As of November 10th, just under one million children have been vaccinated since the FDA authorized the Pfizer-BioNTech COVID-19 Vaccine for Emergency Use in Children ages 5-11 Years, according to a White House official.
This number alone has the potential to prevent 58,000 Covid infections, 241 hospitalizations, 77 intensive care unit stays and one death, based on a modeled scenario published by the FDA.
Meanwhile, many parents are still on the fence, as “No medical decision is risk free” says Dr. Britta Zimmer, a naturopathic physician on the Big Island.
One of the most prominent concerns expressed by parents is the risk of myocarditis. Myocarditis is inflammation of the heart that can occur as an autoimmune response to a viral infection, such as COVID-19.
Based on previous COVID vaccine data, the myocarditis was most frequently found in males aged 12–29 years according to the CDC. In most cases, patients diagnosed with myocarditis “responded well to medicine and rest and felt better quickly.”
In this highest risk group for myocarditis, there were “40 cases per million doses of vaccine” says Dr. Peter Gregg, a local Big Island pediatrician. The rate of myocarditis is expected to be much less with children ages 5-11, he says. “If you catch COVID you have a 6x more likely chance to get heart inflammation than from the vaccine.”
Another hesitation is the potential prevention of natural immunity. Natural immunity is acquired through the “infection with the actual disease,” and vaccine-induced immunity is acquired through “the introduction of a killed or weakened form of the disease organism through vaccination,” according to the CDC. Both are forms of active immunity, meaning they “trigger the immune system to produce antibodies to [a] disease.”
The distinction is that natural immunity is often “shorter lived” than immunity from a vaccination, says Dr. Gregg. Natural immunity could last for less than six months. He says that this can be inferred based on precedents in other countries.
For example, back in March of 2020, Sweden decided against imposing a lockdown with the goal of developing “herd immunity.” The idea was that by contracting COVID-19, the population would begin producing antibodies, therefore preventing the spread of the virus.
A study published in the Journal of the Royal Society of Medicine in August of this year found that this attempt was not successful, as around 15% of Stockholm citizens developed antibodies after contracting the disease opposed to the predicted 40%.
Parents are also wondering what is the safest decision for their immune-compromised children. “Children with underlying medical conditions are more at risk for severe illness from COVID-19 compared with children without underlying medical conditions” according to the CDC.
It is for this reason that Dr. Gregg advises, “If you have a medically fragile child, it is more important for them to be immunized because it could be more concerning if they got the disease.” This includes children who have heart murmurs, diabetes, and asthma. However, this advice does not apply to those who currently have myocarditis.
Dr. Gregg points out that the side effects of vaccines mimic side effects of the disease at a much lower rate and in a much milder version. This autoimmune response triggered by the vaccine is a visible indication that the body is actively working to immunize the body against the disease.
While this is true, it is also important to note that “if a person does not experience those immune side effects or immune symptoms, that doesn't mean that their immune system isn't working” says Dr. Jasmine Marcelin, an infectious diseases expert. “Some people's immune systems, like mine, are just really loud, obnoxious even. And then others just go along quietly, do their job and don't make a fuss.”
There is also a general concern regarding the safety of the vaccine in relation to the limited time afforded to the studying process. “The vaccine’s safety was studied in approximately 3,100 children age[s] 5 through 11 who received the vaccine and no serious side effects have been detected” according to the authorization statement released by the FDA on October 29th.
These pools are big enough to detect significant differences, says Dr. Gregg. He acknowledges that while many vaccines are studied for years, this was considered a pandemic emergency. Therefore intensive study was undergone in a short amount of time, and it is still ongoing. Millions of people will be receiving this pediatric vaccine, meaning there will be “lots of data within the first few months that these vaccines are rolled out and administered.”
In terms of the effectiveness, “the vaccine was found to be 90.7% effective in preventing COVID-19 in children [ages] 5 through 11,” as stated in the FDA’s same press release.
It is evident that “5-11 year olds are certainly vectors of the [SARS-Co-V2] virus,” says Dr. Zimmer. In other words, children can easily transmit COVID-19 to other people. While this age group can still potentially contract COVID-19 while vaccinated, “The amount of viral shedding and the extent of the disease and the symptoms are much less [than] if you are unvaccinated.” If a vaccinated person gets mild symptoms from contracting COVID-19 then “that’s a win.”
As Dr. Gregg puts it, it ultimately comes down to choosing your risks.“Risk of the vaccine, or risk of the disease.”