Understandably, parents of 5 - 11 year olds have many questions about the Pfizer-BioNTech mRNA COVID-19 vaccines for this age group. Let's try to address them.
How is the paediatric vaccine different from the one for adolescents and adults?
The Pfizer-BioNTech vaccine for age 5-11 contains the same active ingredients but is a third of the dose available for adolescents and adults. It is also packaged differently, and the vial has a cap of a different colour to help health workers differentiate between the two types of vaccines.
Is the mRNA COVID-19 vaccine effective?
Particularly with the emergence of more recent strains such as the Omicron strain and its subvariants, we know that being vaccinated may not necessarily prevent acute infection and there is evidence that the immune protection provided by the vaccine wanes over time. That’s why it’s still important to continue Public Health measures such as hand washing or sanitizing, and staying home when unwell. However, the vaccine still provides effective protection against severe illness and even death caused by the Sars-CoV2 virus (the virus that causes COVID-19).
My child/children will turn 12 later in the year. Should they receive the adult or paediatric dose?
The COVID-19 vaccine dose varies according to the age on the date of vaccination. So, if they haven’t turned 12 yet, your child/ren should receive the paediatric dose. If they turn 12 in between their first and second vaccine dose, the second dose should be an adult dose. However, if they happen to receive a second paediatric dose, the dose does not need to be repeated and they will still be considered to be fully vaccinated.
How many vaccine doses will my child receive?
Children aged 5 -11 years will receive two vaccine doses. In Trinidad and Tobago the doses are currently given 4-8 weeks apart.
What happens if my child has recently had COVID-19?
COVID-19 vaccination is recommended for children ages 5 years and older, including those who have already had COVID-19 infection. Research indicates that people get better protection by being fully vaccinated compared with only having been infected with the virus. If your child has had a recent COVID-19 infection, please inform the medical personnel at the vaccine site and/or discuss it with your child's healthcare provider prior so they can advise on the optimal timing for the vaccine in accordance with local Public Health guidelines. For example, in Trinidad and Tobago the current Ministry of Health guidance is that if your child/ren had a recent COVID-19 infection, you should wait for 3 months before they receive the mRNA COVID-19 vaccine.
My child has allergies – is it okay to get the vaccine?
The Pfizer-BioNTech mRNA COVID-19 vaccine contains no latex, eggs or electronic components. Having a history of food allergy is not a contraindication to receiving the vaccine. Usually all children who receive the vaccine will be observed by medical personnel for about 30 minutes at the vaccine site after the vaccine is given, to make sure that they are ok. Serious allergic reactions to the vaccine are rare. However, you should consult with your child’s doctor if your child has a history of a serious allergic reaction to previous vaccines and in particular if they have had an allergic reaction to polyethylene glycol (PEG) – this is one of the components in the Pfizer-BioNTech mRNA vaccine. A history of a serious allergic reaction to PEG may mean that your child will need to be exempted from receiving the vaccine.
What are the possible side effects of the vaccine?
The commonest side effects are mild and can include a sore arm (at the injection site), muscle aches, fever, chills and tiredness. These usually respond well to rest, pain relief (like paracetamol) and drinking lots of fluids. Typically, they resolve within two to three days, and they are signs that your child’s immune system is responding appropriately to the vaccine.
There can be much rarer side effects like allergic reactions to the vaccine, as mentioned above. This is why children are monitored for about 30 minutes after the vaccine is given.
Even rarer are complications like myocarditis (inflammation of the heart muscle). Evidence so far has shown that this is much less common in the 5 – 11 age group compared to adolescents and young adults. Myocarditis can present with chest pains, shortness of breath and heart palpitations; if it occurs, it’s usually 3 -5 days after the second dose, and the reported few cases in the 5-11 age group have been mild and resolved completely. If you are concerned that your child has developed symptoms like chest pain, difficulty breathing or palpitations, especially 3-5 days after the second vaccine dose, please inform your child’s doctor.
Why should my child get vaccinated?
There are 3 groups of benefits to getting your child vaccinated:
Short term benefits: Although the majority of children generally experience relatively mild illness with acute COVID-19 infection, it is possible for children to become seriously unwell, especially if there are underlying co-morbidities like obesity, diabetes, immunosuppression or sickle cell disease. COVID-19 vaccination ha been shown to significantly reduce the chances of severe illness and death.
Collateral benefits: Getting fully vaccinated also helps to provide an additional layer of protection for more vulnerable family members like the elderly or those still too young to be vaccinated, since vaccinated persons are less likely to spread the virus to others. In addition as more people become vaccinated, the Sars-CoV2 virus is less likely to circulate and this reduces the possibility of newer potentially more dangerous variants to emerge.
Long-term benefits: A history of COVID-19 infection can cause longer term consequences such as long COVID or, in children, MISC (a severe inflammatory reaction that can occur throughout the body typically up to 5-8 weeks after having an acute COVID-19 infection). Being fully vaccinated does offer protection against these long-term complications.
I have heard that the expiry date for the mRNA vaccine has been extended. Should I be concerned?
The COVID-19 mRNA vaccines were initially authorized for emergency use in light of the global pandemic. That means that there as a lot of caution taken in determining the initial proposed expiry dates. However, as new data becomes available on stability studies, this may allow for extension of the initial expiry date once appropriate policies, safety and storage procedures are followed. For example, in April 2022 the FDA granted an extension for the shelf life of the authorized Pfizer-BioNTech COVID-19 Vaccine from 9 months to 12 months when stored between -90°C to -60°C. So, provided the vaccines have been stored appropriately, it is possible for an approved extension of the expiry date to occur, on the basis of available biosafety data.
How do I prepare my child for the vaccine?
My tips for preparing your child/children for the vaccine are:
Talk to them openly and let them know why it’s helpful for them to receive the vaccine.
Emphasize the positive, especially the opportunities that vaccination will bring – protecting vulnerable family members for example.
Talk to your child’s doctor and ensure you get your own questions answered. Children can tell when we feel uncertain or anxious. Encourage your children to ask their own questions!
On the day of the vaccine, ensure they have eaten a good breakfast and/or lunch and are well hydrated.
Let them rest and take it easy if they need to for a couple of days after the vaccine.
Have some pain relief like paracetamol available, in case they have any side effects like headache, muscle aches or fever after the vaccine. A cold pack applied for a few minutes to the vaccine site can also help if it’s a bit sore.
Consult with your child’s doctor if you are worried or have any concerns.
Be well,
Paula
Dr Paula Robertson is a mom and a paediatrician with over twenty years' experience working with children
and young people.
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