ASK THE DOCTOR: Your child and the COVID vaccine by Laura Byrne
When the Food and Drug Administration (FDA) approved Pfizer’s two-dose COVID vaccine for use in children ages 5-11, many parents rejoiced in this moment. But, we also know many of you have your hesitations—and some serious questions. You're not alone. That's why we’re once again turning to Dr. Christina Canody, director of the pediatric service line at BayCare and Dr. Allison Ford Messina, chairman of the Division of Infectious Disease of Johns Hopkins All Children’s Hospital, to get answers for you. Just like with adults and teens, Pfizer’s COVID vaccine for kids will be two doses, spaced three weeks apart with full immunity taking hold two weeks after the second dose. It is important to point out that a child’s dose is smaller than the adult and teen dose at 10 micrograms compared to the 30 micrograms adults and teens receive.
TBPM: We know there is hesitation among some parents about the COVID vaccine for their children since it’s a new mRNA vaccine they’ve never received before. What would you tell parents who are concerned about the COVID vaccine technology?
TBPM: Some people are still skeptical about how quickly the COVID vaccines were developed. How do you address their concerns?
DR. CANODY: It’s important for families to know mRNA technology has been around since about 1990, so it’s been over 30 years. It’s been used especially in targeted and brain cancers where there are very specific cells to limit, so it’s a very targeted therapy. There is a lot of research and information. And when you put unlimited dollars, unlimited resources, and very smart people together, you can come up with a vaccine quickly. And obviously, this was not rolled out quickly in children. It took almost a year for it to come out in younger children, and they wanted to make sure it was safe.
DR MESSINA: The way it works is not terribly dissimilar from many other vaccines. The change is in the delivery platform. The way I think about them [the mRNA vaccines] and the way this delivery platform works is they are very elegant. They only deliver just the protein that we need the body to make an antibody to and YOUR TEEN AND THE nothing else. There are no extraneous COVID VACCINE: products. It’s a little molecule of fat in order to keep the mRNA stable. It’s a tiny Medical experts piece of mRNA that’s delivered. It codes at Tampa General for something called a spike protein, and Hospital answer that’s what we need to make antibodies to prevent you from getting sick. common questions Sometimes people raise the concern, well—isn’t that bizarre that you are introducing mRNA to my cells? Remember that when you get sick with a virus, viruses always introduce their mRNA into your cells. They introduce a lot of mRNA. They introduce enough mRNA that it makes an entire virus. So, if you’re afraid of the vaccine because you are afraid of the exposure to mRNA, you are getting mRNA in spades if you actually get COVID. There’s really not a lot of difference between how your cells process the mRNA that the vaccine gives you versus the virus except— and this is a very important except—that the vaccine only contains just that little portion. It DOESN’T contain the whole virus. And if it doesn’t contain the whole virus, it’s not going to make you sick because it doesn’t replicate. All it does is give you a little bit of that protein so you can make antibodies to it.
Another thing that should make this less of a concern is that the 5-11-year-olds are getting this vaccine after literally millions and millions of people have already received it. And there have not been any serious safety signals that have been seen.
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TBPM: Kids come in all shapes, sizes and weights. Should a smaller 5-year-old not receive the COVID vaccine quite yet, and on the flip side, should a larger 11-year-old opt for the dose teens and adults receive?
DR. CANODY: A diverse group of children ages 5 through 11 were included in this study, and just as well of a diverse group of weights [was] in there. Based on the study data, there was really no difference in the weight-based dosing or in age-based within that realm. They truly looked at the response rate and any side effects that were found. In general, the side effects were even lower than in teenagers. And when it comes down to weight, it truly has to do with your immune system function. It’s one thing when you are talking about metabolizing an antibiotic and dosing it based on weight, and it’s another thing when we are looking at immune function. We know that throughout childhood and adolescence, the immune system takes different steps. We know there’s one step when they hit that 2-month-old age when the blood-brain barrier gets thicker. They hit another step around 6 months of age. They hit another step around 2-2.5, a little bit more around 5, and then again early on in adolescents somewhere between 10 and 12. And then we truly move into an adult immune system by age 15 to age 16.
