Should Children get the COVID-19 Vaccine?
The CDC just recommended Pfizer's COVID-19 vaccine for use among 12-15 year olds, following FDA approval on Monday
The FDA and CDC have given the nod to Pfizer’s COVID-19 vaccine for kids 12 and over on an emergency use authorization basis, and states will begin vaccinating this age group this week. Millions of parents are now facing a real choice--and with trials underway for younger children 6 months and up, millions more families will face this decision later this fall or winter.
Is the COVID-19 shot a good idea for children? This post summarizes the reasons and evidence on both sides and concludes that yes, you should get your children vaccinated.
First, why is this even a question?
It’s optional, at least for now. The COVID-19 vaccine will likely remain optional for children in the vast majority of states and school districts for the time being, since it will be rolled out under emergency use authorization.
Many parents are undecided, even those who got vaccinated themselves. Even among parents who are already vaccinated themselves, or who want it as soon as possible, only half planned to get their children vaccinated right away. This is from an April poll by Kaiser which also found that overall, only 29% of parents wanted to get their child vaccinated right away.
Why are parents reluctant to vaccinate their children?
Children have been less likely than older people to be infected by COVID-19. As compared with their share of the population (in gray), case counts among children have been relatively low (in red).
If infected, children tend to have milder effects and are much less likely to die than older people. Fewer than 500 children have died from COVID-19 in the United States to date.
Early studies suggested that children were less likely to spread COVID-19 than adults. (However, more recent data suggests otherwise—more on this below.)
Parents may be worried about short-term side effects. Side effects for this age group are similar as for young adults. Children aged 12-15 may experience temporary pain at the injection site (91%), fatigue for a day or so (78%), or headache (76%). A smaller number also have chills (49%) or muscle pain (42%). Less common side effects include fever, joint pain and nausea.
Parents may be worried about unknown, long-term side effects. These fears were commonly mentioned by parents, according to a ParentsTogether poll. COVID vaccines have been used in trials starting in March 2020, so we have just over a year of experience and data on their safety, which for some parents may not feel like enough.
The vaccines were developed quickly, and parents may fear the process was rushed. Prior to COVID-19, the fastest any vaccine had been developed from viral sampling to approval, was four years in the 1960s, for a mumps vaccine.
Families may not trust the government, pharmaceutical companies, the media, or others involved in the process. In 2019--that is, even before COVID-19 and a divisive election--75% of Americans believed that trust in the federal government was shrinking, and 64% said that trust in each other was shrinking. Without trust in our institutions, parents may be very reluctant to seek out the shot.
What are the reasons to vaccinate my children?
The vaccine will protect your child from COVID. Among 1,005 children ages 12-15 who took part in the Pfizer trial, none got COVID-19, whereas there were 16 cases among the 978 children who got the placebo. While no vaccine can offer a complete guarantee, this one is extremely effective.
Children now account for 22% of all COVID cases. This is just math, but it’s worth mentioning that as older Americans are increasingly protected from the virus through vaccines, overall case counts have dropped, and the share of cases among (largely still unvaccinated) children has gone up. Nearly four million children have gotten COVID in the United States so far, and if we want case counts to drop among children like they have for older adults, it makes sense to vaccinate them.
COVID ranked among the top 20 causes of death for children during the pandemic. Some children who get COVID-19 also end up with MISC-C, a poorly-understood syndrome which can be fatal. The coronavirus can strike in very random ways; your child being healthy today is not a protection against severe COVID or MISC-C. Given the extraordinary effort and care that we put into protecting children from danger, knocking out a leading cause of death with a 20 minute appointment will be attractive to many parents.
Families with babies or anyone who is medically fragile have an extra incentive to vaccinate their older children. Recent studies have found that infected children have as much, or even more, of the virus in their upper respiratory tracts as compared with adults, calling into question earlier studies suggesting that children might not be able to spread the virus. Babies under a year, who can’t be vaccinated yet, are also “significantly more likely to be infected” than older children, and those with compromised immune systems are at high risk even once they’re vaccinated. Vaccinating eligible children protects vulnerable people.
Short-term vaccine side effects are temporary and not as bad as COVID itself. Yes, they’re unpleasant, but Tylenol or Advil can be given to reduce fever or pain after the vaccine--just check with your pediatrician.
The vaccine will leave your body and there’s no reason to believe that it affects fertility or has other long-term impacts. On the other hand, many long-term impacts of COVID itself remain untreatable and poorly understood. According to former CDC director Dr. Tom Frieden, “If you get infected with the virus, it will go all over your body and stay there for at least a week and be much more likely to cause you long-term problems than the vaccine. …[Whereas] if you get the vaccine, it will prime your immune system, but then the vaccine is gone. It will not be with you anymore.”
The vaccines were developed quickly because of advances in science since the 1960s. These advances have allowed the COVID vaccines to be developed quickly without sacrificing safety, according to Dr. Anthony Fauci.
You don’t need to trust the government or the pharmaceutical companies to understand and trust the science and results of these vaccines. Over 95% of doctors have gotten the COVID vaccine as soon as they could, according to Dr. Tom Frieden. As more children and adults that you know get the vaccine and are able to resume activities without getting sick, you’ll also have real-life evidence of your own.
The more we vaccinate, the more we can return to normal school, life, and work. Higher rates of COVID-19 vaccination among children and adults will help more schools to return to in-person instruction, and to stay open with fewer closures due to exposure. Many teachers have been concerned for their health during the pandemic and will probably be glad to know that their students are vaccinated.
It’s free, the logistics are getting easier, and there are even incentives. Cities, states, and businesses are rolling out offers to encourage people to get the vaccine.
If you’re ready to get yourself or your family vaccinated but haven’t been able to manage the scheduling, transportation, time off, or other logistics, know that it’s getting easier as more convenient systems continue to be developed--so don’t give up! Click here to find vaccine appointments, or check your state health department website for more information. There are also many vaccine assistance groups on Facebook (search “vaccine” + the name of your city or state), where you can find friendly locals who can help you more personally.
So. Although COVID-19 isn’t as deadly for children as it is for seniors, experts and doctors agree that the benefits still outweigh the risks and inconvenience.
Further reading:
An article from Harvard Health on COVID-19 and kids, including some info about the vaccine trials in children.
A podcast episode from This American Life about the pandemic. The episode’s second part is about the conversations a leading Republican pollster and others had with vaccine-hesitant Trump supporters. Recommended listening for anyone who identifies as such, or who is talking with a friend or family member who does.
A piece from the Financial Times about vaccinating children for COVID-19, including a graphic showing how far along each manufacturer is in developing a vaccine for the different age groups of children.