In January 2020, I was performing CPR on a young boy who went into cardiac arrest from complications from the influenza virus. In January 2021, I was carefully monitoring the blood pressure of a teenage girl with inflammation of the heart due to having had a COVID infection.
As a pediatrician in Los Angeles, I have had no shortage of experience caring for children with devastating health consequences from the influenza virus and the COVID-19 virus. Miraculously, we now have the opportunity to vaccinate our children against both viruses, but some parents are still hesitant. Does a healthy child really need to be poked with a needle, especially twice?
When compared to this time last year, the percentage of children who have been vaccinated against flu is about 7% lower. The usual fever, body aches, and cold symptoms can seem nonthreatening. But complications from flu include pneumonia, dehydration, brain dysfunction, and even death. Luckily, the 2020-2021 influenza season was unusually mild, likely because of quarantining and social distancing.
Previous flu seasons have led to hundreds of deaths and thousands of hospitalizations in children. Sadly, the first pediatric influenza death of the season was just recently reported in Mississippi. Among pediatric deaths from flu, about 80% of these children were not fully vaccinated. The American Academy of Pediatrics recommends annual flu shots for all children without medical contraindications, starting at 6 months of age.
The Centers for Disease Control and Prevention (CDC) issued its official recommendation that children age 5 to 11 years be vaccinated against COVID-19 with the Pfizer pediatric vaccine. Nearly six weeks later, less than 20% of U.S. children in this age group had received at least one dose, and the vaccination rate appears to be slowing.
In this age group alone, COVID-19 ranks as one of the top 10 causes of death. Multisystem inflammatory syndrome (MIS-C), a serious post-COVID complication affecting the heart and other organs, has afflicted over 2000 children age 5 to 11.
The most common reason for COVID vaccine hesitancy appears to be concern relating to unknown long-term effects of the vaccine in children. In fact, COVID-19 vaccines have undergone the most intensive safety monitoring in U.S. history. Clinical trials involving thousands of children identified no serious safety concerns. Previous claims linking COVID-19 vaccines to infertility have been scientifically disproven.
The American Academy of Pediatrics recommends COVID-19 vaccination for all children 5 years and older who do not have medical contraindications. Given the variability in immune response after COVID-19 infection, the CDC recommends vaccination for individuals who were previously infected in order to provide a more reliable immune response.
While no adults enjoy inflicting additional “pokes” to children, parents should not limit their child to just one of these immunizations. If the child is eligible, both vaccines can and should be given for the health and safety of the child. The flu shot can be given at the same time as the COVID vaccine, or any time before or after.
There is no evidence that timing of when these two vaccines are given affects the efficacy of either one. Additionally, if a child is currently sick with a mild illness or taking antibiotics, they can still get vaccinated without risk of worsening their illness.
As I often tell parents in my clinic, I understand how difficult it is to see your child in pain from a shot and then feeling poorly as their body mounts its immune response to a vaccine. But you can hold them and soothe them and care for them at home until those mild symptoms resolve, and that is much more than parents can do when their children are in the hospital.
As a doctor I want to keep children out of the hospital. Even during this pandemic, together we can help to keep children safer and at home.
Catherine Thriveni, M.D., completed her residency in Pediatrics at the UCLA David Geffen School of Medicine.
References:
https://www.cdc.gov/flu/fluvaxview/dashboard/vaccination-dashboard.html
https://www.jacksonfreepress.com/news/2021/dec/14/msdh-reports-first-pediatric-flu-death-season/
https://publications.aap.org/pediatrics/article/148/4/e2021053744/183303/Recommendations-for-Prevention-and-Control-of
https://www.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/children-and-covid-19-vaccination-trends/
https://downloads.aap.org/AAP/PDF/Child%20Vaccinations%20Report%20US%20and%20by%20State%20Dec%208%20revised.pdf
https://www.cdc.gov/flu/highrisk/children.htm
https://www.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/covid-19-vaccine-for-children/about-the-covid-19-vaccine-frequently-asked-questions/
https://www.cdc.gov/coronavirus/2019-ncov/vaccines/children-facts.html
https://publications.aap.org/pediatrics/article/doi/10.1542/peds.2021-054332/183385/COVID-19-Vaccines-in-Children-and-Adolescents
https://www.cdc.gov/vaccines/covid-19/clinical-considerations/covid-19-vaccines-us.html
https://publications.aap.org/aapnews/news/15643
https://www.cdc.gov/vaccines/covid-19/clinical-considerations/covid-19-vaccines-us.html#Coadministration
