On Tuesday, Dr. Dean Sidelinger, State Health Officer and State Epidemiologist, and Dr. Antwon Chavis, Assistant Professor of Pediatrics at Oregon Health & Science University and a pediatrician at Doernbecher Pediatrics Clinic, answered questions on the recent authorization to extend COVID-19 vaccinations for youth between 5 and 11 years old.
“By our estimates there are approximately 330,000 youth within that age group who are now eligible to receive a Covid-19 vaccine,” Dr. Sidelinger said. “This is welcome news for younger children and their parents because it gives more people the opportunity to protect themselves and their loved ones from COVID-19. As we’ve learned through experience throughout the pandemic, the virus spares no one.”
Dr. Sidelinger noted that cases among children in Oregon have been at their highest in recent months, including the number of children diagnosed with multisystem inflammatory syndrome (MIS-C).
“Pediatric cases of COVID-19 have accounted for approximately 15 percent of total cases,” he said. “The proportion of cases in this age group increased most dramatically during August and September.”
While information about the long-term impacts of the COVID-19 disease in kids remains unclear, it is known that those who contract the virus naturally are at risk for post-infection complications like MIS-C, Dr. Chavis said.
MIS-C is a rare, but serious condition associated with COVID-19 that can cause different parts of the body – including the heart, lungs, kidneys and brain – to become inflamed.
“According to the CDC, more than 5,500 children nationwide have been diagnosed with MIS-C; half of these children are between the ages of 5 and 13 years old. At OHSU Doernbecher, we’ve treated more than 20 patients for this condition; the vast majority of cases had either mild or no symptoms of COVID-19 prior to their MIS-C diagnosis. The availability of vaccines means we can greatly reduce the risks of contracting severe illness, and long-term consequences, like MIS-C, for those age 5 and up.”
Similar to data seen from the adult vaccine trials, the COVID-19 vaccine was nearly 91 percent effective in preventing COVID-19 in children aged 5 to 11, Dr. Sidelinger said. There were no severe adverse events among vaccine recipients in the clinical trial. Reactions were mild, similar to those seen in adolescents and adults and with other vaccines routinely recommended for children and were less common in those ages 5 through 11 than in those ages 16 through 25.
As of Nov. 9, more than 6,700 Oregon children ages 5 to 11 were vaccinated and the supply of Pfizer pediatric vaccines is increasingly quickly. Dr. Sidelinger urged parents to be patient as they wait for the vaccine to be available for their children. Those who have been unable to schedule an appointment for their child are encouraged to go to the Get Vaccinated Oregon website https://covidvaccine.oregon.gov/ to find nearby vaccination opportunities and to register for announcements as events are added.
Questions & Answers
Q: Can you discuss transmission rates among those who are vaccinated compared to those who are not?
Dr. Sidelinger: Most cases are seen in those who are not fully vaccinated. If you are not vaccinated, you are four times more likely to get sick with the virus. Breakthrough cases represent a minority of cases and almost all severe cases requiring hospitalization are being seen in the unvaccinated. The vaccine will cut risk by more than four, keep you out of the hospital and keep you from dying of COVID.
Q: Is it true the risk benefit model only looked at one known harm –myocarditis?
Dr. Sidelinger: Initially, companies developing vaccines go through trials. In the trial, some are given the vaccine and others a placebo that has no vaccine in it. Researchers then look for adverse side effects. While side effects have been extremely rare, myocarditis is one of them, but also very rare. It is more common in males. The rate of myocarditis from any cause after an infection is much lower in younger kids and was not seen in clinical trials. If it does occur, it is likely to be mild. The most common side effects are a sore arm, tiredness and head ache.
Q: My child recently had COVID-19. Should I still get her a vaccination, and if so, how long after?
Dr. Chavis: We do still recommend vaccines. The immunity from the vaccine is longer lasting than natural exposure.
Dr. Sidelinger: If a child has recovered, it is safe to go out and get it.
Q: My child turns 12 in January. Should I get it now or wait until they are 12 to get adult dose?
Dr. Sidelinger: I would say get it now. This will give your child a head start on getting protected. The dose given to 5 to 11-year-olds is just as effective as the dose given to older children and adults. Get your child an appointment scheduled to get the first dose now and the second at least 3 weeks after. In children turning 12 even sooner, it’s OK to get the first before the 12th birthday. They’ll get the smaller dose tested in younger children. If the birthday comes before the second dose, they will get the adult dose.
Q: What are the long-term effects of COVID-19 vs. the vaccine?
Dr. Chavis: Ideally, if you get COVID-19, you will recover and get vaccinated after. The risk in children who contract COVID-19 include the MIS-C we discussed earlier. The risk for long haul COVID-19 is symptoms that take a long time to resolve. In terms of risks for vaccines, the vaccine is processed within weeks after getting vaccinated. The process includes breaking down and removal of vaccine components. The only thing that remains is the immunity that is going to protect you. We don’t expect long term effects from vaccines.
Dr. Sidelinger: We’ve been using this vaccine from Pfizer for about a year. There are no long-term side-effects. This is a very safe vaccine and it works very well in protecting us from COVID-19.
Q: When will children be mandated to get the vaccine?
Dr. Sidelinger: A lot of parents have been asking that question. Oregon has a process in place to add vaccines to the currently listed schedule of vaccines that are required for school entry. It would involve convening an advisory group to talk about risks and benefits and other aspects of adding that vaccine to the group. It would involve public input. It would take several months to a year. I don’t see it happening soon.
Q: What are some of the side effects of the vaccine? Can we send them to school right after vaccination or should they take off school?
Dr. Chavis: I don’t know that I would expect significant enough side effects that you should change the day to day habits that they have. If a kiddo has a fever or is very fatigued to the point that participating might not be super safe, they can avoid it in that instance. If it’s just a sore arm or fatigue, it will be short term and it means the vaccine is working and you are developing immunity. It’s OK to continue with regular day to day activities.
Q: Do you wait three weeks from first vaccination or four weeks?
Dr. Sidelinger: It is currently recommended to wait 21 days between the first and second. If you can’t get second appointment in three weeks and have to wait, it’s OK to go ahead and get that second dose when it’s available.
Q: Will the vaccine make people sterile?
Dr. Sidelinger: There is no evidence the vaccine will make you sterile. That’s held true in hundreds of millions of vaccinations. The vaccine never enters the nucleus of the cell. It can’t get into the DNA. Pregnant women may get sicker with COVID. We encourage everyone who is pregnant to talk to their provider about getting the vaccine.
Q: Are there plans for pediatric doses for children younger than school age?
Dr. Sidelinger: There are studies on going now, some for children as young as 6 months, some at two years. We anticipate those studies to complete their enrollment and look over data in the coming months, and possibly in the New Year we can see vaccinations that are safe and effective for this population as well. So, let’s celebrate that our 5 to 11- year-olds are eligible now and look forward to the day when even younger kids and virtually all of us are eligible for this safe and effective vaccine.
Watch the video below.