A pediatrician with Northwestern Medicine said fully vaccinating youth is key to ensuring a level of herd immunity is reached, which in turn will enable a faster return to pre-pandemic lifestyles.
On Monday, the U.S. Food and Drug Administration authorized the emergency use of the Pfizer-BioNTech COVID-19 vaccine in children as young as 12, and the Centers for Disease Control and Prevention followed suit on Wednesday. Previously, the vaccine only has been available for those 16 and older, while the other two vaccine distributors whose vaccines are authorized for use in the U.S., Johnson & Johnson and Moderna, limit vaccine use to those 18 and older.
What parents should know: A Q&A with Northwestern Medicine pediatrician
Dr. Mayuri Morker, a pediatrician at RMG Primary Care at 8150 Gateway Drive in Sycamore and at Northwestern Medicine Kishwaukee Hospital’s pediatric nursery, said her patients and their parents already have been expressing a lot of interest in the vaccine.
“We have a discussion on a daily basis when I have patients over 16,” Morker said. “And then I’ve had school-age parents who are definitely interested in it and want their child to be able to return to school without restrictions because they’re seeing the impact these restrictions have had on their development. So anything they can do to help get back to normal, they’re interested in.”
She said Northwestern Medicine currently is not equipped to act as a clinic-provider for the Pfizer vaccine for those 12 and older since the vaccine requires significant cold storage.
“When the state passes out these vaccines, they have these vaccination sites that are able to accommodate that. There is talk that we may have, through our convenient immediate care, a drive-thru process,” Morker said. “But right now, they’re just saying anywhere you can get vaccinated, you should.”
Morker said she realizes the idea of a mandatory vaccine for school-age children to return to full-time school is controversial. However, many schools already require a number of immunizations within the first five years of a child’s life.
“Kindergarten is one of our first entry to school points, so K-vaccines are an accumulation of vaccines that you’ve gotten in first five years of your life. They start at 2 months; you get your last booster sets at kindergarten.”
Early childhood vaccinations include those for illnesses such as diphtheria, tetanus, polio, hepatitis B, pneumococcus, influenza, measles, mumps, rubella, chickenpox. Those are required for school entry, Morker said. Sixth graders then need a meningitis and another tetanus shot, she said, and then they need a second meningitis shot during their senior year of high school.
“Those are the required vaccines into the school system, and we have been giving these for years and years and know the efficacy for it, safety of it,” Morker said. “Unfortunately, as we see the anti-vaxxer population growing, having that belief in science, confidence in how the vaccines work and how effective they are really helps the community stay safe. It protects the population that’s vulnerable. There are some adults who can’t get vaccinated. So taking it lightly is not the approach. Realizing how the vaccines work and the important purpose it serves and keeping the community [safe] is the message.”
Daily Chronicle: What does opening up the COVID-19 vaccine to a younger age group mean for the pandemic’s trajectory?
Mayuri Morker: “Just being able to vaccinate more of the population is the biggest advantage. Everyone keeps talking about herd immunity. Upward of 85% of the population needs to be vaccinated for us to get to some sort of normalcy that we were used to before. Getting to that in the adult population, which is at higher risk of complications, is obviously a big achievement. The pediatric population also makes up a great amount of our population, and so to be able to start vaccinating some components of that, the more we can vaccinate, the better can get to those normal times.”
DC: What would you say to a parent or teenager who’s wary about getting the vaccine?
MM: “We’ve been giving them since December. We have that data piling up telling us the safety of the vaccine and effectiveness of the vaccine. The take-home point is going to reputable sources for your information and getting that information accurately so you can make the decision. Each parent, those are your children and you make what you think is the best decision for them. But also, in young teenage populations, they also understand that it’s about their body, so involving them in that decision is also important. Socialization is important to them, so we can see they want to get two doses.”
DC: Are there any components to this COVID-19 vaccine for those 12 and older that are different from the vaccine currently being offered to adults?
MM: “They will give the same vaccine. They [clinical trial researchers] just had to make sure the same dose would be effective, that this younger population wouldn’t have more severe or different side effects. Most [vaccines] that we give are the same throughout [different age groups]. Even with the flu vaccine, they used to have a baby dose, they used to call it. It was smaller for younger kids, and in the last couple years that has gone away and everyone gets the same dose. The components and the actual allergens inside remain the same.”
DC: What are some challenges, if any, you foresee in getting vaccinations into the arms of our younger population?
MM: “The biggest thing is that communication, availability of information. No one is denying that [side effects] won’t happen. It’s a vaccine. It’s supposed to help your body build immunity so you will see some minimal side effects. When you put it into the pediatric or young teenage population, the similar concept is that we’re hoping we can convey the safety of the vaccine and also seeing the effectiveness of it. It’s preventing you from getting to that part where you need to be hospitalized and getting you to that low transmissibility after you’re fully vaccinated so you’re not passing it to somebody who either couldn’t get vaccinated or is a higher-risk person in your life. So I think having that information available and confidence that we are providing a safe product. There’s data out there. Hundreds of millions of people, adults over 16, have gotten the vaccine. We’ve done studies on the 12- to 15-year age range. Just because it [the vaccine being developed] happened so fast doesn’t mean that steps have been skipped or people overlooked something. That confidence in science is one of the biggest things we can promote.”
DC: In the clinical trials, did children and teenagers report side effects, such as those reported in some adults, after receiving the vaccine? Is it still a two-dose vaccine for those younger than 16?
MM: “Yes. It’s pretty similar with arm soreness, fatigue, if you had COVID-19 before, you may have more symptoms.”
DC: Now that the vaccine has been available in adults for months, are you seeing COVID-19 community spread in young people who haven’t yet been able to get the vaccine?
MM: “Yes. The good thing is we are not seeing patients being admitted to the ICU or needing much hospitalization, which has been the case for us [pediatric doctors] throughout the pandemic. These kids are not severely ill, but most of them are needing clearance for school or group settings, so flu-like symptoms needing clearance. In testing done, we’ve seen a higher number of positives in our pediatric population. So we want to be assured that when they’re in a group setting, they’re doing everything. It’s always been a concern, a child taking [the virus] home to somebody who can be at higher risk – a parent, grandparent, teacher, where severe illness occurs in those adults. So we are seeing the schools are being vigilant about anybody that has any symptoms that they need clearance. Hopefully that’s what the vaccine will decrease for us, not having to miss school or need a COVID-19 test for every symptom without constantly being pulled out and needing to quarantine.
“For teenage sports and other group events, this will be big things because those will be controlled. If vaccination rates are high, we can more confidently move forward.”
DC: Do you believe the COVID-19 vaccine should be required for school-age children?
MM: “I think the mandatory part is always under discussion and a controversial subject. Speaking for myself, anything that we know can help cut down transmission and severity of symptoms can be beneficial to us returning to normal, and I think this vaccine can provide that. We can get back to school as we know it, activities, without limitations of 3 or 6 feet apart, wearing masks. I think for us to start incorporating that back, we need the vaccine.”