Dr. Kenneth Alexander Answers Columbia Mom Reader’s COVID-19 Vaccine Questions

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You asked and got the answers! Columbia Mom readers submitted questions about COVID-19 vaccines for children, and we had the unique opportunity to sit down with Dr. Kenneth Alexander, the Chief of Infectious Diseases at Nemours Children’s Health in Florida to have your questions answered. We know the information provided by Dr. Alexander will help you make the best decision for your family when concerning COVID-19 vaccines, especially as it relates to our children. 

Should unvaccinated children remain masked up even among vaccinated company? So this is a really important question in this day and age. And to begin with, there’s really no doubt that masks work. But the real question is, as the pandemic is changing, do, we still need to have all these kids and all these masks? Well, with an unvaccinated child, of course, they’re not as protected as a vaccinated child. But we are seeing changes in the pandemic COVID numbers are dropping.

So the first thing to do is think about your family. What’s the risk to the child? You have a child who’s got asthma that might have bad COVID? Or are they otherwise healthy? Do I have a family member at home who’s at risk for bad COVID, perhaps an elderly grandparent? And finally, what’s the risk in the community. And here, the CDC has a new program to help us assess the risk of COVID in our community, low, medium, or high.

And then it becomes your decision as a parent. So if the risk in the community is low, you’ve got a healthy kid and don’t have, say elderly grandparents in the house, it’s probably okay to go without a mask. On the other hand, if you’ve got a kid with asthma, you’ve got elderly parents at home, maybe there’s a lot of COVID in the community, maybe it’s time to leave that mask on.

Can we go about normally after young children are fully vaccinated? So, after they’re vaccinated, the world looks a lot better, right. And I’ve even heard parents say, “I just feel so relieved after their child is vaccinated.” But again, the decision process is the same. Only now you’ve done what you can do to protect your child. So if your child is vaccinated, their risk of bad disease is really, really low. If you’re vaccinating everybody at home, you vaccinated everybody around that child. And if you don’t have high-risk people at home, or if you do, and they’re vaccinated, again, everybody’s protected. And if the risk in the community is low, I think you can get on to life just as we like to do it, go to the restaurant, go to the park, go to the movies.

How safe and effective are vaccines for kids? Here, we really have an exciting story. Now, the story still evolving, right? We’ve only had COVID vaccines for a little bit over a year. But so far, what we’re seeing is that these vaccines in every age group have been first of all, very effective, we are keeping people out of the hospital, and very safe. Now for the safety part of it. We continue to monitor this, and we’ll be monitoring for years. That’s what the FDA does. That’s what all different government agencies do, and a lot of private groups. But I can tell you that in America, we have a vaccine safety program that is the envy of the world. And so far COVID vaccines, even for children look to be very safe and effective.

Can children get natural immunity against COVID Instead of what’s provided by the vaccine? Natural immunity is a tricky game. Of course, natural immunity is what you get after you have the infection. The trick with natural immunity is it’s unreliable and expensive compared to vaccines.

Unreliable. What do I mean? Well, it turns out that not everybody gets the same immunity when they get a COVID infection. If you get really bad COVID You actually get a pretty decent immune response. Kids tend to get mild COVID and probably don’t get a very good immune response. And it doesn’t last very long. We’ve known that from other Coronaviruses.

Now, why do I say expensive? Well, the vaccine is free. The disease? Well, you know, I work in a children’s hospital, and I’ve had kids in the hospital really, really sick with COVID. So why would you want to get immunity and risk having your kid in the hospital when you can get a free vaccine and not have to worry about it?

Should we be concerned about COVID vaccine side effects for kids, including the risk of myocarditis? Vaccine side effects are something that happens with every vaccine. I mean, as adults, we all know, you got that tetanus booster, and it gives you a sore arm. When you get that flu shot and you feel kind of yucky for a couple of hours. Well, you got to remember that that’s the sign of your immune system, doing what it’s supposed to do. So, some vaccine side effects are to be expected and are probably even good. Like that low-grade fever.

Now we hear words like myocarditis, and fevers and stuff. And that sounds very scary as a parent. And indeed it is. Nobody wants things like that to happen. But the thing we have to keep in mind there is the risk of myocarditis with the vaccine is way, way, way lower than the risk of myocarditis if you get COVID. So, it turns out that while the vaccines never entirely without risk, it’s a whole heck of a lot safer than getting the disease.

How well are we seeing the 5 to 11 vaccines holding up? And will this group need boosters? So right now, five to 11-year-olds are only approved for two doses, a first dose, and then a second dose. For older people 12 And up, they’re approved for a booster dose. Now let’s talk about how vaccines work for just a second. Because if you think about it, what a vaccine is, it’s kind of like a wanted poster for your immune system. And so if I take a wanted poster, and I show you the picture, once you’ll say, I can recognize that guy, if I show you the picture twice, you go, I could pick that guy out of a lineup. And if I show you the picture three times you go, I could pick that person up out of a crowd. And that’s what the first dose second dose and third dose do is they help your immune system, remember better?

What’s the current position on regular annual COVID vaccines? Will it be similar to the flu shot? Well, remember, we get the flu shot every year because the flu changes, we really don’t know what’s going to happen with COVID. Yet. Now, we do know from decades of research and Coronaviruses that the immune system naturally kind of forgets them. And the fact that you need a booster dose is not a sign that the vaccine doesn’t work. It’s a sign that well that’s kind of what the virus and the immune system do together.

Again, going back to that wanted poster, if you go two or three years without seeing that picture, you kind of forget what the person looks like. So we don’t know yet how frequently we’re going to need boosters, the science is being done. And of course, you and I are waiting to see what the virus does, which is always a complicated part of the story. So this is an important, let’s wait and see.

Should my child be vaccinated even if they already had COVID? So vaccinating children is really important. And as we talked about before, the trick that you and I have here is that wild-type disease can give you some protection, but it’s unreliable. And so we don’t have good evidence to show that it gives you long-term protection. And it looks like vaccine protection is better. And you get protection without having the risk of being sick.

Now let’s just talk about vaccinating our kids for just a second to we vaccinate our children, or we have this discussion, because we love them, right. All parents want to do the right thing. And so what you and I are trying to do is determine what’s the right thing to do because I love my child. And when you come to me as a pediatrician and say, I love my child, should I vaccinate them? My best answer to you is to say I’ve been vaccinated. My wife has been vaccinated. My daughters have been vaccinated. My niece who was pregnant during the bad part of Delta, I got her vaccinated all the people I love are vaccinated. So from my perspective, vaccination is what you do for the people that you love.

We are grateful to speak directly with Dr. Alexander to answer your questions about COVID-19 vaccines for children. 

Watch the video in full here:


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