Why We Recommend COVID Vaccination

WHY WE RECOMMEND COVID-19 VACCINATION

COVID vaccination is a critical tool to protect against COVID-19.

• The CDC COVID vaccination schedule includes 3 vaccines that are currently authorized for children.
  • Pfizer and Moderna (mRNA vaccines) are authorized for 6 mo and older; Novavax for 12 yo+.
    • AAP Pediatric COVID-19 Vaccine Dosing Quick Reference Guide
• Updated bivalent mRNA vaccines protect against the original virus and two Omicron variants.
  • The FDA discontinued authorization of monovalent mRNA vaccines on 4/18/23.
  • The top 5 Omicron variants account for 95% of the current cases in the US.
  • Optimal 4-6 month (minimum 2 month) interval after last COVID infection or vaccine.
  • The dates when updated bivalent vaccines became available vary by age group.
• Staying up to date with your vaccine is the safer & more dependable way to build immunity.
• COVID vaccines don’t cause infertility, pregnancy, lactation or significant menstrual problems.
• FDA authorized COVID vaccines are effective against severe disease, hospitalization, and death.
  • MIS-C: 1 vaccine dose reduces the risk from 200 per million to 1 per million COVID cases.
  • Hospitalization: Unvaccinated 5-11 yo 2x, 12-17 yo 1.6x, & 18-49 yo 4x higher risk.
  • Death: Unvaccinated 5 yo+ 10x higher risk & 12 yo+ 20x higher risk.

COVID-19 infection risks

• > 1.1 million U.S. COVID-19 deaths and > 234,000 U.S. children have lost a primary caregiver.
• 1,596 pediatric COVID deaths through 4/26/23: 46% 0-4 yo; 30% 5-14 yo; 24% 15-17 yo.
  • From 8/1/21 through 7/31/22, COVID was first the leading cause of pediatric infectious mortality.
  • In the < 5 yo age group: more deaths/year from COVID-19 than from pre-COVID pandemic flu; 24% of hospitalized admitted to ICU; 63% of hospitalized had no underlying medical condition.
• 5.5 million reported pediatric COVID cases; most are mild, some develop significant health problems:
  • MIS-C (9,445 cases) is serious complication starting 2 to 6 weeks after COVID infection.
  • Long COVID in children ( > 56 days) is more common (~2%) than MIS-C (0.03%).
  • COVID infection may increase the risk of newly diagnosed diabetes in children and adults.

COVID-19 vaccination risks

• COVID vaccines are monitored by the most intense safety monitoring efforts in U.S. history.
• Severe adverse events such as anaphylaxis are rare; anaphylaxis to amoxicillin is at least 40x more likely.
• Common side effects are typically mild, temporary and similar to those associated with other vaccines:
  • 6 mo to 3 yo: injection site pain, sleepiness, poor appetite, fussiness, lymph node swelling.
  • 4 to 17 yo: injection site pain/swelling/redness, fatigue, headache, chills, lymph node swelling.
• COVID vaccine-associated myocarditis is typically mild and self-limited.
  • Vaccine-associated myocarditis risk factors: 2nd dose; male > female; 12-29 yo; Moderna > Pfizer.
  • 12-17 yo boys are up to 6x more likely to develop myocarditis from COVID infection.
  • CDC suggests that an 8 week interval between dose #1 and dose #2 in the primary series may increase protection and further minimize the rare risk of endocarditis.

Last updated on May 7, 2023