Here's what to expect—and the answers from top health experts to the questions on many parents’ minds.

By Kate Rockwood
June 03, 2021
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Three vaccines have been deemed safe and effective against COVID-19: those developed by Pfizer, Moderna, and Johnson & Johnson, after the Centers for Disease Control and Prevention (CDC) and the FDA briefly paused the use of the Johnson & Johnson vaccine in April. As of now, every American 12 and older is eligible for a vaccine, and younger kids may get the go-ahead soon. As a parent, you probably have lots of questions—and we spoke with top health experts to get answers.

girl mask
Credit: Santi Nuñez/Stocksy

Q: How much longer until the vaccine is available for all children? And why are kids last?

Making vaccines safe for kids isn't as simple as lowering the dose. The FDA requires vaccines to be studied in children, because kids' immune systems are still developing and they might experience side effects that don't occur in adults.

A clinical trial has two parts, explains Buddy Creech, M.D., associate professor of pediatrics and director of the Vanderbilt Vaccine Research Program. The first finds the dose that hits "that Goldilocks level of good immune response with the least side effects," he says. The second is "age de-escalation," or adjusting that dose for teens, then older kids, then little ones.

The Pfizer vaccine gained approval for ages 12 to 15 in May, after a trial indicated it's 100 percent effective in that group (that's better than in adults, for whom it's 95 percent effective). Moderna's and Johnson & Johnson's trials for kids ages 12 to 15 are ongoing, and Pfizer and Moderna are in trials for kids 6 months to 11 years old. It's unclear when these will be ready, but experts expect late 2021 or early 2022.

Q: My partner and I are vaccinated, as are our adult relatives. Who can our unvaccinated kids visit with?

Kids who are unvaccinated are still a threat to one another. So if there are two households where the adults have been vaccinated but not the babies and kids, they should still visit only while masked and outdoors. But that doesn't mean your children are destined to be in masks nonstop until they're vaccinated. If your unvaccinated child is around only fully vaccinated adults and kids, no one needs to wear a mask and your gathering can take place outdoors.

Q: Will kids' risk of getting the virus decrease as more adults around them are vaccinated?

It's likely. "Each vaccination inches us closer to herd immunity," says Shirin Mazumder, M.D., an infectious diseases specialist and associate professor of medicine at The University of Tennessee Health Science Center, in Memphis. Herd immunity is the tipping point at which enough people are immune to COVID that person-to-person transmission becomes unlikely. (Because kids make up nearly a quarter of the U.S. population, some experts believe we need them to get vaccinated to achieve this.)

But keep in mind that no one knows just what percentage of the population needs to be vaccinated to reach herd immunity (some estimate 60 percent; others say 90 percent), and there are experts who now believe that because of vaccine hesitancy and the continued spread of new variants, we may never reach that goal.

However, that doesn't mean life can't return to normal. The hope among epidemiologists is that even if we can't achieve herd immunity, we can still protect the most vulnerable segments of the population from the virus through vaccination, making COVID little more than a seasonal illness like the flu.

Q: Is getting the vaccine worth risking side effects for my child?

Absolutely. Experts argue that side effects like headache, fever, or fatigue are well worth it to protect kids and others from the virus. Even if you think your child is only at risk of a mild case of COVID, removing the risk makes vaccinating them worthwhile.

While kids' hospitalization rates are low, of those kids who were hospitalized for COVID, one in three were admitted to the ICU—a similar rate to adults' hospitalizations. The CDC has also tracked around 3,000 cases of a related condition, multisystem inflammatory syndrome in children (MIS-C), which can harm the heart, lungs, kidneys, and other organs. A disproportionate percentage of those cases occur in Black and Latino children, for reasons still being studied.

In April, the KFF COVID-19 Vaccine Monitor found that only three in ten parents intended to vaccinate their kids against COVID; 18 percent said they would do so only if schools required it. But it's key to remember that when one child tests positive, their whole camp or class has to quarantine, and each person with whom they've come in contact needs to be notified. So getting the shot won't just protect one child but everyone they encounter, including some, like infants or the immunocompromised, who may not be able to get vaccinated.

Q: Will kids with high-risk conditions (like asthma or an autoimmune disorder) be vaccinated first?

Probably not, says Krutika Kuppalli, M.D., an infectious diseases physician at the Medical University of South Carolina, in Charleston. "Production should be scaled up so we'll have enough vaccines for everyone," she says. In other words, you shouldn't have to worry about where your kid falls on a giant list, as adults experienced in the spring.

Q: Are there kids who shouldn't get the vaccine?

Not many. The only adults who are advised to avoid it are those with severe allergic reactions to a component of the vaccine, such as polyethylene glycol in the Pfizer and Moderna vaccines or polysorbate in the Johnson & Johnson one. (Food, seasonal, and environmental allergies aren't a problem.)

People with an autoimmune condition or a suppressed immune system aren't excluded; often, having an underlying health condition "is all the more reason to get vaccinated," Dr. Kuppalli says. We may learn more as data from additional pediatric clinical studies is collected, she says. If you have concerns once a vaccine is available to your child, talk to your child's doctor.

Q: If my kid already had COVID, do they still need the vaccine?

Yes. Researchers don't know how long or how strongly antibodies from past infections prevent reinfection. But recent studies show that the vaccine can raise the number of antibodies by as much as a thousandfold, making it easier to fight off reinfection. Scientists now think the vaccine can also fight the variants currently circulating around the globe.

Q: Will the COVID vaccine become like a flu shot we get every year?

We don't yet know how long these vaccines protect against the virus. Researchers have collected 6 months' worth of data in adults so far, and the vaccines' protection shows no signs of waning, Anthony Fauci, M.D., chief medical advisor to the president and director of the National Institute of Allergy and Infectious Diseases, has said. To figure out the duration of protection, researchers will monitor antibody levels in volunteers. If they see a dip, they'll know a booster may be necessary.

Another factor at play is variants: As the virus mutates, it's possible that existing vaccines might not be as strong at fending off those variants. That doesn't mean scientists will have to go back to the drawing board, but it might mean that vaccinated people will need a new shot in the future that offers targeted protection.

This article originally appeared in Parents magazine's July 2021 issue as "Next Up: The COVID-19 Vaccine for Kids" Want more from the magazine? Sign up for a monthly print subscription here

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