COVID Q&A: Common questions about vaccines for kids 5-11

ANCHORAGE, Alaska (KTUU) - Alaska children ages 5-11 are now able to be vaccinated against COVID-19. Planning ahead by the state, pediatric clinics and other health care providers meant that doses of the Pfizer-BioNTech vaccine for young children were in the state by the time they were given Emergency Use Authorization by the Centers for Disease Control and Prevention late Tuesday.

The state’s immunization program ordered and received 33,000 doses of the pediatric Pfizer vaccine, according to the state health department. That allocation combined with 7,500 doses coming to pharmacies through the Federal Retail Pharmacy Program will be enough to vaccinate 55% of the state’s estimated 73,594 children in that age range.

While at least one national study showed that 30% of parents were planning to get their children vaccinated immediately, many parents still have questions and concerns. Here are local doctors’ and Alaska health officials’ answers to some of those common questions:

Children aren’t largely affected harshly by COVID-19. Is it necessary for them to be vaccinated?

Doctors and state health officials say it is still important for children to be vaccinated against COVID-19.

While Alaska has not had any children under 17 die from COVID-19, the state said Wednesday in a science webinar that 16 children have been hospitalized for Multisystem Inflammatory Syndrome in Children, known as MIS-C. Children affected by the condition — often weeks after a COVID-19 infection has resolves, can be hospitalized in the intensive care unit, and have died in other states.

“We’ve been lucky in Alaska, we have not had any pediatric deaths,” explained Dr. Lisa Rabinowitz with the Alaska Department of Health and Social Services, who is also a practicing physician. “But we have seen 16 cases of MIS-C and those kids are very sick, many of those were in the ICU for a prolonged stay. We still get great benefit from vaccines for that severe illness.”

The state said on Wednesday that there have been about 43 children age 17 and under hospitalized due to COVID-19 in Alaska.

Can kids transmit COVID-19?

Yes. Dr. Joe McLaughin, the state of Alaska’s chief epidemiologist, says there’s better data now than there was early on in the pandemic. That data “indicat(es) that kids are efficient transmitters of the virus to other people,” McLaughlin said Wednesday.

Citing a recently released study, McLaughlin said the data shows that especially with young children who are directly cared for by their parents, guardians and siblings, there is a higher rate of household transmission.

Is the COVID-19 vaccine effective for kids?

Data presented to the FDA showed that the vaccine was 90.7% effective in preventing symptomatic COVID-19 in children 5-11 in the study. Dr. Anne Zink, Alaska’s chief medical officer, compared the efficacy of vaccines to other safety measures families take.

“(Vaccines are) not perfect. Car seats aren’t perfect either. But we buckle up our kids when we put them in the car,” she said. “And these are an amazing tool to help minimize the risk to our children as well.”

How many shots do kids get, and how much time is there between them?

Kids get two doses of the lower-dosed vaccine, spaced three weeks apart. Just as in adults, two weeks after the second shot, children will be considered fully vaccinated.

Dr. Mishelle Nace, a Fairbanks-area pediatrician, suggests families consider the timing of their children’s vaccines to any holiday travel plans, as that five-week window before full protection comes close to most schools’ holiday breaks.

Is a child’s dose the same as a dose for kids over 12 and adults?

No. The dose for children under 11 is one-third the amount of vaccine as adults and children 12 and older get. But that’s not because of how small they are.

Unlike medication, vaccine doses are not based on size and weight — they are based on the strength of an immune system. Children have stronger, more robust immune systems than older children and adults, meaning they get the same immunity response to a lower dose as an older person does with the larger dose.

“It’s not a smaller dose because kids are smaller,” Zink explained. “It’s smaller because kids’ immune systems are really in tune to developing a robust system to fight viruses and bacteria, and really good at responding to vaccines in general.”

The vaccine for younger children also uses a smaller needle than the vaccine for adults and adolescents.

How long does the vaccine stay in my child’s body?

Vaccines don’t stay in your body, Zink explained Wednesday.

“They last a few hours to a few days, are quickly destroyed by your body, and your body’s natural immune system is then what takes apart the virus and fights the virus once it’s seen,” she explained. “It’s more efficient at doing that if you have received a vaccination.”

What should I do if my child is 11 when they get the first shot, and 12 before they can get the second?

Doctors suggest getting the dose that is appropriate for your child’s age at the time that they get it, so in this scenario, the child would get the dose for younger kids first, and an “adult” dose second. But doctors say the guidance is flexible for this particular situation.

“There is some leeway for this specific scenario,” Rabinowitz explained. “If you got the lower dose at 11 and got the lower dose at 12, you don’t need to repeat that, it won’t be considered an error, and vice versa. The recommendation is to follow the age when you can.”

Are there risks to children from getting the vaccine?

Yes.

“Vaccines are not risk-free,” Zink said Wednesday. “But neither is COVID. And we look at the risk of COVID versus the risk of vaccine, and we’re just consistently seeing that the vaccine is much more safe compared to getting COVID overall.”

With so much COVID-19 transmission in the Alaska community, Zink said that, as a parent, it’s no longer a choice between vaccinating your child or not vaccinating your child.

“We’re making a decision if our kid is going to see COVID with a really strong, robust immune system to take it down that’s been taught by vaccine, or without having that tool.”

She spoke to the size of study groups sometimes limiting visibility of uncommon side effects, pointing out that even in the adult trials, there were no signs of anaphylaxis until the vaccines were rolled out to a wider group of the public. In a roughly one-month span after the introduction of the Pfizer and Moderna mRNA vaccines, 66 cases of anaphylaxis related to the vaccination itself were reported.

A look at how often anaphylaxis happened found that the Pfizer vaccine had an incidence of 4.7 cases of anaphylaxis per million doses administered, while Moderna had 2.5 cases per million doses of vaccine administered. Of the 66 cases of anaphylaxis that were reported, just fewer than half (32) were admitted to the hospital. Of those, 18 people were admitted to the ICU, and seven were intubated. The study’s authors had follow-up data that 61 of the 66 people were discharged from the hospital or had recovered by the time their case was reported. They received no information that any of the others died from the impacts.

The risks of vaccination were weighed by the FDA and CDC panels that authorized the vaccine’s use in children 5-11, Zink said.

“They looked at the risk of COVID to the actual kids, they also looked at the risks to the community, they looked at the risk of vaccination,” Zink said. “With all of those factors, weighing them, (they) felt as though they were incredibly safe and efficacious.”

Both panels unanimously approved the vaccine’s use.

What are some of the side effects from the vaccine?

The Pfizer study of vaccine in 5- to 11-year-olds found no serious side effects in children involved in the study. The most common side effects were pain at the injection site, fatigue, and a headache, which were comparable to the effects seen in children who received a placebo shot.

One of the most worried about side effects seen in some older adolescents and young men after vaccination is myocarditis. The condition, inflammation of the heart, can be caused by viral infections of other sorts than a coronavirus. One study found that people of all ages were 16 times more likely to have myocarditis with a COVID-19 diagnosis than without one.

RELATED: Alaska families, doctors discuss COVID vaccines for kids, potential side effects

Can my child receive the COVID-19 vaccine at the same time as other vaccines?

Yes, doctors say it is safe for children and adults to get other vaccines and the flu shot at the same time as a COVID-19 vaccine.

“In terms of pediatrics, you can also co-administer vaccines with the pediatric Pfizer,” Rabinowitz said Wednesday. “So we’re encouraging that as we try to get kids caught up on their vaccines.”

How can I sign my kid up for a COVID-19 vaccine?

The Anchorage School District is holding a walk-in vaccine clinic the rest of this week, and Monday through Wednesday through the rest of the month at the school district headquarters. It will offer drive-through clinics at some high schools on Saturdays for most of the rest of the month, except Thanksgiving weekend. While the clinics are walk-in and drive-through, the district does suggest pre-registration.

The state of Alaska has a vaccine finder tool, and the Municipality of Anchorage has a vaccine finder tool. Some private clinics and commercial pharmacies are also offering vaccines.

Clarification: This article has been edited to clarify the number of Alaska children age 17 and under hospitalized due to COVID-19, after the Alaska Department of Health and Social Services provided more precise data showing the number of children hospitalized because of the virus, rather than being hospitalized and COVID-19-positive.

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