In the USA, the number of COVID-19 cases is increasing again – including among children. In mid-May 2022, the Food and Drug Administration approved a booster shot of the COVID-19 vaccine for US children ages 5 to 11, and the Centers for Disease Control and Prevention subsequently recommended a booster shot for that age group.
Of course, many parents wonder about the importance and safety of booster vaccinations for their school-age children. Debbie-Ann Shirley, a pediatric infectious disease specialist at the University of Virginia, answers some common questions she hears about COVID-19 and booster shots in children that she hears in her practice, and explains the research why booster shots are recommended for children ages 5 to 5 will be 11
1. How important is a booster vaccination for children?
COVID-19 is generally milder in children than in adults, but serious illness can occur.
As of the end of May 2022, more than 15,000 children aged 5 to 11 have been hospitalized with COVID-19 and 180 children have died. During the peak of the recent winter wave of the highly transmissible Omicron variant, 87% of children aged 5 to 11 hospitalized with COVID-19 were unvaccinated.
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Additionally, the rare but serious condition that can occur in the weeks following COVID-19 infection, known as Multisystem Inflammatory Syndrome in Children, or MIS-C, occurs most commonly in children ages 5 to 11. Over 3,800 cases of MIS-C have been reported in this age group, 5 to 11 years, and 93% of children who developed this complication were unvaccinated.
Some vaccines – including those for COVID-19 – become less effective over time. Booster shots help boost the immune response. Several childhood vaccinations, such as tetanus and diphtheria, require booster shots.
COVID-19 boosters have been shown to improve declining protection in adolescents and adults. The side effects are similar to those reported with the first series. The risk of myocarditis, or heart inflammation – a rare side effect that can occur after a COVID-19 vaccination – appears to be lower after a third dose than after the second.
2. How well does immunity hold up after the first COVID-19 vaccinations?
When administered to children 5 to 11 years of age, Pfizer-BioNTech’s vaccine produced an antibody response similar to that seen in 16 to 25 year olds in a clinical study that formed the basis of the FDA’s original approval of the vaccine October 2021. However, studies after the vaccinations were approved found that the effectiveness of the vaccine in the 5- to 11-year-old age group declined rapidly during the Omicron surge. Nevertheless, the syringes continued to protect against serious illnesses and hospital stays.
Vaccination has also been shown to provide high protection against multisystem inflammatory syndrome in children.
3. Does a third dose make a difference in children?
In a clinical trial, researchers tested Pfizer’s vaccine in children ages 5 to 11 with a 10-microgram booster dose, which is the same dose children received for their primary series and one-third the dose given to adolescents and adults is used. No new safety concerns were identified when tested in 401 children, and in the smaller subset of children tested for immune response, the third injection significantly increased antibody responses, including against the Omicron variant. Therefore, a third immunity-boosting dose appears to be beneficial in this age group similar to older age groups.
The booster dose can be given five months or more after the second injection. But by the end of May 2022, less than a third of children ages 5 to 11 had received two shots, meaning only about 8 million school-age children were eligible to start the booster shot. This could prove important protection for them and help limit disruption to school and summer activities, especially as mask requirements have fallen by the wayside.
Immunocompromised children who were initially allowed to receive three starting doses of the COVID-19 vaccine can now also receive a booster shot – or a fourth dose – as early as three months after their third dose.
4. Is the COVID-19 vaccine safe for children?
As of the end of May 2022, more than 18.5 million doses of the COVID-19 vaccine had been administered to children in the 5-11 age group. Most of the side effects of the COVID-19 vaccine – such as pain at the injection site – were mild and short-lived in children. Fatigue, headaches, and muscle aches are other common side effects.
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Reports suggest that most cases of myocarditis improve rapidly after vaccination with medication and rest. Myocarditis rates were lower in children aged 5 to 11 than in teenagers. In any age group, myocarditis is more likely to occur after infection than after vaccination.
5. What about the children under 5 years old?
For parents of children aged 6 months to 5 years, COVID-19 vaccines are finally in sight. On May 23, 2022, Pfizer released new data for this age group stating that three vaccinations elicited strong antibody responses, were well tolerated with no new safety concerns and, based on preliminary data, the series was 80% effective in preventing COVID-19 Infection. In late April 2022, Moderna released similar data showing that two doses of its vaccine stimulated good antibody responses and was well tolerated in children under 6 years old.
The FDA is expected to meet in June 2022 to discuss new low-dose formulations of the Moderna and Pfizer vaccines for this group.
If approved by the FDA, the CDC will then make recommendations on its use for the more than 20 million children ages 6 months to 5 years in the United States
This article was republished by The Conversation under a Creative Commons license. Read the original article.