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Vaccinating Keiki for COVID-19

Artwork by Yuko Green

As of May 10, 2021, children as young as twelve are eligible to receive the COVID-19 vaccine. Currently, trials are being conducted on the efficacy of the Pfizer COVID-19 vaccine for children younger than 12, with the hope that sufficient data will be available on the vaccine’s effectiveness and safety for young children by the fall. 

Some people may be wondering since most children who develop COVID-19 have mild or no symptoms, is it important to vaccinate keiki for COVID-19? 

As the age range of children who are approved to receive the COVID-19 vaccine expands, this question will become increasingly important. When considering whether or not to vaccinate your keiki for COVID-19, it is important to understand the facts related to the vaccine and consider the relative risks and benefits of vaccination.

How likely are keiki to be infected with COVID-19, and does the virus pose a substantial risk to their health?

Since the beginning of the pandemic, according to the Department of Health there have been over 42,000 confirmed cases of COVID-19 in Hawaii State. Almost 6,000 of these cases have been among kids under 18, which is 14% of the total infections in the state. While children are not as likely to become very sick from COVID-19 compared to older individuals, researchers at Harvard found that some keiki who contracted COVID-19 developed multi-organ systemic infection (MIS-C), which can lead to serious heart issues. Although the risk of death from COVID-19 is lower among keiki than other age groups, the risk of dying is not negligible—in the US, almost 350 keiki under age 18 have died due to COVID-19 since the beginning of the pandemic. Beyond the direct risk that COVID-19 poses to keiki health, it is important to limit the spread of COVID-19 among keiki because keiki are more likely to have no or mild symptoms, which makes it easier for them to spread the virus to more vulnerable individuals. 

Is the COVID-19 vaccine protective against different variants of the virus?

With every new variant of the virus that emerges, there are concerns that the new variant will be able to evade the vaccine. Recently, there has been news about the Delta variant of the virus, which, compared to other variants, seems to be more contagious and leads to more severe symptoms. So far, research has revealed that the COVID-19 vaccines are very effective at both decreasing the risk of infection from COVID-19 and decreasing the risk of developing severe illness if an individual does contract COVID-19, regardless of the specific variant. While we cannot predict how future variants of the vaccine will behave, the evidence so far shows that getting vaccinated COVID-19 is protective against the virus as a whole, and not just a specific variant.  

Is the vaccine safe and effective for young keiki, and when will it be available for them?

An additional consideration is how younger keiki will respond to the vaccine, and how effective the vaccine will be at protecting keiki from contracting the virus, or developing severe symptoms if they do contract the virus. Although generally keiki who do contract COVID-19 show no or mild symptoms, there are still some children who’ve had to be hospitalized, suffered long term health effects, or even died from COVID-19. The current minimum age to receive the vaccine is 12, as this is the youngest age group on which there has been extensive testing done. Studies have shown that keiki this young were protected from being infected with COVID-19 compared to keiki who did not receive the vaccine. There are trials going on currently to test the efficacy and safety of the Pfizer COVID-19 vaccine for keiki younger than 12 with the hope that data will be available on the vaccine’s safety and efficacy by this fall

Will keiki experience side effects immediately after getting the vaccine?  

Because COVID-19 vaccines do not contain the live virus that causes COVID-19, it is impossible to contract COVID-19 from the vaccine. However, because the vaccine is meant to teach your body how to fight COVID-19 if it does come into contact with it, it is normal (and good!) to experience side effects after receiving the vaccine, because this means your body is developing immunity to the virus. For the youngest keiki on which there has been thorough testing done so far, the most common side effects usually occurred after receiving the second dose, and included a sore arm, fatigue, headache, fever and muscle pain, and normally lasted 1-3 days. Parents can call their child’s pediatrician to ask about medicines that can reduce symptoms. 

Are there long-term and/or latent side effects? 

Some parents have concerns about long-term and/or latent side effects from the vaccine and have chosen to wait for a period of time to see how the vaccine works among people before deciding whether their child should receive the vaccine. However, looking at the history of vaccines reveals that long-term and/or latent side effects from the COVID-19 vaccine are very unlikely. Vaccines are usually only taken once or twice, so unlike daily or frequently taken medications, there is not an accumulation of the vaccine in your body that could cause long-term side effects. According to Dr. Paul Goepfert, director of the Alabama Vaccine Clinic, there has never been a vaccine with long-term side effects. In the past, for vaccines that have had more serious side effects, the side effects have occurred within six weeks of the first vaccine dose. The vaccines continue to be monitored very closely. The CDC says that the COVID-19 vaccines have “the most intensive monitoring” of any vaccine ever tested in the U.S. 

What about myocarditis?

Recently there has been news about the connection between the COVID-19 vaccine and myocarditis. Myocarditis is inflammation of the heart that can present as chest pain, shortness of breath or heart palpitations, among other symptoms. Particular groups of people are more vulnerable to this condition—males ages 12-39 are most likely to contract myocarditis (rate of infection of 1 in 31,000 compared to 1 in 212,000 for females of the same age). However, contracting COVID-19 also places children at risk for developing myocarditis, as approximately 1 in 3,200 children who contract COVID-19 develop rare inflammatory syndrome, which can cause myocarditis. The American Academy of Pediatrics encourages vaccination of children because the risk of developing myocarditis is higher from contracting COVID-19 than it is from getting the vaccine, but there are many factors that influence the decision to vaccinate children. 

There are other considerations to take into account when determining whether to vaccinate your keiki for COVID-19, such as:

  • whether members of the family have been vaccinated,
  • the amount of social interactions your family is having with individuals outside of the family,
  • potential risk of exposure to the virus, and 
  • whether there are high-risk people in the family or pod who can’t be vaccinated.

Keiki Heroes is here to support your family as you analyze your unique situation and weigh the benefits and costs of vaccinating your keiki for COVID-19.

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