics around the efficacy of the ones that are now available for younger children?
Mobeen Rathore, MD: So this vaccine study was really not powered to study the efficacy, but the effectiveness in this study was a 90%. So extremely good effectiveness there.
Prakash Chandran: Okay. And are there any potential side effects of this vaccine for younger children?
Mobeen Rathore, MD: I think what you should expect this some what we call "reactogenicity" and that's where after you get any shot, you will have some pain, you may have swelling, you may have redness. You may sort of feel a low-grade fever. You know, it's like you're coming down with something, but that should not last more than a 48 to 72 hours. And after that, we expect the children to be just fine. This is not unusual for other vaccines also.
Prakash Chandran: Yes. And Dr. Rathore, this may seem obvious, but what are the potential risks of being vaccinated versus those of not being vaccinated?
Mobeen Rathore, MD: Well, it's like saying, is there any difference between not wearing a seatbelt and wearing a seatbelt, right? If you wear a seatbelt, you know, you will be protected when you're in an accident. So when you get the vaccine, you are going to be protected against the disease. You may still get the infection, but you're not going to get sick so that you will not be so sick that you have to be admitted to the hospital or your child in this case admitted to the hospital or get into the ICU or get on a breathing machine or even die of the disease. So yes, you get the vaccine, you're protecting yourself. You may get the infection, you're not going to be as sick. So that's a tremendous benefit of this vaccine.
Prakash Chandran: Now, you know, there's going to be people out there that say, "You know what? During COVID it has been shown that younger children have a stronger just the immune system. They're not necessarily at risk for going to the hospital. I don't necessarily need to get my younger child vaccinated." What might you say to them?
Mobeen Rathore, MD: All I will say is this is misinformation. Children are equally likely to get infected as adults. It is true that they often don't get as sick. Kids do get sick. They do get into the hospital. They do get into the ICU. They do get on the breathing machine. And yes, they do die of this coronavirus infection. So I think it's not that, you know, kids just don't get sick or die of this.
Now, it's much less than what you see in adults, but we have to remember also it's not just that getting sick from the acute infection, kids when they get the infection, even if you don't know about it, it is asymptomatic, they can get this dreaded MIS-C disease, which occurs about four weeks after the infection, even if the infection is not symptomatic and you don't even know your child had infection. And they can get very sick with that and they often end up in the ICU. So it's just not that the fact that they don't get acutely ill, they can have this MIS-C, but they can also get COVID long, which, you know, if I get COVID long, I may live another 20 years, right? If an 8-year-old gets COVID long, they have to live with it for the next 80 years. So I think we need to keep things in perspective.
Prakash Chandran: Yes, that makes a lot of sense. And also another piece of this is they are carriers. So even if it doesn't necessarily affect them, it could affect someone that's kind of a little bit more immunocompromised and really have some severe effects and potentially even death. Isn't that the case?
Mobeen Rathore, MD: Yes, absolutely. I think, as I said, the child may not get that sick, but they can get the infection, which means they can potentially transmit that infection to somebody who's at risk. You know, it could be their 90-year-old grandma who for whatever reason cannot get the vaccine, or it could be their eight-month-old sibling who cannot get the vaccine. So I think when you get the vaccine, you'd not only protect yourself, you protect people around you. And that's another reason to protect children less than five years of age. It's extremely important that everybody around them is vaccinated.
Here's another important point, Prakash. We need to get kids back to their normal lives and sooner we get all the kids vaccinated, these school-aged children, sooner they can get back to school, sooner they can have normal school life, sooner they can have normal activities. This disease has caused major impact on the lives of children. You know, the mental health disease have gone up during the pandemic in children, suicide ideation and suicide rates have gone up. So children have really suffered. You know, it may not be seen because they may not be dying necessarily, but they suffered tremendously from this pandemic. So we need to start our children up on a footing that they can get back to normality. All of us need to get back to normality. The sooner we get everybody vaccinated, the sooner we'll get back to normal.
Prakash Chandran: Yeah. I mean, I couldn't agree more with you, Dr. Rathore. Still though, I do want to address there's going to be people out there that are apprehensive about getting their children vaccinated because there haven't been any long-term studies. Like how could there be, right? This was just really authorized. So maybe you can talk a little bit to those concerns. You know, parents that just are worried about the longer term side effects that this vaccine might have on their children.
Mobeen Rathore, MD: So, Prakash, I'm a parent and it's my job description as a parent to be worried about my children. My children are grown. They're in the thirties. I'm still worried about them, right? So this is in our job description as parents. So yeah, I think that's a very legitimate question.
Let me just say a couple of things. One, most side effects of the vaccines occur in the first six to eight weeks. And millions of doses of this vaccine have already been given to adults. And the side effects are extremely rare. Any risk of side effects from this vaccine are so much lower than the risk of the actual infection. So the harm that is caused by the infection is much, much higher than any harm this vaccine can cause.
Another way to look at it is this vaccine is so protective, so helpful to children that if even if there is a small risk of harm, the benefits outweigh that harm by miles. So I think this vaccine is safe. It is effective. Millions of doses of this vaccine have already been given and we need to be protecting our children and we need to be getting them vaccinated so we can get them back to normal life.
Prakash Chandran: Absolutely. So if a parent wants to get their child vaccinated, what should they do? Where can they go?
Mobeen Rathore, MD: Well, I think there are many things they can do. They can first call their friendly pediatrician's office who will guide them. They may be giving it in their office or they can guide them where they can get the vaccine. In many states, the vaccines are being given at the local pharmacies. You can go to your pharmacy chain's website and see if they are administering vaccine to younger children. But starting at your pediatrician's office is probably the best way to do it.
Prakash Chandran: Okay. Well, that's wonderful, Dr. Rathore. Anything else that you'd like to share with our audience before we close here today?
Mobeen Rathore, MD: I think we need to get all our children vaccinated as soon as possible to protect them, to protect people around them, to protect our community and for the nation to get out of this pandemic, so we can all get back to normal life, especially the children who really have suffered a lot in this pandemic and they are really the silent victims of this pandemic.
Prakash Chandran: Dr. Rathore, I think a perfect message to end on. Thank you so much for your time.
Mobeen Rathore, MD: Thank you, Prakash.
Prakash Chandran: That's Dr. Mobeen Rathore, Chief of Pediatric Infectious Disease and Immunology at Wolfson Children's Hospital. Thank you for listening to Baptist Health Radio. If you have additional questions about COVID-19 and the vaccine for children, call the Baptist Health COVID-19 helpline at (904) 302-5050 or visit wolfsonchildrens.com/COVID19. For more general information, you can visit us online at baptistjax.com, that's Baptist, J-A-X dot com, or call for a personalized physician referral at (904) 202-4968. Also be sure to check out the entire podcast library for topics of interest to you.
This has been another episode of Baptist Health Radio. My name is Prakash Chandran. Thanks so much, and we'll talk next time.
Prakash Chandran: This COVID-19 Baptist Health Radio podcast was recorded on November 16th, 2021.
Welcome to Baptist Health Radio. As the most preferred healthcare provider in Northeast Florida, we are here to help you stay informed with the latest news, views and resources for your health and well-being.
Children continue to account for a quarter of COVID-19 infections in the United States. Those who get the virus are able to spread it to other children, including babies and toddlers who are too young to be vaccinated and adults who might be at higher risk for severe illness. With holiday gatherings on the horizon, it is critical to get children vaccinated now to prevent a new surge of COVID-19.
Joining us today to help answer the most common questions about the COVID-19 vaccine for children is Dr. Mobeen Rathore, Chief of Pediatric Infectious Disease and Immunology at Wolfson Children's Hospital. This is Baptist Health Radio, the podcast from Baptist Health of Northeast Florida. My name is Prakash Chandran.
So Dr. Rathore, really great to have you here today. I wanted to start by asking, is the vaccine approved and effective in younger children?
Mobeen Rathore, MD: Well, Prakash, thank you so much for doing a podcast on this important topic. Yes, the vaccine is in fact approved by the FDA under EUA for children five years of age and older. And yes, the vaccine is effective. It's the same vaccine that we use in adults. So there's no reason why it would be effective in adults and not in children.
Prakash Chandran: Okay, understood. And in terms of the types of vaccines, you know, I guess in adults, we have like Moderna, Pfizer, Johnson & Johnson. Is that all of the same types of vaccines for children as well?
Mobeen Rathore, MD: Well, the vaccines are a little bit different. Moderna and Johnson & Johnson are different types of vaccines. Moderna is messenger RNA and Johnson & Johnson is an adenovirus vector vaccine. The vaccine that's approved for children five years of age and older is the Pfizer vaccine. And that is also a messenger RNA vaccine. So vaccines are slightly different platforms.
Prakash Chandran: Okay, understood. What about the dosage? Will younger children get the same dosage as adults?
Mobeen Rathore, MD: Yeah, thank you very much. That's an important question. Yes, the vaccine is similar, but the dose is one-third of what the adults get. So the study that was done found that the one-third of the dose is as immunogenic, and what we mean, the body's response is as good as the full dose that is given to older children and adults. So same vaccine, smaller dose.
Prakash Chandran: And what about how the dose is administered? Because it's a third of the adult dose, do you still need two shots or is a single shot enough?
Mobeen Rathore, MD: No, this is also two doses. So they still need two doses at least 21 days apart. And once they get their second dose, we consider them protected two weeks after that. So in five weeks, you can get your child protected and safe and try to get their lives back to normal.
Prakash Chandran: And after that second shot, I remember there was just a little bit more of an immunoresponse as my body got used to the vaccine. Is it going to be similar for children? Can parents expect that second shot might cause a little bit more of an immunoresponse in the child?
Mobeen Rathore, MD: Yeah, that's the reason we need two shots. The first shot gets your body prime and the second shot gives the body's antibody response a boost so you're protected for a longer period of time.
Prakash Chandran: Okay, understood. And, you know, you mentioned earlier the EUA, which is the emergency use authorization. Talk at a very high level about what was done in order to get that authorization, you know, like studies or research, just to make sure it's safe for our younger children.
Mobeen Rathore, MD: Oh, yeah, absolutely. I think these vaccines, the way it was studied was very similar as you would study other vaccines. They did a study which is basically showing that the vaccine is not inferior to what is used for the adults and older children and it had 3000 children in this study and they found that the first vaccine was safe in this children. It was also found to be very effective and the response was as good as the response in adults, even with one-third the dose.
I think there's some misconception that EUA for some reason is not as robust. It's just that they do this very quickly. The evaluation of medications under the EUA is similar to what you have in the regular approval. And it is fully expected that this vaccine will also get full approval just as the vaccine has got full approval in the adults.
Prakash Chandran: And I remember when the initial vaccines first came out for adults, the efficacy was I think ninety plus percent depending on the type of vaccine. Do you have statistics around the efficacy of the ones that are now available for younger children?
Mobeen Rathore, MD: So this vaccine study was really not powered to study the efficacy, but the effectiveness in this study was a 90%. So extremely good effectiveness there.
Prakash Chandran: Okay. And are there any potential side effects of this vaccine for younger children?
Mobeen Rathore, MD: I think what you should expect this some what we call "reactogenicity" and that's where after you get any shot, you will have some pain, you may have swelling, you may have redness. You may sort of feel a low-grade fever. You know, it's like you're coming down with something, but that should not last more than a 48 to 72 hours. And after that, we expect the children to be just fine. This is not unusual for other vaccines also.
Prakash Chandran: Yes. And Dr. Rathore, this may seem obvious, but what are the potential risks of being vaccinated versus those of not being vaccinated?
Mobeen Rathore, MD: Well, it's like saying, is there any difference between not wearing a seatbelt and wearing a seatbelt, right? If you wear a seatbelt, you know, you will be protected when you're in an accident. So when you get the vaccine, you are going to be protected against the disease. You may still get the infection, but you're not going to get sick so that you will not be so sick that you have to be admitted to the hospital or your child in this case admitted to the hospital or get into the ICU or get on a breathing machine or even die of the disease. So yes, you get the vaccine, you're protecting yourself. You may get the infection, you're not going to be as sick. So that's a tremendous benefit of this vaccine.
Prakash Chandran: Now, you know, there's going to be people out there that say, "You know what? During COVID it has been shown that younger children have a stronger just the immune system. They're not necessarily at risk for going to the hospital. I don't necessarily need to get my younger child vaccinated." What might you say to them?
Mobeen Rathore, MD: All I will say is this is misinformation. Children are equally likely to get infected as adults. It is true that they often don't get as sick. Kids do get sick. They do get into the hospital. They do get into the ICU. They do get on the breathing machine. And yes, they do die of this coronavirus infection. So I think it's not that, you know, kids just don't get sick or die of this.
Now, it's much less than what you see in adults, but we have to remember also it's not just that getting sick from the acute infection, kids when they get the infection, even if you don't know about it, it is asymptomatic, they can get this dreaded MIS-C disease, which occurs about four weeks after the infection, even if the infection is not symptomatic and you don't even know your child had infection. And they can get very sick with that and they often end up in the ICU. So it's just not that the fact that they don't get acutely ill, they can have this MIS-C, but they can also get COVID long, which, you know, if I get COVID long, I may live another 20 years, right? If an 8-year-old gets COVID long, they have to live with it for the next 80 years. So I think we need to keep things in perspective.
Prakash Chandran: Yes, that makes a lot of sense. And also another piece of this is they are carriers. So even if it doesn't necessarily affect them, it could affect someone that's kind of a little bit more immunocompromised and really have some severe effects and potentially even death. Isn't that the case?
Mobeen Rathore, MD: Yes, absolutely. I think, as I said, the child may not get that sick, but they can get the infection, which means they can potentially transmit that infection to somebody who's at risk. You know, it could be their 90-year-old grandma who for whatever reason cannot get the vaccine, or it could be their eight-month-old sibling who cannot get the vaccine. So I think when you get the vaccine, you'd not only protect yourself, you protect people around you. And that's another reason to protect children less than five years of age. It's extremely important that everybody around them is vaccinated.
Here's another important point, Prakash. We need to get kids back to their normal lives and sooner we get all the kids vaccinated, these school-aged children, sooner they can get back to school, sooner they can have normal school life, sooner they can have normal activities. This disease has caused major impact on the lives of children. You know, the mental health disease have gone up during the pandemic in children, suicide ideation and suicide rates have gone up. So children have really suffered. You know, it may not be seen because they may not be dying necessarily, but they suffered tremendously from this pandemic. So we need to start our children up on a footing that they can get back to normality. All of us need to get back to normality. The sooner we get everybody vaccinated, the sooner we'll get back to normal.
Prakash Chandran: Yeah. I mean, I couldn't agree more with you, Dr. Rathore. Still though, I do want to address there's going to be people out there that are apprehensive about getting their children vaccinated because there haven't been any long-term studies. Like how could there be, right? This was just really authorized. So maybe you can talk a little bit to those concerns. You know, parents that just are worried about the longer term side effects that this vaccine might have on their children.
Mobeen Rathore, MD: So, Prakash, I'm a parent and it's my job description as a parent to be worried about my children. My children are grown. They're in the thirties. I'm still worried about them, right? So this is in our job description as parents. So yeah, I think that's a very legitimate question.
Let me just say a couple of things. One, most side effects of the vaccines occur in the first six to eight weeks. And millions of doses of this vaccine have already been given to adults. And the side effects are extremely rare. Any risk of side effects from this vaccine are so much lower than the risk of the actual infection. So the harm that is caused by the infection is much, much higher than any harm this vaccine can cause.
Another way to look at it is this vaccine is so protective, so helpful to children that if even if there is a small risk of harm, the benefits outweigh that harm by miles. So I think this vaccine is safe. It is effective. Millions of doses of this vaccine have already been given and we need to be protecting our children and we need to be getting them vaccinated so we can get them back to normal life.
Prakash Chandran: Absolutely. So if a parent wants to get their child vaccinated, what should they do? Where can they go?
Mobeen Rathore, MD: Well, I think there are many things they can do. They can first call their friendly pediatrician's office who will guide them. They may be giving it in their office or they can guide them where they can get the vaccine. In many states, the vaccines are being given at the local pharmacies. You can go to your pharmacy chain's website and see if they are administering vaccine to younger children. But starting at your pediatrician's office is probably the best way to do it.
Prakash Chandran: Okay. Well, that's wonderful, Dr. Rathore. Anything else that you'd like to share with our audience before we close here today?
Mobeen Rathore, MD: I think we need to get all our children vaccinated as soon as possible to protect them, to protect people around them, to protect our community and for the nation to get out of this pandemic, so we can all get back to normal life, especially the children who really have suffered a lot in this pandemic and they are really the silent victims of this pandemic.
Prakash Chandran: Dr. Rathore, I think a perfect message to end on. Thank you so much for your time.
Mobeen Rathore, MD: Thank you, Prakash.
Prakash Chandran: That's Dr. Mobeen Rathore, Chief of Pediatric Infectious Disease and Immunology at Wolfson Children's Hospital. Thank you for listening to Baptist Health Radio. If you have additional questions about COVID-19 and the vaccine for children, call the Baptist Health COVID-19 helpline at (904) 302-5050 or visit wolfsonchildrens.com/COVID19. For more general information, you can visit us online at baptistjax.com, that's Baptist, J-A-X dot com, or call for a personalized physician referral at (904) 202-4968. Also be sure to check out the entire podcast library for topics of interest to you.
This has been another episode of Baptist Health Radio. My name is Prakash Chandran. Thanks so much, and we'll talk next time.