On March 31, COVID-19 vaccine maker Pfizer announced their trials in children aged 12 to 15 showed a 100% efficient and robust antibody response, exceeding the rate found in their age 16 to 25 trials. 

Recently, Mayo Clinic held a question and answer session about the COVID-19 vaccine and children.

Dr. Nipunie Rajapakse, a pediatric infectious disease expert, and Dr. Joseph Poterucha, a pediatric critical care specialist, answered questions from journalists about what parents should know, why children should get vaccinated and how to keep children safe as the vaccine awaits approval for their age groups.

Q: Why do we need to vaccinate children if they’re not likely to develop severe illness or die from COVID-19?

Rajapakse: We know there are various, multiple benefits to children from vaccination both on an individual basis and also from a public health perspective. I think a situation like a pandemic is a really important situation to balance those benefits. While there have been relatively few, compared to adults, children who have needed to be hospitalized or who have died from this infection, there have been children who have died, over 300 in this country alone. … We can’t yet clearly predict which child may be at risk for more severe illness and which is not. That's one of the reasons we want to broadly use any protective measure we have for children.

Q: Do vaccine variants lower the effectiveness of the vaccine?

Rajapakse: Certainly the vaccine variants throw a bit of a wrench in things because we know that they are, at least the b117 variant, easily transmissible. That just makes it all the more important that we strictly adhere to the recommendations regarding masking and distancing, especially when we return to schools.

Poterucha: There is some data that exists right now, and we’re still learning about, perhaps, the COVID vaccine will protect against some of these variants. There’s a study the last couple of days from the Israel team. It's still efficacious but at a lesser rate.

Q: What do you say to parents who are worried about giving their children the vaccine?

Poterucha: I can feel that. Parents are coming in with really legitimate questions. There’s a lot of unknowns with the vaccine. We all have concerns as parents about how our children are going to fare. Fear is a natural human tendency and we really care about how our kids do. What we know with this recent study and the Pfizer vaccine is that it's safe and effective. A lot of the reactions you may be worried about that would typically manifest in the sixth week after vaccination are not happening. It’s been nine months and we’re seeing good safety data. No concerns with the delayed autoimmune processes or delayed immunization reactions. We know that it’s safe. 

Q: Do pregnant and breastfeeding women pass antibody protection to their baby?

Rajapakse: The initial Pfizer and Moderna trials that were done in healthy adults purposefully excluded pregnant women. There were some women who became pregnant after enrollment in the trial and the data on those trials did not raise any concerns about harmful effects of the vaccine on the women themselves or their babies. Since the vaccines have been rolled out more widely we now have a lot more pregnant and breastfeeding women who have chosen to receive the vaccine. 

Poterucha: If I’m a pregnant woman, or my wife is pregnant, why do I want to get the vaccine? We know that COVID infection in pregnancy is associated with things like preterm labor and complications, need for prolonged hospitalizations or ICU. We have seen this in COVID positive patients. Why not get the vaccines and spare ourselves that burden?

Q: What can we do to keep kids safe until a vaccine has been approved for them?

Rajapakse: We’ve really seen many children during the pandemic falling behind on their routine childhood immunizations. We would really encourage any parents out there to contact their primary care provider to make sure their child's routine vaccines are well up to date. Especially as we see grandparents being vaccinated, and families interacting now with some of the elderly members of their family. Along with children returning to in person school, potentially traveling and doing other things where they could be exposed to some of these other vaccine preventable illnesses, or could transmit them to other vulnerable people in the community.

Q: If vaccines aren’t approved for all kids before fall 2021, how safe is in person school?

Rajapakse: I think we’re all really hopeful that for the older age group, the 12 to 15 year olds, we’ll be able to have many of them vaccinated through the summer and before we start the new school year. I think the more kids in schools that are vaccinated, the safer the school community overall will be. We do know that there are ways to reopen schools to make in person learning safer. Using a variety of the methods that we have recommended over the course of the pandemic, like masks, physical distancing and handwashing along with improving ventilation can make schooling safer. 

Q: When will a vaccine be approved for kids under 12?

Rajapakse: Both Pfizer and Moderna have been enrolling kids in the younger age groups, six months to 11 years in age, those results are not out yet. They’re still enrolling. We anticipate we might have some information from those trials by the end of the year. We anticipate a vaccine approval for that age group at the earliest we’re looking at 2022 based on what people are estimating right now.

If you are interested in enrolling your child into a vaccine trial know that none are currently taking place in Minnesota. Both Moderna and Pfizer pediatric vaccine trials are for children aged six months to 12 years old. The locations are listed here for the Pfizer trial and here for the Moderna trial.

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