Nov 16, 2021 12:30 PM

Recently, the Pfizer-BioNTech COVID-19 vaccine was authorized for children ages 5 to 11. As of today, 193 million people ages 12 and over have been safely vaccinated in the U.S. Although younger children are less likely to die or be hospitalized from COVID-19, recent statistics show why pediatricians and University of Utah Health experts support the vaccine for younger children.

In the U.S.:

  • Children are just as likely to be infected with the coronavirus as adults.
  • There have been more than 8,300 hospitalizations of children ages 5 to 11 due to COVID-19.
  • 32% of these children had no underlying conditions.
  • At least 94 children in this age group died from COVID-19.
  • 1,800 schools closed due to COVID-19 outbreaks in August and September 2021.
  • These closures affected 933,000 children.

“When looking at the impact that COVID-19 has had on children, it is a lot more complex than comparing how sick young kids get relative to how sick older people get,” said Andrew T. Pavia, MD, Chief of the Division of Pediatric Infectious Diseases at U of U Health and Director of the Hospital Epidemiology Program at Intermountain Primary Children’s Hospital. “The amount of hospitalizations and deaths are still far more than a typical influenza would impact in the same time period. There is also a secondary impact on their mental health due to schools shutting down and their education being impacted.”

Pavia explains those aren’t the only reasons children should be vaccinated. It also helps protect them from:

  • Spreading the virus to family, friends, teachers, and people in the community who are at higher risk of getting sick.
  • Getting multisystem inflammatory syndrome (MIS-C), a rare but serious condition associated with COVID-19.
  • Debilitating, long-term effects of COVID-19 such as loss of taste and smell, fatigue, and memory problems.

As a result, health experts encourage parents to weigh the risks of getting COVID-19 with the marginal risk of getting a complication after the vaccine. “If you do so rationally, you can see that [children] have a much more severe outcome if [parents] do nothing than if they get the vaccine,” Pavia said. “If there was no benefit to children, we would be making a different decision. But we think that there is a benefit to them, their families, and the community.”

Q&A on COVID-19 Vaccine for 5- to 11-Year-Old Children

Is the Pfizer-BioNTech vaccine effective and safe for children 5-11?

A study of 3,200 children conducted by Pfizer shows that the vaccine was 90% effective at preventing symptoms of COVID-19 in 5 to 11-year-olds, and that their immune response was comparable to that in people 16 to 25 years old. Similar to what we see in other age groups, the side effects experienced were sore arms, redness of the arm, and sometimes swollen lymph nodes, fever, and chills. Inflammation of the heart (myocarditis) is a treatable but serious side effect that occurs very rarely in older teens and adults. Health experts think the smaller dose vaccine for kids 5 to 11 may reduce their risk of myocarditis, and there were no cases reported in in the clinical trials. However, these trials were not large enough to detect such rare events.

Are there systems in place to monitor the safety and effectiveness of the vaccines?

As the vaccine is distributed to millions of children, it is important to continue to monitor safety. The Vaccine Adverse Event Reporting System (VAERS) solicits reports of any potential illness that occurs after the vaccine has been administered without regard to whether it was associated with the vaccine or not. Then, Vaccine Safety Datalink—composed of 100 million people in the health care system—look at the data and compare it to health records to see if the incidence and frequency at which people are developing a particular symptom can be linked to the vaccine. This system learned about the extremely rare blood clots that occurred with the Johnson & Johnson vaccine, so it works extremely well.  The same system is monitoring vaccine safety in children.

Is the Pfizer-BioNTech vaccine safe for children with underlying conditions?

Children with underlying conditions are the ones who benefit the most from the vaccine since they are at higher risk for serious illness from COVID-19. Of the 3,200 children in the Pfizer study, 12% had underlying conditions and none had serious side effects from the vaccine. Data on the 193 million adults and older children that have already received the vaccine, many of whom had underlying medical conditions, also determined that there is no additional safety concern for this group.

I don’t know if my child is allergic to anything. Is it still safe to get the vaccine?

Children who have common allergies to milk, pollen, or latex are not at increased risk of allergic reaction to the COVID-19 vaccine. Severe allergic reactions, or anaphylaxis, to the Pfizer-BioNTech vaccine are very rare in adults, occurring at about 5 cases per million doses. People who have had a severe allergic reaction to the vaccine are allergic to a specific ingredient in the vaccine that is called polyethylene glycol (PEG). By the time a child reaches the age of 5, children who have had the recommended childhood vaccinations have already been exposed to this ingredient. If a child did not have a severe allergic reaction to those vaccines, that is a good indication that they would not be allergic to the Pfizer vaccine.

Is puberty affected by the Pfizer-BioNTech vaccine?

No. There is no biological reason that the vaccine would affect the signals from the brain or hormones that could affect puberty.

Can the Pfizer-BioNTech vaccine cause infertility?

No. There is no evidence that antibodies made after COVID-19 vaccination or vaccine ingredients would cause any problems with becoming pregnant, now or in the future. In addition, studies have found no differences in the ability of people who were vaccinated to become pregnant.

How do I know that severe symptoms won’t start three years after the vaccine?

With the vaccines that are available today, we know that any symptoms that occur usually happen within the first two to three months, and typically much sooner. It has been more than a year since people were first vaccinated in clinical trials, and no additional symptoms have emerged over time. Additionally, there is no biological reason to think that this could happen. For these reasons, it is unlikely that symptoms will occur three years later. The Pfizer-BioNTech vaccine prepared for children in the 5-11 age group is a lower dosage, at one-third the dose for adults. It is possible that there would be even fewer side effects due to the lower dosage.

Will my child need a booster shot?

We don’t know the answer yet. This information can only be determined after assessing the lasting response to the vaccine once it has been administered to enough children in this age group.

How does the Pfizer-BioNTech vaccine prevent hospitalizations if there have been breakthrough infections?

Since COVID-19 vaccines are not 100% effective at preventing infection, some people who are fully vaccinated will still get COVID-19. However, even when fully vaccinated people develop symptoms, they tend to be less severe symptoms than in unvaccinated people. This means they are much less likely to be hospitalized or die than people who are not vaccinated.

How does adding vaccinated children to the population affect herd immunity?

Vaccination helps keeps children from spreading the virus in the community. If a substantial number of children get vaccinated, it will help get the pandemic under control.

How comfortable should I be with sending a disabled child back to school after vaccination?

If your child’s disability is one that should not affect the vaccine’s ability to work, such as a neuromuscular condition that does not affect the immune system, then it is fine to send them back to school right away. If the disability does affect the immune system, such as if your child is undergoing a cancer treatment or has recently had an organ transplant, the vaccine may not work as well because they may not be able to build up a robust immune response. In that case, it’s best to talk to your pediatrician.

Will my child still need to wear a mask if they received the Pfizer-BioNTech vaccine?

In many regions of the U.S., the virus is still very active due to substantial and high community transmission. In these areas, children and adults should continue to wear masks in high-risk situations including in crowded, indoor places where there may be people who are unmasked and unvaccinated. Such locations may include schools and restaurants.

Where can I get the Pfizer-BioNTech vaccine for my child?

The Pfizer vaccine is readily available in retail pharmacies and pediatrician offices. Go to  or call 1-800-232-0233 (TTY 888-720-7489) to find a vaccine provider near you.

What else can I do to protect my child from COVID-19?

Make sure that you are vaccinated and encourage other people who are close to your child to get vaccinated. That will not only help further protect your children, but it will also help protect yourself and the people around you.

Watch the full press conference with Pavia here. Llisten to an interview about children and COVID-19 vaccines on Top of Mind with Julie Rose.

covid-19 vaccine children infectious disease

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