Here are experts’ answers to questions about COVID-19 vaccines for little kids

Four weeks ago, the U.S. Centers for Disease Control and Prevention signed off on COVID-19 vaccines for young children. Days later, doctors’ offices and clinics began rolling out shots for babies and toddlers.

In Portland, Ore., a clinic featuring bubbles, toys and a dance party delivered more than 1,100 shots in two days. In Arizona, more than 2,000 kids under 5 have received their first dose in about three weeks. Over the same time period in Fayetteville, Ga., one practice has given out roughly 100 doses to young kids.

As of July 14, nearly 400,000 kids under 5 have received at least one dose, the CDC reports. That’s about 2 percent of eligible children in this age group. 

Pediatrician Eliza Hayes Bakken has seen an initial rush of parents who signed up for appointments as soon as the vaccines became available. “There’s a huge push of families that want to be in that first group that’s vaccinated,” says Bakken, who treats kids at Oregon Health & Sciences University Doernbecher Children’s Hospital in Portland. She suspects demand will soon taper off, following a pattern pediatricians have seen with vaccinations in older age groups. 

Getting young kids vaccinated may be a long, slow haul, says Adrianne Hammershaimb, a pediatric infectious disease specialist at the University of Maryland School of Medicine in Baltimore. About half of U.S. parents with children under 4 said they were likely to get their kids the shot, her team reported last month in the Journal of the Pediatric and Infectious Diseases Society. That number is “lower than we’d like, but it’s not surprising,” she says. 

Only about 55 percent of U.S. adults surveyed say COVID-19 vaccination has been extremely or very effective at limiting the coronavirus’ spread, the Pew Research Center in Washington, D.C., reported on July 7. In Hammershaimb’s experience, the issue isn’t that most parents are anti-vaxxers or mistrust all vaccines. Rather, “parents are genuinely concerned about the unknown,” she says. There’s a lot of misinformation out there, she notes, and people are trying to figure out what’s best for their kids. 

As BA.5 continues to spark cases (now accounting for some 65 percent of new infections in the United States), parents are talking to doctors about COVID-19 risks, vaccine safety and vaccination timing. Here, Hammershaimb and three other pediatricians answer some common questions they’ve been getting.

Is COVID-19 really a problem for kids? 

“This is one big question we get a lot,” Hammershaimb says. Kids are just as likely to catch COVID-19 as adults, though cases tend to be milder. Half of kids infected may have no symptoms at all. 

The disease also tends to be deadlier for adults than children. In people ages 55 and older, COVID-19 is the third leading cause of death in the United States, scientists reported July 5 in JAMA Internal Medicine. But COVID-19 can hit kids hard, too. It ranks as the eighth leading cause of death in people 19 and under in the United States. 

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“You hear on TV that COVID is not a big deal for kids,” says Sara Goza, a pediatrician in Fayetteville, Ga., who served as president of the American Academy of Pediatrics in 2020. “That’s a little bit shocking.” In her practice, she’s seen infected children develop long COVID and chronic fatigue. “This disease is not without its complications,” she says. 

Bakken’s 9-year-old son caught COVID-19 in 2020, before the vaccine came out. His case wasn’t particularly serious, but he did have long-term effects. He had to take more medication to control his asthma and be extra cautious playing sports. That may seem minor, Bakken says, but it didn’t feel that way for her son. “It affected his daily life.”

What are the side effects of COVID-19 vaccines? 

Parents taking their young kids to get the shot can expect to see side effects similar to those common in other childhood vaccines. Fatigue, fussiness, redness at the injection site ​​— those are signs the body is responding to the vaccine like it’s supposed to, Bakken says. Some kids may have no side effects, and that’s OK, too, she says. 

Vaccine safety is another topic parents have questioned (something that also came up in a recent Science News Twitter poll). Clinical trials and real-world data suggest the vaccines are safe for kids and adults, Bakken says. “Adverse events are exceedingly rare — much more rare than complications from COVID itself.”

Take myocarditis, the rare heart inflammation condition sometimes seen after getting Pfizer’s or Moderna’s mRNA COVID-19 vaccines. In boys between the ages of 12 and 17, myocarditis crops up in roughly 1 out of 10,000 following vaccination, scientists reported July 13 in the BMJ.

But teen boys are up to six times more likely to experience heart complications after COVID-19 infection compared with after vaccination, CDC scientists reported in April. In younger boys, ages 5 to 11, heart complications following vaccination are even more rare. And in most people with myocarditis following vaccination, symptoms improve quickly and the heart fully recovers. 

Hammershaimb is keeping an eye on CDC and U.S. Food and Drug Administration monitoring systems that track potential adverse events to the vaccine. If anything concerning comes up, she says, ”we can intervene, halt the vaccination program, and take a close look at any cases that are reported.” Ultimately, she says, parents need to weigh the hypothetical risk of a rare adverse reaction against the known risks of COVID-19 infection. 

Should parents wait until the fall to vaccinate their kids?

No, Hammershaimb says. She encourages parents to sign their kids up for their shots this summer, so they’ll head into fall with some coronavirus protection already built up. It’s possible that COVID-19 boosters targeting the omicron variant may be available as the school year kicks off, but that doesn’t mean parents should wait, she says. “We want kids to be as protected as they can be when they go back to the classroom.” 

Sophie Katz, a pediatric infectious disease doctor in Nashville, agrees. Though the current vaccines’ ability to prevent omicron infection in kids seems to wane rapidly, the shots continue to be effective against hospitalization, she wrote in a JAMA editorial in May. And a study of kids in Israel who had received the Pfizer vaccine found that two doses offered moderate protection against the original omicron variant, scientists reported in the New England Journal of Medicine on June 29. 

Katz’s 13-month-old baby has already had COVID-19, but she says, “I am 100 percent going to get her vaccinated.” For Katz, it’s a matter of protecting her child from severe disease. “I will do anything to keep my daughter out of the hospital.”

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