What Do the New COVID-19 Vaccine Guidelines Mean for School-Aged Children?

Stephen Drye, M.D., Family Medicine

In May, the U.S Food and Drug Administration (FDA) and the U.S. Centers for Disease Control (CDC) expanded emergency use authorization for the COVID-19 Pfizer vaccine to adolescents between the ages of 12 and 15. Previously, only children ages 16 and up could receive the vaccine.

While the decision fell towards the end of the school year for most children, making it easy for school districts to keep upholding their current mask and social distance guidelines, summer has now almost gone and passed, and schools are now tasked with how they will proceed with guidelines into the new school year. Parents have also been tasked with deciding whether or not to get their child vaccinated.

So what does it all mean for the new school year, especially if you’d like your kiddo to go back to full-time in-person learning this fall? We spoke with Stephen Drye, M.D., a family medicine physician on the medical staff at Texas Health Allen and at Texas Health Family Care in Wylie, to discuss the safety and efficacy of the vaccine in children and how parents should navigate the decision-making process.

 

What Parents Should Consider

Childhood vaccinations have long been a tense topic among many parent groups, with parents typically falling staunchly on one side or the other. The same seems to be true in regard to the COVID vaccines. Just as with any other vaccine, the decision is strictly up to the parent, says Drye, but parents who choose to not vaccinate should also be prepared for restrictions when it comes to masking and social distancing for their children, especially at school.

“It’s still a bit too soon to say, but I imagine a lot of the school districts will require anyone 12 and up to be vaccinated and to be able to show that they had their second dose at least two weeks prior to the start of school so that they have full immunity,” he explains. “The decision is really up to the parents, but schools are also most likely going to have guidelines in place for students that aren’t vaccinated, whether that means they have to still wear masks or they have to stay socially distanced from others, etc. and that will be something that parents and kids will have to grapple with.”

 

Safety and Efficacy

Although fewer children have been infected with COVID-19 compared to adults, children still can be infected with the virus that causes COVID-19, get sick from COVID-19, and spread COVID-19 to others.

“Not to scare anyone but there are still instances in which perfectly healthy children end up getting bad cases of COVID-19,” Drye says. “While most children will recover from COVID relatively easily — if they even get symptoms at all — there is always the chance your child may have complications and there’s no way to predict who will do well and who won’t. So getting your child vaccinated eliminates the guessing game for how your child will do if they get sick.”

The vaccines are safe and effective for both adults and children. The Pfizer-BioNTech COVID-19 vaccine is 100% effective in preventing the COVID-19 virus in children ages 12 through 15. The vaccine is 95% effective in preventing the COVID-19 virus with symptoms in people age 16 and older.

More than 2,200 U.S. children ages 12 through 15 were involved in the study for efficacy and safety. About half the group was given the Pfizer-BioNTech COVID-19 vaccine, while the other children were given a fake (placebo) shot.

A week after the second dose was given, research showed no cases of COVID-19 in the 1,005 children given the Pfizer-BioNTech vaccine. Among 978 children given the placebo, there were 16 cases of COVID-19. None of the children had previously been diagnosed with COVID-19.

Moderna and Johnson & Johnson are currently testing the safety and efficacy of their vaccines in children, with Moderna recently reporting a similarly high efficacy in children ages 12 to 17.

Recently, it was reported that a small number of children and adolescents who had received the Pfizer COVID-19 vaccine developed a heart inflammation condition called myocarditis. The cases usually occurred within four days after getting the shot, according to the CDC, and most cases appear to be mild. But it still may cause parents to pause as they consider getting their child vaccinated or not. However, Drye and other health professionals say that finding rare side effects after a mass vaccination, especially a new vaccine such as with the COVID vaccines, is common. Additionally, if myocarditis turns out to be related to the vaccine, the risk is negligible when compared with the risks of being infected with COVID-19.

“When you’re vaccinating millions of people, there’s going to be outliers, there’s going to be people who have adverse reactions,” he explains. “But statistically speaking, there hasn’t really been a significant amount of complications.”

As for right now, children under the age of 12 cannot get the vaccine, although clinical trials are currently underway involving younger children.

The vaccine also shouldn’t be given to a child with a known history of a severe allergic reaction to any of its ingredients.

 

Side Effects

If you’ve been vaccinated and experienced some negative side effects as a result of your second dose, and you’re worried about how your child may fair, Drye adds that beyond a sore arm, most children won’t have any symptoms post-vaccine.

According to the CDC, children ages 12 through 15 given the Pfizer-BioNTech COVID-19 vaccine had side effects similar to those experienced by people age 16 and older. The most reported side effects include:

  • Pain where the shot was given
  • Fatigue
  • Headache
  • Chills
  • Muscle pain
  • Fever
  • Joint pain

Similar to adults, children have side effects that typically last 1 to 3 days.

 

Where and When

As for where and when you should get your child vaccinated, sooner is better than later, whether that means getting it at a vaccination hub, retail pharmacy or even your child’s school. Drye also says your pediatricians or family practice offices may not have the vaccine on hand or limited quantities.

“If you plan on waiting until your child’s back-to-school check-up or sports physical exam, or even if you just want your child to get it from their doctor who they know and you trust, I would really call ahead and see if they have it,” he adds. “But because they’ve gotta have that two-week immunity period before school starts, sooner is really better than later.”

 

How to Decide

Choosing to get your child vaccinated is purely up to you and there are many things you should consider while making the decision, such as your child’s personal health, risk factors and the risk factors of friends and family who will be in close contact with your child. The vaccine has been proven safe and effective in children 12 and up, with a 100% efficacy rate in those between the ages of 12 and 15.

Drye notes that as with most other injections, your child may be nervous or scared. Talk to your child and address any concerns they may have. Be honest with them and explain that shots can pinch or sting, but it won’t hurt for long. You can also remind them that vaccines help keep him or her healthy.

Overall, Drye says he’s finding most parents are jumping at the opportunity to get their child vaccinated for both peace of mind and also to allow their child to get back to a normal life of socializing with friends and going back to school in-person sans wearing a mask or staying six feet apart.

“Even if it’s just a cold, I think most parents, if given the chance, would do what they could to prevent their kid from getting sick and feeling under the weather,” Drye adds. “This vaccine gives you a chance to do that for COVID-19.”

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