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Answering listeners' questions about COVID vaccines for young children

AILSA CHANG, HOST:

Many parents like Cassandra Schwartz (ph) have been waiting with bated breath for the COVID vaccine to become available to their very young children.

CASSANDRA SCHWARTZ: My baby's been in a grocery store one time in her entire life. We don't go anywhere that's inside with her, you know, that's not, like, a friend's house that we fully vetted or her day care.

CHANG: Now that children from 6 months to 5 years old are eligible for the vaccine, many are breathing a sigh of relief. But that doesn't mean everyone is. The most recent Kaiser Family Foundation poll found that only about 1 in 5 parents will vaccinate their toddlers right away. Plenty of people still have questions about the vaccines. And here to answer some of them are NPR health correspondent Rob Stein and Dr. Nia Heard-Garris. She's a pediatrician and researcher at Feinberg School of Medicine at Northwestern University and at the Ann & Robert H. Lurie Children's Hospital of Chicago. Welcome to both of you.

ROB STEIN, BYLINE: Nice to be here.

NIA HEARD-GARRIS: Thanks for having us.

CHANG: Well, thanks for being here. Rob, I want to start with an update on the whole campaign to vaccinate this very last group to become eligible. We're talking about kids younger than age 5. How are things going so far in that campaign?

STEIN: Well, you know, the federal government hasn't released any hard numbers yet about how many kids have gotten the shots. But the early indication so far is that the demand for the shots for these littlest ones is living up to expectations, which, frankly, were very low. That's because most parents of kids ages 5 to 11 still haven't gotten their kids vaccinated, even though they've been eligible for months. And the parents of the younger kids are even more reluctant. The pace at which states started off ordering the vaccine was pretty lackluster. So the Biden administration has been warning that it will take a while to convince most parents to get their shots for their little kids.

CHANG: What about this whole choice between Pfizer versus Moderna for really young kids? Is there a preference that you have?

HEARD-GARRIS: This question keeps coming up for a lot of my patients. We really think that the Pfizer and Moderna have equal efficacy, meaning that they are both are effective and they're both going to keep your kids safe against COVID, you know, or at least prevent them from being in the hospital and getting really, really sick. So, bottom line, just go get whatever you can. They're both safe and effective.

CHANG: I'm going to start now with Amanda Gray from Bangor, Maine. She writes, quote, "I feel like I have been waiting two-plus years for this news that I could finally get my daughter vaccinated. And here I am thinking maybe it's best to wait. The current COVID strain is not as fatal, especially in young children. Do I wait to vaccinate till right before back to school? Should I wait until a more aggressive and lethal strain circulates, perhaps this winter?" OK. Dr. Heard-Garris, what do you say to Amanda Gray?

HEARD-GARRIS: I say, Amanda, I hear you. I get it. You're not alone. But I want to let you know, you know, omicron may appear less virulent because there's a fair number of people that have already been exposed to COVID. So it actually offers some protection to the rest of us. And so that's why it seems less virulent. But for a child that has not been exposed or vaccinated to COVID, they still face the same risk of mortality, and they still face the same risk of hospitalization. So I would say, Amanda, don't wait. Go get your kid vaccinated. We've been waiting for two years. Go out. Do it.

CHANG: Next step is Felix Ortiz from Canton, Ohio.

FELIX ORTIZ: Why is it taking long for some of the local health departments, as well as children's hospitals, to be able to get the right doses? I have contacted both of mine here, and I've been told that it might be until early July before they're able to get the right doses.

CHANG: OK. So for the parents who want to just go and get their kids vaccinated, they can't. Rob, can you answer this question from Felix Ortiz?

STEIN: One reason I've been hearing is the way they've been packaged, believe it or not. They come in 10-dose vials that have to be used within 12 hours. And many doctors are apparently hesitant to order the vaccines because they don't have 10 kids to vaccinate every time they puncture a vial, and they're afraid they'll end up wasting a lot of vaccine. I talked about this with Claire Hannan. She's the executive director of the Association of Immunization Managers.

CLAIRE HANNAN: It's OK to waste vaccine. They need to worry more about wasting an opportunity to vaccinate than to worry about wasting the nine remaining doses in the vial.

STEIN: You know, that's because there's plenty of vaccine available. And even though COVID-19 doesn't necessarily pose as great a risk to kids as it does to older people, it still can be quite dangerous.

CHANG: OK. Let's now move on to a question from Allison Cloyd from Arvada, Colo. She writes, quote, "with the efficacy of Moderna being so much lower for the under-5 crowd and Pfizer having a very small sample size, is it worth having my 3-year-old vaccinated if she tested positive for COVID in February? How does that calculus change knowing we have a 10-week-old baby who can't be vaccinated yet but is breastfed - parentheses, I'm triple vaxxed - and was still in utero when I had COVID at that same time?" Dr. Heard-Garris, there's a lot to unpack here, but maybe you can give some advice to Allison here.

HEARD-GARRIS: You know, I think it's a good question, especially since, you know, her child, Allison's child, was actually positive for COVID-19 in February. And even though she had it in February, her immunity is starting to wane. So we say about, you know, 30 to 90 days after getting COVID-19 infection is an ideal time. It's still safe. You can immediately get your COVID-19 vaccination right after. But if you want to wait some time, you know, 30 to 90 days is still the safe window. She's well beyond that now. So I think it's time, especially because she has a vulnerable 10-week-old at home.

CHANG: All right. And our final listener question is from Vadnais Heights, Minn.

HOPE SAVARIA: Hello. My name is Hope Savaria. My question is, what sorts of side effects should we expect for the 24 hours or so after the vaccine? Will it be similar to those seen in adults, mild flu-like symptoms? And is there anything we can do to help mitigate these effects, such as administering children's Tylenol or ibuprofen before the vaccine?

CHANG: I remember I had a really swollen left armpit. What do you think, Dr. Heard-Garris? What kind of symptoms will we see in these young kids?

HEARD-GARRIS: So sometimes kids will have fever. They'll have some pain at the site and redness and swelling at that injection site. And that's really similar to some of the other vaccines that we typically give. They also might be irritable. They might be fussy. They might be a little bit more sleepy or not want to eat as much as they normally eat. All, again, pretty, pretty common. But specifically with the COVID-19 vaccines, they might have some swelling. So just like you, Ailsa had some swelling under your arms and others might have swelling in their groin (ph) area. And that's just where their lymph nodes are. So the lymph nodes kind of get bigger and swollen. It's a sign that your body's responding. So that lymph node swelling is a little bit more common in older kids, we've seen, and adults, but your small child might develop it, too. So it's important to be aware of that. And I would say these symptoms show up 1 to 3 days kind of after they've gotten their shot. So if it's weeks and weeks later, I would advise parents to see their pediatrician.

And then the other question, you know, about Tylenol and ibuprofen - and there's a lot of controversy about this. I don't think in the scientific world we really know if you give Tylenol and ibuprofen before you give the vaccine, if that will actually lessen your body's response to the vaccine. So I would say to wait until your child develops any symptoms. So if they have fever or if they're not feeling well, then go ahead and give the Tylenol and ibuprofen. But let the vaccine do what it does best before you give those medicines.

CHANG: That was Dr. Nia Heard-Garris, a pediatrician and researcher at Feinberg School of Medicine at Northwestern University and at the Ann & Robert H. Lurie Children's Hospital of Chicago. And she was joined by NPR health correspondent Rob Stein. Thank you to both of you.

STEIN: Sure, nice to be here. Thanks for having me.

HEARD-GARRIS: Thanks for having me. Transcript provided by NPR, Copyright NPR.

Rob Stein is a correspondent and senior editor on NPR's science desk.