The long-awaited COVID-19 vaccine for children age 5 to 11 could be just a few short weeks away from authorization. The White House told the nation’s governors in a private call on Tuesday that “states should prepare to begin vaccinating elementary-school-aged kids against COVID-19 in early November,” according to ABC News, and that it would work with local health officials to determine where to send first doses of the vaccine. The Biden administration also told governors that, pending approval from federal authorities, it had secured enough doses to vaccinate the 28 million children ages 5 through 11 who are expected to become eligible.
“It’s important that all of us recognize that parents have been waiting for a pediatric vaccine for a long time,” White House COVID coordinator Jeff Zients reportedly said on the call, “so they will understandably be very eager to get their kids vaccinated.” The pediatric vaccine rollout is expected to follow that of the adult shot, with availability through pediatricians and other doctors, pharmacies, hospitals, clinics and some schools.
The first pediatric vaccines will come from Pfizer and BioNTech, which last month found its shot to be “safe and highly effective” in young children and went on to request an emergency use authorization from the Food and Drug Administration. (A decision is expected by Halloween.) The CDC, which delivers a final word on vaccine use, has slated meetings on the pediatric vaccine for November 2 and 3, according to The New York Times.
Pfizer has been among the pharmaceutical companies studying their COVID-19 vaccines for kids, including side effects and efficacy. According to their September report, “this thing works,” Dharushana Muthulingam, M.D., M.S., an infectious-disease physician, tells Vogue.
But if the adult vaccine rollout is any indication, the conversation and deliberations around giving the shot to children will be complicated and compounded by parents’ concerns. “It’s very natural that most of us are more protective of our children,” said Muthulingam. Many parents currently have more questions than answers about the pediatric shot. What will the under-12 vaccine mean for kids, families, school, and daily life? Muthulingam, who cares for COVID-19 patients, weighed in.
If kids are vaccinated, will they still have to wear masks to school?
“We’re all looking for these markers of improvement in our pandemic lifestyle,” Muthulingam acknowledges. But “I’m very cautious about thinking, this will be the thing that makes everything normal, because it’s very likely we’ll never go back to normal,” she said.
Just as the vaccine wasn’t a magic solution for adults to stop masking altogether—especially in the face of the delta variant—the same will likely hold true for kids. “The two big pieces of context are: What’s going on in your community, and what’s going on for you?” said Muthulingam. In areas where there is a high transmission of COVID-19—which most regions of the country are still considered to be—“the CDC recommends you still wear a mask in public indoors, even if you’re vaccinated. That’s probably going to apply to children too,” as well as schools, given they house large, indoor gatherings. Especially through the winter, Muthulingam added, and in regions where there’s not a lot of vaccination, “it’s prudent to continue wearing a mask.”
As for individual calculations, “it’s not just the kid,” said Muthulingam, “but who they go home to.” Immunocompromised kids or kids living with immunocompromised family members, elderly grandparents, or younger, unvaccinated siblings should consider continuing masking. Muthulingam also reminds both adults and children that they are not considered to be fully vaccinated and maximally protected against COVID-19 until two weeks after their last dose: “That’s important because the delta variant seems to affect partially vaccinated people more than previous variants.”
Should parents who got vaccinated themselves be more concerned about vaccinating their kids under 12?
Some parents point out that kids are at a lower risk of serious illness or death from COVID-19, so they don’t feel as eager to vaccinate them. Others worry vaccinating kids could be more of a risk to them than COVID-19 itself. But according to Muthulingam, “there’s a global statistical conclusion that the risks of the vaccine are far outweighed by the risk of the disease”—for both children and adults. “It is the case that [kids] have milder disease than adults, but some tiny percentage do get these more serious illnesses that require going to the hospital.” She references the data that a small percentage of people, especially young adult males, who get the COVID-19 vaccine can get myocarditis, or inflammation of the heart. “But then a study came out that said that condition is way more common in COVID than the vaccines,” said Muthulingam.
As an infectious-disease physician, Muthulingam said she plans to vaccinate her children, ages four and one, as soon as she is able, as long as the approval process goes as expected. “I see how bad COVID is every day. I want to protect not only my children but the other children who may or may not be able to benefit from the protection of the vaccine,” she said—including kids with autoimmune disease or cancer or organ transplant patients. Even though healthy kids don’t get sick as often or as severely as adults, they can still transmit COVID. “Even though we’re this hyper-individualistic society, it really is a communal effort,” she added. “How are we going to care for the vulnerable in our society?”
Will kids get the same severe-flu-like symptoms that some adults developed after their COVID-19 shots?
The data is not yet conclusive, as Pfizer is thus far the only pharmaceutical company to report data on its pediatric vaccine. But Muthulingam said doctors estimate that kids will not develop the same severe adverse reaction to the shot that some of their parents did. Pfizer found that kids 5 to 12 only need one-third of the dose that adults receive—“both because they are smaller but also because they have immune systems that learn faster with less stimulus,” Muthulingam said. As a matter of “educated speculation,” Muthulingam said, medical experts presume the smaller dose will link to less of a reaction.
Muthulingam also weighs the possibility of a reaction against the multiple “nasty illnesses” that kids routinely battle at school and day care. “Part of socializing your child is training their immune system,” she said. “There’s a reason we give a lot of vaccines in childhood: because they mount this really robust immune-system response in this developmental phase and it takes less to do it.” This is why children can bring home various viruses and recover quickly, while their parents contract the same bug and are 10 times sicker. “There’s always a chance you have that rare, severe reaction,” Muthulingam said. “But again, those severe reactions are worse if you actually get infected with COVID.”
How can parents educate themselves about the COVID-19 vaccine for young children?
Most parents are going to have questions, and they should seek answers from trusted medical professionals. “If you feel overwhelmed by all the information and you have a lot of competing misinformation coming from sources, that’s going to affect how you interpret the risk,” Muthulingam said. More than Twitter, Facebook, or any cable news station, “I’m hoping people will have a chance to talk to the pediatrician they trust.”
Originally Appeared on Vogue