AG is a 2-month-old, healthy chubby baby with “Michelin man” rolls and pinchable cheeks, and he’s my patient. I’m a pediatric intern at Harbor-UCLA Medical Center, a safety-net hospital in Los Angeles. When AG missed his checkup in late December, I was worried. Only initials are being used to protect the baby’s identity.
My colleague told me that AG recently had been in our emergency room. At that time, he had a cough, runny nose and congestion, which made it hard for him to eat and sleep. He tested positive for COVID-19 but didn’t require hospitalization.
When I talked to his mom, MG, on the phone, she was guilt-ridden that she couldn’t protect AG and his three siblings, ages 2, 4 and 6, from COVID-19. She and her husband were vaccinated, but her 6-year-old wasn’t. She had planned to get him immunized at his upcoming checkup. Within the week, all four children were ill with COVID-19.
MG’s children caught COVID-19 during the circulation of the highly contagious Omicron variant. That variant brought on a huge surge in cases and led to the most pediatric cases since the pandemic struck. As of late February, nearly 1,000 kids 18 and younger had died due to COVID-19 in the U.S.
February also brought news that the Food and Drug Administration was delaying its approval of COVID-19 vaccines for children ages 6 months through 4 years, while awaiting additional data. This was heartbreaking news for many parents of young kids, as well as pediatricians.
Although children ages 5 to 11 are eligible for COVID-19 vaccines, less than 17 percent have been immunized, according to the Centers for Disease Control and Prevention. Slightly more than 60 percent of adolescents ages 12 to 17 have been vaccinated.
With low vaccination rates, mask mandates ending and kids returning to more activities, children 12 and younger are now among the most vulnerable to this nasty virus.
Getting immunized is one of the best tools to protect against COVID-19, so I recommend vaccination to my eligible patients. If parents decline, I ask them why they’re hesitant.
The most common reason I hear is fear that something bad will happen. In a survey from Kaiser Family Foundation, 3 in 10 parents said they don’t plan to immunize their children against COVID-19, with many citing adverse reactions as the reason.
Parents in my clinic express worry that the messenger RNA (mRNA) vaccines are new and that they could change their child’s DNA. A few parents have even said, “I just don’t want my child to be part of an experiment.”
But, the mRNA vaccines aren’t new or experimental and they can’t alter DNA. The “m” stands for messenger. The mRNA delivers a message to cells’ DNA to make the spike protein of SARS-CoV-2, and then it’s completely broken down. The body recognizes the spike protein as foreign and makes an immune response.
The mRNA vaccines have been around for decades. They were used for research into the related coronavirus, SARS, in 2002, and in curtailing the Ebola epidemic in 2016. Because the mRNA technology already existed, applying it to COVID-19 vaccines could happen quickly.
The Pfizer BioNTech and Moderna products are mRNA vaccines and have demonstrated safety and efficacy. But only the Pfizer BioNTech vaccine can be used for kids younger than 18. It has FDA full approval for individuals 16 and older and emergency use authorization for youth, ages 5 through 15.
Since December 2020 in the U.S., more than 325 million doses of the Pfizer vaccine and 208 million doses of the Moderna vaccine have been given to individuals ages 12 and older. Nearly, 26 million doses have been given to children ages 5 to 18.
Despite those large numbers, some parents are still worried about vaccine side effects. One alarming side effects that parents ask me about is myocarditis or inflammation of the heart, which occurs at a rate of about 2.3 per million vaccine doses, mostly in young male patients. But, inflammation of the heart and blood vessels also occurs with COVID-19.
I encourage parents to weigh the risks and benefits of vaccination. There are risks for adverse reactions after COVID-19 vaccines, or any vaccine, but they’re usually mild, most often at the injection site and are self-limited. The benefit is protection against severe COVID-19 and death. Although most COVID-19 cases in kids are mild, some children suffer complications and become critically ill.
With so much misinformation out there, especially on social media, as well as frequently changing public health guidelines, it’s hard for parents to know what to do. I assure parents that my objectives are to help them filter through the noise and to answer their questions. They’re relieved to have a chance to talk about their concerns.
Fortunately, AG and his siblings all recovered from COVID-19. I encouraged his mother to immunize her oldest. For the younger three, ensuring the people they come into contact with are vaccinated, masking, handwashing and maintaining routine health care are the best things she can do for them.
Until they’re able to get vaccinated, these are the best things all of us can do to protect young children.
Dr. Mathew Kraus is a pediatrics intern at Harbor-UCLA Medical Center and a Southern California native.