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The United States Food and Drug Administration (FDA) recently authorized use of the Pfizer-BioNTech vaccine in adolescents ages 12 and older. What will this mean for children in our region and what information do parents need to know to make informed choices when this becomes available in the Mid-South? Le Bonheur and University of Tennessee Health Science Center Division Chief of Pediatric Infectious Diseases, Dr. Sandy Arnold, answers some of the most common questions we’ve heard from parents in response to this news.

Q: What’s the latest on vaccines for kids?

The current FDA decision opens the Pfizer-BioNTech vaccine for adolescents in the 12-15 age bracket. The Pfizer-BioNTech vaccine is already available for teens 16 and older.

Moderna expects results soon from its own clinical trial involving adolescents in the 12-17 age range.

Q: Is this Pfizer vaccine for 12 and older different from the one adults get?

This vaccine is the same that adults have been receiving for many months now and requires two doses for the best level of protection against COVID-19.

Q: What are the side effects?

During clinical trials, side effects in 12-15 year olds were mild and very similar to those in the 16-25 age range: soreness at the site of injection, fever, body aches and chills that typically only lasted a day or two after getting the vaccine. Just as with adults, it typically takes two weeks after receiving the second dose to build protection (immunity) against COVID-19.

Q: If my child already had coronavirus, should they still get a vaccine?  

For adults, vaccination has been recommended in individuals who have previously had COVID-19. Although reinfection is rare, it can occur and the immunity provided by vaccination is much more potent and long-lasting than that from natural infection. Vaccine immunity also appears to provide better cross protection against coronavirus variants that are present in the U.S. and around the world. While we don’t have specific data on this for children, the FDA will likely recommend vaccination even among those who have been infected previously for the above-mentioned reasons. Some people have chosen to wait 90 days after natural infection to be vaccinated, but it is not harmful to be vaccinated after infection and it can be done at any time after infection.

Q: If my child had multisystem inflammatory syndrome (MIS-C) as a result from COVID, do you recommend they get a vaccine?  

We know that it is safe to receive vaccine after COVID-19 illness. Because MIS-C is a rare condition, this is really unknown at this time. Since it is possible to be reinfected with this coronavirus, preventing reinfection is very important so parents of children who have recovered from MIS-C may choose to vaccinate their children.

Q: Will schools require this vaccine for in-person attendance as they do for many other vaccinations?

That’s something we’re still waiting to see. Many universities are now requiring vaccination for students who are returning to in-person instruction in the Fall. Recommendations for specific vaccines come from the CDC’s Advisory Committee on Immunization Practices or ACIP; however school vaccination requirements come from individual state governments. This is something each state will have to grapple with as vaccine becomes available for younger and younger age groups. It is important to note that schools have not been sources for large outbreaks of COVID-19 so we will have some time to make thoughtful decisions.

Q: Where can 12-18 year olds receive the vaccine?

Once available, children will be able to receive vaccine at the same public sites as adults are currently receiving vaccine. Children will need to be accompanied by a parent or guardian to sign the consent form.

Q: Can we come to Le Bonheur or go to our pediatrician’s office for this vaccine?  

Currently, Pfizer vaccine is shipped in large cartons and requires an ultracold freezer for storage. This makes it difficult for individual offices to stock this vaccine. Physicians’ offices in Shelby County are provided Moderna vaccine right now because of the smaller number of doses per carton and because it can be stored in number of doses per box of vaccine. Moderna vaccine is only approved down to 18 years of age.

Q: Should I call our pediatrician before I make an appointment for my child to receive a vaccine?  

You do not have to let you pediatrician know before you make an appointment for your children 12 years of age and older to receive vaccine. Individuals who receive vaccine have their doses entered into the state vaccine registry so your physician will be able to see if you have received vaccine. You can also share a copy of your child’s COVID-19 vaccine card with your physician the next time you see him or her. However, if you have any questions or concerns, it’s always advisable to call your pediatrician for guidance.

Q: When will children younger than 12 be able to get a vaccine?

Both Pfizer and Moderna have begun trials in children 6 months to 11 years of age. These studies are starting back at Phase I, which is a study to find the optimal dose to produce the needed effect with the least side effects. Because younger children are smaller and their immune systems less mature, it is not known if the current adolescent/adult dose is the right dose, or if different doses are needed within this broad age group. After Phase I, they will then move on to phases II and III where they will test the safety and efficacy. This will take a little longer to have results than the phase III trial in adolescents so we might have to wait until late summer or early fall for enough data to be available for the FDA to review.