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ATAGI has now approved the COVID vaccine for 5-11 year olds. Supplies are slowly rolling in, and parents are being asked to book in their 5-11 year olds. So as a parent, what do you need to know about COVID in your 5-11 year old and the vaccine?
Do children get COVID badly, and can they die?
Children aged 5-11 do get COVID. However, it is usually a mild illness lasting on average five days. There is a very low risk of going to hospital or dying in this age group.
There have now been nearly a million cases of COVID in Australia. Around 6000 or 7% of those have been in children under 9. There has only been one death in Australia in a child aged 5-11 from COVID and they had underlying health problems.
Children at most risk of having serious complications from COVID are those with underlying health problems. Underlying health problems that we know increase the risk include obesity, type 2 diabetes, asthma, heart and pulmonary diseases, neurologic, neurodevelopmental (in particular, Down Syndrome) and neuromuscular conditions.
Two rare complications can occur related to COVID in all children.
A study published on 7 January looked at children who had been diagnosed with Diabetes and found it was more commonly diagnosed in children who had COVID in the previous 30 days. It is thought that COVID may trigger the development of Diabetes in some children. The study recommends that measures such as vaccination will help prevent this complication.
Another severe but very rare complications of COVID that can affect children in this age group is Paediatric inflammatory multisystem syndrome. It can affect children with no underlying health problems and usually happens some weeks after a bout of COVID. Some studies report it happening to 3 per 1000 children infected with COVID, with most needing hospitalisation and a death rate of 2%. ATAGI recommends that vaccinating help prevent infections and complications such as Paediatric inflammatory multisystem syndrome.
Parents worry about long term effects of COVID like long COVID syndrome. The evidence so far is very reassuring that children do not have long term problems with Long Covid syndrome.
Is the vaccine effective in protecting my child?
The vaccine seems to be very effective. In a study of 2268 children aged 5-11 years old’s, the vaccine was shown to be 90.7% effective in preventing proven COVID infections. This is a great result but not a huge trial and conducted before Omicron arrived.
When you look at worldwide figures, COVID vaccination in children will prevent more deaths than vaccinations for meningitis.
Will the vaccine protect other family members and my community?
Children may only have mild COVID infections or no symptoms at all, but they are still infectious. They can infect others, including teachers and members of the family.
There is compelling evidence vaccinating children aged 5-11 greatly decreases the risk to the rest of the family and community of getting COVID and being hospitalised.
Is the vaccine safe?
In the trial of 2268 children, there were no serious adverse events. Other countries started vaccinating 5–11-year olds in November, and by 31 December, over 8 million 5–11 year olds had been vaccinated in America. So far, no unexpected adverse effects. There is a risk of myocarditis and pericarditis in children as there is in adults.
Myocarditis and pericarditis are inflammation of the heart muscle or the outer lining of the heart. This can be a complication of COVID infection but can also occur after the Pfizer/Moderna mRNA vaccines and can be a side effect in children. Of the 8 million doses given in America, there have only been 11 cases of myocarditis and the children have all recovered. See our article on Myocarditis/Pericarditis and the vaccine
In both animal and human studies, the Pfizer vaccine did not affect fertility.
All of this is very reassuring, but it is impossible to give a guarantee of no long term effects but the evidence is mounting for the safety of the vaccine.
What more should I know about the vaccine
The Pfizer vaccine for 5-11 year old’s is a third of the dose for adults and children 12 and over. The vaccine is two doses given 8 weeks apart. While you get the greatest effect 1-2 weeks after the second dose there is still some protection 1-2 weeks after the first dose. The main side effects are pain where the injection was given, tiredness and a headache. In the study the doses were given only 3 weeks apart but the vaccine has been shown to be more effective when the doses are given further apart and there is believed to be less risk of myocarditis. If your child turns 12 after the first dose, they will get the adult dose for the second dose.
The vaccine can be given at the same time as other childhood vaccines.
Would we vaccinate our child?
If our child had an underlying health condition that increased their risk of severe illness with COVID we would be rushing to get them vaccinated.
If our child was in close contact with a vulnerable family member we would be getting them vaccinated to protect the family member as soon as possible because the risks of the vaccine are low.
If our child had no underlying illness and we did not need to protect a family member, we would weigh up our personal circumstances to decide how quickly we organise the vaccine. We would weigh up any concerns we have that the vaccine is relatively new against the reality that when our child goes back at school they are more likely to be infected if they have not been vaccinated and although they may not be seriously ill they could be ill for around 5 days, there is a small risk of complications and they are likely to bring the infection home to us.
As with everything COVID there is never one answer for everyone. We will be ordering the vaccines this week. We are happy to go through the information with parents to help them decide what is right for their child and their families circumstances.
Photo by Jonathan Borba on Unsplash