Uncertain about vaccinating your young child? Chatham’s medical director might be able to help

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Chatham County Public Health Department Medical Director Michaela McCuddy hosted an “Ask the Doctor” session last Friday afternoon to answer any questions parents might have about getting their children vaccinated.

Dr. McCuddy answered questions in both English and Spanish via a Facebook live Q&A session for the first hour of the event and was available by phone to answer individual questions for the remaining time.

Here’s what she had to say:

Is the COVID-19 vaccine safe for children 5 through 11?

Yes, we can say that it is safe and effective, and that was why there was a unanimous decision by the FDA and the CDC when they made this recommendation. These trials have been the most extensive and with the most intensive safety monitoring in the history of the U.S. We can say very confidently that these vaccines are both safe and effective, and that’s why we’re recommending them for you. I always like to discuss risk and benefit when we talk about vaccines and illness, and that is going to be a theme of this talk today — is thinking about what the risks are of getting the vaccine versus the risks of COVID-19 infection in a child, and I hope that by the end of this, you will be able to gather that as medical professionals, we feel that the risk of COVID-19 is significantly higher, which is why we are recommending (the vaccine) for you.

Why is it important for a child to get vaccinated against COVID-19? We know that children generally have complications less frequently than adults, so why do they need to get the vaccine?

While children do have complications less frequently, they do still have complications. They are not excluded from this. We have had about 1.9 million cases of children since the pandemic started, and we have had almost 100 deaths in children in this age group, 5 to 11, from COVID-19. So, there is definitely still significant risk for children, which is why we want to protect them. Also, we have been seeing that with the Delta variant since July of this year, the rates of COVID-19 in this age group, specifically age 5 to 11, has been increasing far more than any other age group that we’ve seen. We’ve also noted that in areas where vaccination rates of adults are low, the hospitalization rates of children in this age group are four times higher. So for that reason, we are seeing that it is indeed very important to vaccinate and protect our children.

Additionally, children who are vaccinated are going to be able to have more freedom to participate in sporting activities, to play with their friends, and they would also not need to be quarantined if they were exposed to COVID-19 — and so that means less school days that are lost and less activities that they don’t have to miss out on if they experience an exposure.

Will the children that are ages 5 to 11 receive the same vaccine or dose?

So the vaccine is the same. The dose is less; it is one-third of the dose that we have been given to adults and older children. Our studies demonstrated that this dose was kind of the sweet spot where we had the least side effects and over 90% efficacy. So, that is how we are dosing it for these children, and the dose that the child is going to receive will be dependent on the age they are when they receive the first dose of their vaccine. So, if they are between 11 and 12, and if they get at age 11 and then turn 12 before the second dose, then they would get the lower dose for their second round of vaccine.


What are the possible side effects for kids taking this vaccine?

Now the side effects that we are seeing in children — they’re very similar to adults. So, the most common are soreness of the arm, fatigue, muscle soreness in general, headache. Sometimes we see nausea, diarrhea, things like that. But those are a little less common than just the general headache, fatigue, muscle soreness. Now, severe reactions are extremely rare, and in this trial, there were over 3,000 children that were included in the trial, and there was not one single event that was life threatening after receiving the vaccine. If you’re concerned about your child having an allergic reaction, you can always always discuss that with your doctor beforehand to address any concerns that you have.

Did this vaccine go through clinical trials?

Yes, it did. As I believe I mentioned before, over 3,000 children were included in these clinical trials. The children that were included on the trials were both children that had previously been impacted, had a COVID-19 infection, and then also children that had never been infected before. We found very clearly that the vaccine was both safe and effective for these children. We will continue to monitor for different reactions and responses to the vaccine as we now are able to kind of ramp up the population that we’re observing since during the trial, we only had a group of 3,000. That will expand to several million that are receiving the vaccine, and they will continue to undergo aggressive monitoring.

What about myocarditis — and what is myocarditis?

You’ve probably heard about it in our adolescent group that received the vaccine. There were very, very rare cases of myocarditis in those that received the COVID-19 vaccine. So, in terms of what exactly is myocarditis, and how does that impact my child if that were to happen? Myocarditis is a localized inflammation of the muscle around the heart. This is a more severe complication. It is very treatable, and there are no cases of these very rare cases in adolescence that occurred. There are no cases that resulted in death. In the 5-to-11 group in the trial of 3,000 children, there was not a single case of myocarditis. Additionally, we know very certainly that the rates of myocarditis are much higher in children that get COVID-19 infections, and the risk with that, and the risk of the infection itself and all of the other complications that can come with a COVID-19 infection are much, much higher.

Where can I get the vaccine (for my children)?

This is very new, so there are a lot of providers that are starting to ramp up their services. The best way to locate the most available vaccine for you would be to discuss with your primary care provider or also talk with your local pharmacy. Here at the health department, we are already available for scheduling appointments to receive a vaccine. It is important that you schedule an appointment before you come. But we are expanding our services and we’ll have availability on Wednesdays and Fridays ... so you can go ahead and call to schedule that appointment today. … The phone number is 919-742-5641 for appointments and then for more locations, you can also search www.vaccines.gov.

How long after the first dose should kids get the second dose, and can it be more than three weeks later?

So yes, that’s a great question. Twenty-one days after the first dose is when children can get a second dose and yes, it can be later. Ideally, it’s close to that window, just so that you can get them protected sooner, but it’s OK if you get it later.

Is there any recommendation on timing of flu and COVID vaccines for children if they need both at the same time?

There is no particular recommendation around timing. It’s OK for children to get multiple vaccines at the same time with the COVID-19 vaccine.

Are the effectiveness rates for children similar in children to what they were in adults for the various brands of vaccine, or different? Is this data available somewhere online?

That’s a great question. So yes, the effectiveness rates are very similar. As I said, the effectiveness of the vaccine in children 5 to 11 was just a bit over 90%. Some great places where you can locate this data if you go to the CDC website for the COVID-19 5-to-11 vaccine. You can actually go through and you can access the report that the FDA released on the study that they did. It’s a pretty dense document — it’s about 84 pages long, but if you really wanted to get into the nitty gritty of that, you can look at that. But the CDC website itself can (provide) the efficacy rates as well.

Should families with 11-year-olds wait until their kids turn 12 to get the higher dose, or go ahead and get the lower dose now?

So, my response to this would be that the efficacy rates, as we said, are very similar, so it would make sense to go ahead and get the vaccine now, as opposed to waiting until they turn 12.

What effect will the vaccine have on kids with asthma?

That’s a good question. I think there’s been a lot of debate about whether or not asthma puts someone at higher risk for complications with COVID. We assumed that they would and actually our studies have shown that children with asthma are not at higher risk for complications with COVID. So, that being said, they’re still at the same risk that children without asthma are, which there is significant risk with COVID-19 infection. So, we recommend that all children, including children with asthma, get the vaccine. Additionally, we did not see any adverse reactions to the vaccine in children with asthma.

Should parents with children younger than 5 still take additional precautions even after an older sibling is able to be vaccinated?

Yes, you still want to take certain precautions, especially if you have a child younger than 5. We know that infants and children younger than 5 are generally at a higher risk for complications with any of these infections, including influenza, COVID-19. So, you definitely want to take precautions in terms of making sure that they are not being exposed due to larger community areas where there may be people that are unvaccinated that could expose them. Also, if your child is at school, and coming home from school, you want to make sure that everyone is practicing really good hand hygiene and still doing our best to protect those children under 5 as well.

Is there any news of new concerning variants spreading like the Delta variant? And if so, have the existing vaccines shown to be effective against it?

Oh, that’s a really good question. So far, there has not been within the medical community, a new variant that we were particularly concerned about rising up within the United States and impacting this. The really good news is that all of the variants that we have identified and we have studied, have been extremely responsive to the vaccine that we have currently. So, that’s really good news, and because of that, we feel pretty confident that if there were a new variant, the vaccine would be effective against it. Additionally, we know that with mRNA vaccine, the benefit of the mRNA vaccine is that it can be modified very easily, and so if there were any situation in which there were a new variant that were less responsive to the vaccine, it would be a lot faster that we could modify the vaccine and have a vaccine that would be responsive to that new variant. That being said, it doesn’t seem like that is going to be an issue right now, which is a blessing.

Editor's note: this story has been updated to correct an error in Dr. McCuddy's original response regarding number of COVID cases. Dr. McCuddy initially said there had been "about 1.9 million hospitalizations of children since the pandemic started ..."  The actual data is 1.9 million cases, not hospitalizations.

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