For parents who are contemplating whether their child should receive a COVID-19 vaccine, Dr. Joseph Fraiman, an emergency medicine physician, says they should ask the following two questions to help them decide.
Experts say that children are at much lower risk of severe disease and death from COVID-19 compared to other age groups.
“The majority of studies haven’t been able to find a single healthy child who’s died from COVID. The studies that say they have found them, they can’t confirm that they were healthy children,” Fraiman said.
Fraiman, who is also a clinical scientist focused on analyzing the methodology and interpreting the risk/benefit analysis of clinical studies, was one of the health experts invited to speak at the event.
For children with underlying health conditions that may make them at risk for COVID-19, Fraiman says, “that’s a discussion with your pediatrician.”
“But if you have a healthy child, the chances of that child dying are incredibly low, essentially close to zero, if not actually zero,” Fraiman said.
The second question that parents should ask is what are the adverse effects from infection versus the vaccine for healthy children, according to Fraiman.
As COVID-19 overall is very mild for most children, it’s important to ensure that the benefits of the vaccines outweigh the harms.
While many children experience mild to no symptoms with COVID-19, some do experience symptoms of long COVID or multisystem inflammatory syndrome in children (MIS-C) several weeks after infection. But that is very rare.
Doctors say that MIS-C—which can cause different body parts to be inflamed—is treatable with many children making a full recovery, including those with long COVID.
“Our findings suggest that MIS-C after COVID-19 vaccination is rare,” the authors concluded. “Continued reporting of potential cases and surveillance for MIS-C illnesses after COVID-19 vaccination is warranted.”
Myocarditis and pericarditis, or inflammation of the heart or the lining around it, have also been found in both infection with COVID-19 and after injection with a messenger RNA (mRNA) vaccine.
Martin Kulldorf, a former professor of medicine at Harvard Medical School, said that it is “unethical to mandate” the vaccines for children with the risks of myocarditis and other adverse reactions that may surface in the future.
“We know that there’s a risk of myocarditis, especially for young boys and young men, but also for girls. There might be other adverse reactions that we don’t know about yet ... and we don’t know what the risk-benefit ratio is. I think, under those circumstances, it’s unethical to mandate vaccinations for children,” Kulldorf said.
He added, “But for children who haven’t had COVID, the question was, we don’t know to what extent it helps against death and serious disease,” Kulldorf said. “Right now in the U.S., the Omicron wave is going down. Right now I think the benefits of vaccinating children are very small.”
Dr. Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia, said that children should receive the COVID-19 vaccine even though they are “less likely to be severely infected.”
But data from New York state showed that the Pfizer COVID-19 vaccine’s effectiveness against infection declined rapidly in children 5 to 11 years old. Protection against hospitalization also declined but was not as steep as in preventing infection.
Dr. Robert Malone, a pioneer of mRNA vaccine technology, says there is no reason to vaccinate children.
“There is no justification for mandating vaccines for children, full stop,” Malone said. “We’re of the strong opinion that if there is risk, there must be choice. This is fundamental medical bioethics 101.”
Malone and Kulldorf were also part of the panelists at the roundtable.