(CNN) — An advisory committee to the U.S. Food and Drug Administration (FDA) recommended Tuesday that the agency grant emergency use authorization for Pfizer-BioNTech’s covid-19 vaccine to children from 5 to 11 years old.
The FDA will then decide whether to authorize the vaccine, and then the Vaccine Advisory Committee of the Centers for Disease Control and Prevention (CDC) will meet to consider whether it should be recommended for that age group. . If CDC director Dr. Rochelle Walensky agrees with that recommendation, younger children could be vaccinated next week.
Many parents and children have questions about what it means to receive this vaccine. Do vaccinated children have to keep masking themselves in schools? Can you see more friends and have sleepovers now? And do young children really get that sick from covid-19?
I have discussed these and other issues with Dr. Leana Wen, CNN medical analyst, emergency room physician, and professor of health policy and management at the George Washington University Milken Institute School of Public Health. She is also the author of a new book, “Lifelines: A Physician’s Journey in the Fight for Public Health“, and mother of two young children.
CNN: What do we know about the efficacy of the covid-19 vaccine for children ages 5 to 11?
Dra. Leana WenAccording to data reviewed by the Food and Drug Administration, the covid-19 vaccine is more than 90% effective against symptomatic disease for children in this younger age group. That’s very good, and it gives parents a lot of assurance that their youngest children will have an excellent layer of protection once the vaccine is licensed and they can be vaccinated.
CNN: Does that mean that once children are vaccinated, they can stop wearing masks in schools?
Wen: The CDC has said that children should continue to wear masks in schools, even after being vaccinated. I think it is a position that needs to be modified over time, depending on local circumstances.
We can think of all protective measures as layers, just as one wears layers when it’s cold outside. The colder it gets, the more you have to wear to stay warm. Some layers are better than others.
If there are many viruses in the community, the risk is high and we need many layers of protection. If the virus level is low, we need fewer layers. The vaccine is the best layer we have, so once younger children are vaccinated, it would be reasonable to discuss what other layers it can substitute for. In areas with low community transmission, and especially if there are other layers such as evidence, it might be reasonable to reconsider masking. This is especially true if all children in a class are known to be vaccinated.
That said, it will take time for children to get vaccinated. There are also many parts of the country that have high community transmission. I would not expect face masks to suddenly disappear once vaccines for younger children are available. Some schools no longer require masks and, of course, just because masks are not required does not mean that children have to remove them.
CNN: What about other social activities? Can younger vaccinated children participate in more activities, such as going to bed outside the home or going to the movies?
Wen: That depends on the parents and the family’s level of risk tolerance. Many families do not allow young children to participate in high-risk activities because they are not yet vaccinated. Once children are fully vaccinated, many parents may decide to return to certain activities. Remember that full vaccination requires two doses, and wait until two weeks after the second dose.
Parents may have withdrawn their children from basketball or soccer because these sports practices are held indoors. Once children are vaccinated, they may decide that the risk of exposure is now much lower and therefore worth the benefit to the child.
If the child is vaccinated and goes to a sleepover with other vaccinated children, the risk would also be much lower now than before the children were vaccinated.
In fact, after vaccination, all activities – even going to the movies – will be much safer. Parents should assess the medical risks in their home and have a conversation with their children about what each of them can do once they are vaccinated.
A family with infants or children 4 years of age or younger, or living with an immunosuppressed elderly relative, may decide to continue taking precautions, such as avoiding closed, crowded places with people of unknown vaccination status. On the other hand, a family that is already fully vaccinated and generally healthy may choose to recover many of the pre-pandemic activities.
CNN: Is the vaccine safe for children ages 5 to 11? What kinds of side effects should you expect?
Wen: In a study of more than 2,000 children between the ages of 5 and 11, the vaccine was found to be safe, with the same types of side effects seen in adults. These side effects include arm pain, redness at the injection site, fatigue, fever, chills, and headache. They are generally worse within 24 hours of the vaccine, and disappear within a few days.
Importantly, there were no cases of myocarditis, or inflammation of the heart muscle, in the study. However, myocarditis is rare and may not be seen in a study of this size. It is possible that, as more children are vaccinated, some cases of myocarditis will be detected, as this inflammatory disease has been linked to the Pfizer vaccine, mainly among young men under 30 years of age.
It is crucial to note that myocarditis also occurs with COVID-19, and the potential risk of myocarditis associated with the vaccine has to be weighed against the benefit of the vaccine in preventing a whole host of problems associated with the disease.
CNN: What about the long-term side effects of the vaccine?
Wen: Covid-19 vaccines have been administered to hundreds of millions of people around the world since December. Side effects are seen in the first weeks of administration, not months after. We also have experience with many other childhood vaccines, which follow the same pattern. Therefore, there is no scientific or physiological reason to believe that vaccines can cause long-term side effects. On the other hand, we know that the coronavirus itself does cause long-term problems, even in children.
CNN: What about children ages 5 to 11 living with younger siblings who cannot yet get vaccinated? How should they continue to manage risk?
Wen: Parents must make a decision about the level of risk they are willing to tolerate. Many could continue to take extra precautions. But knowing that their vaccinated children are better protected, they might decide to allow some extracurricular activities and some indoor activities to return, especially if their vaccinated children associate only with others who are also fully vaccinated.
CNN: What would you say to parents who are still hesitant to vaccinate their children?
Wen: I get it. All parents want the best for our children.
I think it is important to note that children can and do get sick from covid-19. According to data presented at the FDA meeting on October 26, there have been 1.8 million cases of Covid-19 in the age group 5 to 11 years. More than 8,000 children in this age group have been hospitalized and, tragically, 143 have died. Although many have had underlying conditions, about a third of those seriously ill children were generally healthy.
Everything we do for our children is to weigh the risks and the benefits. The known risks of COVID-19 must be considered alongside the benefits of vaccines. In my family, we are looking forward to vaccinating our young children when authorized, so that we can resume many activities that we have put on hold out of concern for our children. For many other families, it will be a great relief when their children can be vaccinated and receive this excellent level of protection against a life-threatening illness.
If you’re unsure, it’s always a good idea to talk to your pediatrician, and in the meantime, let’s make sure all adults and older children who are eligible to be vaccinated do too.
George is Digismak’s reported cum editor with 13 years of experience in Journalism