COVID-19 Vaccine and Kids: What Parents Should Know

The pediatrician-in-chief at NewYork-Presbyterian Komansky Children’s Hospital shares what parents need to know about getting their kids vaccinated.

When the Food and Drug Administration (FDA) authorized the use of the Pfizer-BioNTech COVID-19 vaccine for adolescents ages 12 to 15, it was welcome news for many parents who are eager for kids to resume school, sports, and other social activities. But at the same time, parents may have questions as this new phase of the vaccine rollout gets underway. What are the side effects in children? What do we know about the long-term safety?

Health Matters spoke with Dr. Sallie Permar, pediatrician-in-chief at NewYork-Presbyterian Komansky Children’s Hospital and chair of the Department of Pediatrics at Weill Cornell Medicine, on what parents need to know about vaccinating their kids in time for summer.

Health Matters: Why should kids get the vaccine?
Dr. Permar: While children have not been the focus of disease in the COVID-19 pandemic, there are children who have endured severe COVID disease requiring life-saving treatment, developed a severe post-infectious inflammatory disorder, and even died from the virus. Those who did not become sick still stand to be its most impacted long-term victims. They lost family members to COVID, they lost touch with their friends, they only saw teachers on screens, and their anxiety and depression grew to epidemic levels. We now have the opportunity to give them their lives back through the gift of vaccine immunity. We can now give our children the hope and immunity they deserve.

Are there any underlying conditions where kids shouldn’t be vaccinated?
Most people — including children — with underlying medical conditions can receive the vaccine. This includes things like weakened immune systems and autoimmune diseases.

In cases of severe allergic reactions — like anaphylaxis — or nonsevere allergic reactions after the first dose of the COVID-19 vaccine, the Centers for Disease Control and Prevention (CDC) states that you should not get the second dose. These reactions are very rare and can be treated during the observation period after the vaccine. An ingredient of the mRNA vaccines that has been implicated in the very rare severe allergic reactions is a common component of many pharmaceuticals called polyethylene glycol, the main ingredient of the common constipation treatment MiraLAX. If you’re unsure about your child, speak with your doctor about your concerns.

What side effects are children experiencing from the vaccine?
The side effects of the Pfizer-BioNTech vaccine in 12- to 15-year-olds are no worse than those of adults. Reactions include soreness in the arm where you got your shot, fatigue, muscle pain, and sometimes a fever. They generally resolve after a day. This indicates the immune system is responding to the vaccine. It is a small price for going back to hanging out with friends without fear of bringing a deadly virus home.

“We now have the opportunity to give kids their lives back through the gift of vaccine immunity.”

— Dr. Sallie Permar

How can parents talk to children about the vaccine and its side effects?
Be honest with your children. Explain to them that while the shot may pinch or sting for a brief moment, it won’t hurt for long, and it helps protect them from getting sick. Remind them that they may feel some mild symptoms for a short time after, but those will go away too, and it’s a sign that their immune system is working. Pain relievers like Tylenol or ibuprofen can be used if needed to help them through it. Help them to see that vaccines are a good thing and they keep us safe.

Could the vaccine cause future infertility in children?
This is a false claim, as there is no data that shows the COVID-19 vaccine can cause infertility, or any biological reason why we would suspect that it would. Moreover, the mRNA vaccines are short lived in your body and do not integrate with your DNA.

What are the current masking recommendations for unvaccinated kids?
Unvaccinated children should still abide by the CDC’s guidance: They should wear masks in public and indoors with people outside of their household. They should also avoid crowds and stay six feet apart. This helps to protect them and others.

What are the masking recommendations for kids who are vaccinated, in particular, if they are going to be in a setting with kids who have not been vaccinated?
The CDC just issued new guidance saying that vaccinated people no longer need to wear a mask outside of their household, except when it is a requirement, say, at a local business or healthcare setting. Vaccinated children can be among other vaccinated children and do not have to wear masks.

However, congregating unvaccinated children with vaccinated children is not recommended. Children who have received the vaccine—while the risk is extremely low—could still catch the virus and pass it on to children who have not been vaccinated.

What would you say to parents who are still anxious about their kids receiving a COVID-19 vaccine?
I would tell them that the benefits of vaccination far outweigh the risks of a COVID-19 infection. As pediatricians, we have cared for children who required life-saving measures due to the infection, and some who didn’t make it. We have witnessed the rise of a new post-infectious inflammatory disease, multisystem inflammatory syndrome in children (MIS-C), which primarily affects children and can result in long-term cardiovascular disease and even death. We now have in hand the ultimate tool to fight these devastating diseases caused by the pandemic virus: preventing it in the first place through vaccination.

Will the vaccine be recommended for babies?
The COVID-19 vaccines that are available—Pfizer, Moderna, and Johnson & Johnson—are currently undergoing several clinical trials at varying stages to determine their safety and effectiveness in children as young as 6 months old. We could see vaccines become authorized for use by the FDA in children under 2 years old as soon as later this year.

Sallie Permar, M.D., helms the pediatrics enterprise at Weill Cornell Medicine and NewYork-Presbyterian/Komansky Children’s Hospital. She is also the Nancy C. Paduano Professor of Pediatrics at Weill Cornell Medicine. Board-certified in pediatrics and pediatric infectious disease, Dr. Permar has been honored with several prestigious awards, including the 2014 Young Investigator Award and the 2020 E. Mead Johnson Award from the Society for Pediatric Research, the Presidential Early Career Award in Science and Engineering, and most recently the Gale and Ira Drukier Prize in Children’s Health Research from Weill Cornell Medicine.