An immunologist answers parents' Covid vaccine concerns

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An Immunologist Answers Parents' Covid Vaccine Concerns
Professor Ed Lavelle spoke to BreakingNews.ie about Covid vaccines for children and addressed some parents' concerns in the following Q&A.
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James Cox

Parents will soon be invited to register children aged five to 11 for Covid-19 vaccination.

The moves comes after vaccines for children were recommended by the National Immunisation Advisory Committee (Niac), following approval from the European Medicines Agency on November 25th.

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“I would be more than happy to give it to my child or my grandchild in that age group,” said Professor Karina Butler, chair of Niac, following the recommendation.

However, some parents still have concerns around vaccinations for children.

Professor Ed Lavelle, head of the school of biochemistry and immunology at Trinity College Dublin, spoke to BreakingNews.ie about Covid vaccines for children and addressed some of these concerns in the following Q&A.

Is the Covid vaccine safe for Children?

"There's no doubt about it," said Prof Lavelle. "The bigger concern people had earlier on was how many people had been vaccinated in those younger age cohorts, but now that’s changed radically in the last couple of months."

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Prof Lavelle cited figures from the US Centers for Disease Control and Prevention (CDC), which revealed five million children aged between five and 11 in the United States have received Covid vaccines without any severe side effects or illnesses reported.

"There’s five million kids in the United States who have been vaccinated without any red flags, so the safety issues have been dealt with. Efficacy looks good in that age group with a lower dose of vaccine. That would have been one of the concerns parents had a couple of months ago. The clinical trials looked very good already, but now real world data from the States suggests that the vaccine is very safe in young children."

He added: "Clinical trials are done very carefully and are very highly regulated but even if people didn’t feel there were enough patients included in those trials, the most recent figure is five million Americans between five and 11-years-old have been vaccinated without any signals regarding myocarditis or anything like that, so that’s extremely encouraging in terms of safety.

"It looks extremely safe. The dose given of the Pfizer vaccine is one third of the adult dose, and they looked very carefully at some suggested side effects in the US and found almost nothing, that was across five million children, so that’s a huge number of kids vaccinated, that should really put people’s minds at ease. It looks extremely safe."

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Is it safe to get the Covid vaccine along with other vaccines children are given?

"When kids get the six in one or seven in one vaccine there’s a number of different diseases covered by those vaccines. The reason that was done was to reduce the number of vaccines you have to give kids, but those vaccines work extremely effectively even when mixed together in one vial.

"The immune system has a huge capacity to deal with multiple challenges so saying if they’re getting the flu or measles vaccine they shouldn’t get the Covid one is just not true, the immune system has enormous capacity to deal with lots of different challenges either sequentially or at the same time. I don’t any issue there."

Is getting vaccinated necessary when children aren't at a high risk of severe illness?

The short answer to this one is yes, according to Prof Lavelle.

While most children do not develop severe illness after Covid infection, there are many risks including the risk of future health complications, and no guarantees.

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He also pointed out that different variants of the virus could cause more severe illness in children.

"There are new variants popping up all the time, and though we’ve been dealing with the virus for two years it’s a very small amount of time, so there’s still uncertainty regarding what exposure to the virus will do long term.

"Do you vaccinate kids for themselves, to allow their education to continue, do you vaccinate them to prevent them passing it on to susceptible adults, or do you vaccinate them because it might give them a degree of protection against another variant that could pop up that might be more dangerous? All those reasons are important, for all those reasons there’s a very strong validity for being vaccinated.

"Assuming it’s fine to be infected is wrong, you don’t know what will happen in all cases, significant lingering effects of the virus are possible. With variants the virus changes so whether different variants could be more infectious in children, precisely what the symptoms will be in children, we don’t know. Thinking that we’re all completely safe even if we contract Covid is a risky option because the virus is changing all the time and even if these vaccines aren’t perfect in the responses they give to variants such as Omicron, they give a degree of immunity which would prevent severe disease.

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"Taking the risk of saying ‘let’s just get infected’ is not a wise option, you don’t know what the consequences are going to be, it might be fine for a majority of children but for some kids it might not be, for me, it’s too high a risk for parents."

"Waiting for a kid to get infected is not a good strategy, a lot of people who are getting Omicron across the world have already been infected with a different variant so letting kids get sick may mean they will again, and get sicker, the argument of letting people get infected is dead in the water because going through it does not necessarily mean you’re going to protect it the next time around sadly."

Will children have to get a booster vaccine?

Prof Lavelle said it is too early to know if children will need a booster dose, however, he said there is no reason to think it will have anything other than mild side effects as reported in adults, especially given the fact children will receive a lower dosage of vaccine.

"We’ll have to wait for the clinical data, the trials we have now were with two doses, so whether a third dose is necessary we have to wait and see. It’s looking like it probably will be required in younger groups. Depending on the schedule, if they start vaccinating kids early next year if a booster is required that wouldn’t be until closer into the spring/summer. Certainly the data from adults would suggest that the side effects from the third dose aren’t any more significant than what we see after the second dose, so that should be similar in kids, and they’re getting a smaller dose of the vaccine to start with."

With mask-wearing and ventilation in schools, do children still need to be vaccinated?

Again, the short answer to this one is yes.

Prof Lavelle said grants for HEPA filters and other measures are important, but they are just extra layers of protection along with vaccination.

"Vaccines on their own won’t be enough, maintaining other measures such as ventilation, wearing masks and social distancing etc are important, but vaccines are crucial, and the boosters will hopefully have a big impact in terms of curtailing this variant over the next couple of months."

What if one parent is unsure about vaccination?

For children under 15 the consent of the child and one parent is needed for vaccination.

There is no simple answer to scenarios where parents are divided over vaccination, but Prof Lavelle urged people to look up the statistics and use official channels to get information on the safety of vaccines for children.

"Make sure you’re getting your information from official agencies and looking at data from clinical trials, not hearsay from other individuals. The biggest issue we have is keeping the schools open and making sure education is not compromised.

"A few months ago with the small number of children vaccinated parents were understandably cautious, but now there are very large numbers vaccinated in similar countries to us with very good outcomes. People should look at the data themselves, information from the WHO, the EMA, the HSE.

"It’s consistent in showing that a lower dose of the vaccine is extremely safe and very effective in terms of driving strong immune responses."

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