Answers to all your questions about the COVID-19 vaccine and kids
Answers to all your questions about the COVID-19 vaccine and kids Image Credit: Shutterstock

With more than 78% of the eligible UAE population now vaccinated, the majority of parents in the country will have already had at least their first shot of the COVID-19 vaccine.

But many parents still have questions about giving the vaccine to their children.

Now that the UAE has approved the COVID-19 vaccine for use on children aged 12-15 years and upwards, here are some of parents’ most common questions about kids and the COVID-19 vaccine.

Which vaccines have been authorized for use on children in the UAE?

On May 23 2021 the Dubai Health Authority announced its approval of emergency use of the Pfizer-BioNTech COVID-19 for adolescents between the ages of 12-15 years. “Approval was given after strict assessment of the outcomes of clinical trials, which assured that the vaccine was safe and 100% effective in this age group,” says Dr Rouba Manachi, specialist paediatrician at Prime Hospital in Dubai.

Clinical trials in the US tested the Pfizer-BioNTech vaccine on more than 2,000 children, and found that it produced a stronger immune response in them than it had in adults. None of the children who got the vaccine became infected with COVID-19, while 18 children in the placebo group did, indicating that it is very effective for this age group. Side effects seemed to be similar to those seen in 16-25 year olds, with fevers found to be slightly more common in 12-15 year olds.

When will children younger than 12 be eligible for the vaccine?

Vaccine studies for younger children are ongoing, with results possible by early Autumn, says Dr Michael Atteya, Specialist Paediatrician, Medcare Medical Centre in Rashidiya. “Right now,

-Pfizer is undertaking clinical trials in healthy children ages 6 months to 11 years. Children are being studied in three age groups: 6 months to 2 years, 2 to 5 years, and 5 to 12 years. Moderna is also undertaking a clinical trial for children ages 6 months to 11 years. Johnson & Johnson and Novavax are continuing trials in adolescents between 12 and 17. The results from the trials in young children are expected to be available in the latter part of the year.”

Pfizer announced in May that it plans to seek emergency authorization from the US Food and Drugs Administration (FDA) in September 2021 to administer its vaccine to children between the ages of 2 and 11, but it will be up to the UAE authorities to judge whether and when approval for its use in younger children is given in the UAE.

Why does it take longer to approve the vaccine for children under 12?

It takes longer to approve vaccines for younger kids because they require “dose escalation studies,” says Dr Atteya. “The trials need to identify the right dose suitable for children. In addition, they have to have consent from their parents before the children participate.”

Dr Rouba expands: “If the vaccine is intended for children, researchers will first test adults, as the process is faster, and then trials will include children,” she explains. “These trials will take a longer time as children`s immune systems are different than adults, and kids at varying age will likely respond differently. Also children cannot make proper decisions alone and both parents typically have to agree to participate in the trials. Because of the challenges with kid`s immune systems and the protection and safety protocols in clinical trials, a COVID-19 vaccine approval for children in different age groups takes time.”

Dr Rouba Manachi, specialist paediatrician at Prime Hospital
Dr Rouba Manachi, specialist paediatrician at Prime Hospital Image Credit: Supplied

How do the vaccines work exactly? Has this type of vaccine technology been used on children before?

The vaccine technology use by the Pfizer-BioNTech vaccine is new and has not been used before, says Dr Rouba. “It works by giving cells genetic material - messenger RNA, or mRNA - that guides them how to make a piece of the virus: the spike protein. The immune system then creates antibodies against it and can remember how to trigger an immune system response if exposed to the virus in the future.”

Vaccines traditionally contain either weakened viruses or a purified protein of the virus, adds Dr Atteya: “But this mRNA vaccine is different because the person receives genetic material – mRNA - that encodes the viral protein. When it’s injected in the body’s muscle cells, the cells translate them to make the viral protein directly in the body. This gives the immune system a preview of what the real virus looks like without causing the disease. This approach mimics what the SARS-CoV-2 does in nature.”

Is the amount of vaccine given to children different to that of adults?

The ingredients and dosing of this vaccine are the same for all currently approved age groups: two doses of 30mg each, given three weeks apart. “Children between 12-15 years old will get the same dose of the Pfizer COVID-19 vaccine as adults, and they should receive two doses 3 weeks apart,” says Dr Rouba.

Can a child who’s recently had other vaccinations get the COVID jab?

Dr Rouba explains that “Both the US Centers for Disease Control and Prevention (CDC) and American Academy of Pediatrics confirmed that the COVID vaccine can be administered on the same day as other routine vaccinations, such as for measles, Diphtheria and HPV, as well as co-administration within 14 days.” Although the CDC originally advised waiting 14 days between having a COVID-19 vaccine and receiving any other routine immunization, this was a precautionary measure and its guidance has since been updated. Always be sure to check with your family doctor first if you are unsure.

Are side effects of the vaccine any different for children than adults?

Adolescents in Pfizer's trials seemed to develop the same side effects as adults, but more frequently, says Dr Rouba. “Pain at the injection site was the most common reaction. Fever, fatigue, headache, muscle pain and were more common after the second dose. Side effects are usually mild and should only last 1-2 days. Cases of severe allergic reactions, or anaphylaxis, to the Pfizer/BioNTech vaccine are very rare.”

Younger people tend to have a more powerful immune response than older people because their immune system is stronger, which can lead to children experiencing more noticeable side effects than their parents.

Both adults and children can have mild side effects that typically last 1 to 3 days and might include:

  • Pain at site of injection
  • Fatigue
  • Headache
  • Chills
  • Muscle pain
  • Fever
  • Joint pain
Dr Michael Atteya – Specialist Paediatrician, Medcare Medical Centre – Rashidiya
Dr Michael Atteya – Specialist Paediatrician, Medcare Medical Centre – Rashidiya Image Credit: Supplied

Can a child with allergies get the vaccine?

The vaccine does not contain eggs, preservatives or latex, and Dr Rouba says that any child with an allergy or risk of anaphylaxis to food, insect venom, oral medications, latex or environmental allergens is eligible to receive the Pfizer/BioNTech vaccine.

However, a child should NOT get the Pfizer/BioNTech COVID-19 vaccine if there is:

  • A history of anaphylaxis to any ingredient of the Pfizer/BioNTech vaccine
  • A history of non-severe immediate allergic reactions to any ingredient of the vaccine
  • An allergy to polyethylene glycol (PEG). PEG is a component in the vaccine
  • If they had a severe allergic reaction to a first dose of the vaccine

Should you give kids pain medication to prevent vaccine side effects?

No, this is not advised because there are some concerns that giving a child pain medication prior to receiving the vaccine could interfere with or even lower its effectiveness. If your child develops local or systemic adverse reaction to the vaccine, he or she can take ibuprofen or paracetamol, as long as you do not exceed the recommended dose.

“But it is not recommended to take these medication before vaccination, because it is not clear how that could affect the vaccine effectiveness,” says Prime Medical’s Dr Rouba.

How much research do we have that the vaccine is safe for children?

Dr Rouba explains: “The study that led to the Pfizer vaccine’s emergency use authorization for children began in March. The study enrolled 2,260 participants ages 12 to 15. Of those children, 1,131 received the vaccine (two shots, given three weeks apart) and 1,129 received saline placebo shots. The vaccine worked even better in children than it does in adults. No children in the vaccine group got sick with Covid-19, while 18 children in the placebo group became ill.

"Also trials testing the Pfizer–BioNTech vaccine in children under 12 began in late March. Moderna began a similar study of its vaccine. Scientists are seeking answers to important questions about how safe and effective the vaccines are in kids.”

Is there any concern that the vaccines may have a different impact on children because they are still growing and developing?

“So far, the COVID-19 vaccine appears to be safe and well tolerated in adolescents and children,” says Prime Medical’s Dr Rouba. “Scientists have only about six months of data on the vaccine in adults and older teens and a few months of data on young children. But given that the vaccine’s mRNA molecule mimics a natural human process, experts say they are confident that the vaccines are safe for growing bodies. One reassuring fact about the mRNA vaccines is that the molecule is destroyed by the cell once it completes its mission, so it doesn’t stay in the body. Ongoing studies will continue to follow vaccinated children closely and robust safety monitoring will help rapidly identify rare or unexpected concerns if they emerge.”

COVID-19 is not thought to pose a great risk to children. Why is it necessary to vaccinate them at all?

“Children rarely develop severe forms of COVID-19, and paediatric deaths from the disease are rarer still,” says Dr Atteya. “But on rare occasions - one estimate puts it at around one case in 1,000 - kids who’ve experienced even mild infections can later develop a sometimes-deadly condition called multi-system inflammatory syndrome in children (MIS-C). So it’s recommended that parents get their kids vaccinated right away as COVID-19 vaccine can prevent the child from getting and spreading the COVID-19 virus, in addition it prevent him or her from being severely ill.”

While children are less likely to develop severe illness from Covid-19, they are still at risk, agrees Dr Rouba. “Nearly four million children in the United States have tested positive for the virus since the start of the pandemic, according to the American Academy of Pediatrics, and more than 300 have died. Some children developed Multisystem Inflammatory Syndrome in Children, or MIS-C, a condition linked to COVID which can affect multiple organs, including the heart. It is crucial to vaccinate majority of population to end the pandemic and reach community immunity – herd immunity- and reduce the mutation frequency.”