Should your child receive the COVID-19 vaccination? The case to do so is not compelling, and the World Health Organization currently recommends that parents hold off on vaccinating their children with the COVID-19 vaccine. The United States CDC says otherwise. What should a parent do?
The Delta variant may change the scenario depending on data that is coming from Singapore, India, and the UK. The information suggests that the variant may be more contagious and have virulent properties in youth. Scientists and public health officials should follow the developments closely.
It’s important to continue the discussion about COVID-19 risks for children aged 0 to 12 years. At the same time, it is crucial to examine the data to date. Researchers at Johns Hopkins and FAIR studied pediatric COVID-19 deaths using data from health insurance companies. They found that 100% of COVID -19 deaths were in children with a pre-existing condition. Thus, parents of a child with comorbidity may want to consider the vaccine.
Since the risk of a healthy child dying of COVID-19 is so close to zero and exceedingly rare, parents are right to ask why they should vaccinate their healthy children.
The most important reason to vaccinate a healthy child may be to prevent multisystem inflammatory syndrome (MIS-C), which can cause very painful, long-term problems. According to the CDC, 4,018 children in the US have developed MIS-C after COVID-19. The average age is 9 years old. 36 of those children died, and 62% of those children were minorities (Latino or black) likely due to the disproportionate rates of chronic conditions and childhood obesity in those populations. This supports the case for vaccinating children with medical conditions including obesity.
Pediatricians and parents should also consider that COVID-19 exposure risk in children is not linear. Since new COVID-19 case rates began quickly declining in May, the weekly rate of new cases of MIS-C associated with COVID-19 has decreased to zero. And this week, a CDC report on child hospitalizations for COVID-19 in March and April, 2021 found no deaths in the entire group of children studied.
There remains the argument for vaccinating kids to benefit the community as a whole. Vaccinating healthy children may help slow the transmission of the virus to kids at risk whose parents chose not to have their child vaccinated.
However, data from Israel suggest that when the vaccination rates among adults is high, the transmission of the virus among children is much lower. That trend is also showing in the U.S. In addition, children are inefficient transmitters of the virus when compared to adults. This may be different for the Delta variant, but so far scientists have not noted any difference.
Some pediatricians are publicly making the case to save the vaccines for use in adults. Richard Malley, MD, of Harvard, and Adam Finn, MD, PhD, of the University of Bristol, have written to not “use precious coronavirus vaccines on healthy children.”
When looking at this from a global perspective, A dose of a vaccine that is globally scarce is better used to vaccinate an older adult in an at-risk community rather than used on a low risk child in a community that has a high rate of vaccination. Thus, it seems to be a very sad decision that states in the U.S. are using hundreds of millions of dollars in lotteries to pay people to get the vaccine.
Another reason to be cautious about vaccinating children is the rate of myocarditis occurring in adolescent children within 4 days of receiving the second dose of the Pfizer vaccine. All 7 of these children were boys between 16 and 19 years old. Both mRNA vaccines have been found to be 100% effective in preventing COVID-19 in kids. But anytime a medication is found to be 100% effective, scientists should look at whether the dose is too high, the interval is too short, or if there is a need for the second dose at all.
Immunity is not conferred just by antibodies. It is also a function of memory B and T cells, which a Washington University study recently affirmed. Since the risk of death in healthy children is near-zero, the recent discovery of rare myocarditis complications immediately after a second dose should prompt a serious discussion about whether a single dose is more appropriate for healthy children.
What if a child has already had a COVID-19 infection? It may be best to forgo a COVID-19 vaccination. Looking at natural immunity in adults as a point of comparison, the observational and empirical data are overwhelming: natural immunity is real and it works.
Researchers from the Cleveland Clinic published a study this week that found “Not one of the 1,359 previously infected subjects who remained unvaccinated had a SARS-CoV-2 infection over the duration of the study.” This is one of many studies showing that natural immunity is powerful. Even though the long-term protection of natural immunity is not known, neither is it known for vaccinated immunity. No data exists beyond 18 months. Actually, we have more data on natural immunity than vaccinated immunity. Based on accumulating data, children who have had COVID-19 should not get vaccinated, unless they are immunocompromised.
Final thoughts
Another reason to consider should be needle anxiety. Many children handle the process of receiving a vaccination just fine, but others find it traumatic. If you as a parent decide to have your child vaccinated, you can help lessen the anxiety by using cold therapy and vibrating devices applied to the skin just prior to injection. This will lessen any pain almost to zero.
The COVID-19 vaccine does make sense for children with pre-existing conditions or who are overweight. It might be a good choice for a teenager at a lower dose. However, given the extremely low risk of a healthy child dying of COVID-19, parents may want to reconsider a 2-dose regimen for healthy children up to age 12. Each parent will have to assess their own child’s individual risk, but the case to vaccinate young healthy kids is not compelling currently.