A young girl holds a stuffed unicorn toy and bites her finger as she receives a shot.

COVID-19 Vaccines and Children: What Is All the Fuss About?

On October 19, 2021, the FDA authorized the Pfizer-BioNTech COVID-19 vaccine for emergency use in children 5 to 11 years of age. With the COVID-19 vaccine now approved for use in younger children, many parents are asking the question: should my child get the vaccine? As we have already seen, many states are beginning to implement vaccine mandates. In the early fall, New York City issued a mandate requiring all public school workers to receive at least one dose of the COVID-19 vaccine, providing no option for weekly testing. In addition, California is the first state to announce that students will have to be vaccinated for the following school year if they want to attend in person. Assemblyman Jeffrey Dinowitz from the Bronx has already introduced a bill that will require the COVID vaccine for all eligible students in order to attend school. As of March 7th, however, NYC lifted school mask mandates and ended the vaccine requirements for indoor dining and venues, leaving mask requirements in schools to be decided by local districts. Despite this, there is always concern for rising cases and new variants to emerge.

Even with no official mandate in place, parents are already resisting vaccinating their children. However, if we look back in history, vaccine mandates are nothing new. If we want children to return to a normal school routine, parents should actively consider getting their children vaccinated.

For a long time in the United States, children have been required to receive certain vaccines to be able to attend school. In order to prevent the spread of smallpox in the 1850s, Massachusetts was the first state to enact a vaccine mandate. By 1963, 20 states along with Puerto Rico and Washington D.C. enacted various vaccine mandates. Multiple outbreaks of measles occurred throughout the country in the late 1960s, prompting a greater emphasis on vaccines in schools. Experts said that when they examined school districts that implemented vaccine mandates against measles, they found lower incident rates, indicating that the mandates were effective.

Beginning in 1977, all 50 states began mandating vaccines in schools. The federal government established the Childhood Immunization Initiative that same year, which was meant to improve vaccination rates against diseases that most children get vaccinated against nowadays such as diphtheria, measles, mumps, and rubella. In 1995, the FDA approved the chickenpox vaccine and, as with the COVID vaccine, many parents were hesitant to vaccinate their children since chickenpox was not shown to be lethal in children. Years later, however, multiple states began enacting vaccine mandates against chickenpox. A 2005 study in the journal Vaccine proved two things: 1) there were lower incident rates of chickenpox in states that mandated the chickenpox vaccine in daycares and schools, and 2) vaccine mandates lead to higher vaccination rates. Vaccine mandates have been around for decades now and it is evident that they can be effective in increasing vaccination rates in children.

A health care worker drops the polio vaccine on a lump of sugar. (Courtesy Wellcome Collection)

Despite the effectiveness of vaccine mandates, parents are still skeptical about the COVID-19 vaccine, and any attempts to enforce the mandate soon are likely to face pushback. Currently, the vaccine in children has only been approved for emergency use, which could create legal problems if school districts try to pass a mandate. Some parents are concerned about the side effects since there have been cases in which the Pfizer vaccine causes myocarditis. Parents also feel that since children are already at a lower risk of contracting the virus, there is no point in getting the vaccine. A survey conducted by the Kaiser Family Foundation assessing parents’ willingness to vaccinate their children indicates that a majority of parents are either waiting to vaccinate their kids or do not plan on vaccinating their kids at all. Clearly, a lot of work needs to be done to motivate parents and gain their trust when it comes to the vaccine.

Parents should know that according to the FDA, the Pfizer COVID-19 vaccine was shown to be 90.7% effective at preventing COVID-19 in children ages 5-11 years old. Thus far, COVID-19 vaccines have proven to decrease the chance of contracting and spreading the virus, as well as preventing serious illness in those who do contract the virus. Clinical trials involved about 3,100 children ages 5-11 years old who received the vaccine with no notable adverse effects. Similar to adults, children in this age group will receive a two-dose series with 3 weeks in between, but at a lower dose—10 micrograms instead of 30. Overall, many medical experts agree that parents should not wait to vaccinate their children. Yes, COVID-19 has been shown to only cause mild symptoms in children, but it is hard to tell how severe the virus will be in a child. One condition – multi-inflammatory syndrome in children – has developed in more than 5,200 children and teenagers as a result of COVID-19. We do not want children to die from contracting a disease that could have been prevented. Also, if a child has a health condition, that places them at greater risk for contracting COVID-19. If a family member of a child is immunocompromised, that is more reason for the child to receive the vaccine.

As of March 25th, 78% of NYC residents of all ages are considered fully vaccinated, not considering booster doses or additional doses for those who are immunocompromised. In addition, more than half of children from the ages of 5 to 17 in NYC are fully vaccinated. Data from the official website of the City of New York indicates that unvaccinated New Yorkers are more likely to test positive, be hospitalized, and die from COVID in comparison to those who are vaccinated. This was shown to be especially true at the beginning of the year with the rapid spread of the Omicron variant. The goal is to keep the percentage of vaccinated New Yorkers increasing, and we can achieve this by vaccinating our children.

Parents have a right to be concerned, as protecting one’s children is always a parent’s first priority. However, parents must be careful when it comes to resisting vaccine mandates. A lot of vaccine misinformation has been seeping its way into public policy. In states such as Idaho, Montana, and Florida, politicians are calling into review current vaccine mandates – even against vaccines for polio and measles. While this may seem harmless at first, there is a growing concern that defiance against the COVID-19 vaccine can open the door to eliminating all vaccine requirements, leading to new outbreaks of diseases that have long been eradicated. This should alarm parents, as many vaccines available now are meant to prevent diseases that can be fatal in childhood.

In On Immunity: An Inoculation, author Eula Biss describes vaccinations as a “kind of banking of immunity.”[1] While we may not think we are at risk of contracting a disease, we make the effort to get vaccinated to protect “those who cannot or will not be protected by their own immunity.”[2] With school vaccine mandates on the rise in New York, parents may feel that their autonomy is being threatened and that they could potentially be putting their child at risk. Despite this, when parents choose to vaccinate their children, not only are they protecting their own children, but they are also protecting the children of others. If there is one thing we can learn from this pandemic, it is that we are not entirely out of the woods yet.

Notes

  1. Eula Biss, On Immunity: An Inoculation (Minneapolis: Graywolf Press, 2014), 19.
  2. Biss, 19.

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