Should Young Kids Get the COVID Vaccine?

The Biden administration’s attempt at strong-arming businesses into mandating vaccines through ’emergency’ OSHA orders — with a four-month gap between announcement and implementation — is now snarled in legal challenges. That federal action has been quite controversial, with a slim majority now opposing required COVID vaccines, per a recent NBC News poll. The next major battle will be over requiring these shots for kids in schools. In Virginia, Democrat Terry McAuliffe attacked Republican Glenn Youngkin for opposing both vaccine requirements (despite Youngkin being outspokenly pro-vax) and school masking. McAuliffe said he planned on requiring vaccines for Virginia school kids within certain age ranges, and hinted that he was open to broadening out such mandates even further. McAuliffe lost the election. But in places like California, these government requirements have already been preemptively announced. Polling shows that most parents maintain a healthy skepticism about giving COVID vaccine jabs to their young kids:

So far, about half of kids 12 to 17 are fully vaccinated in the U.S., compared with nearly 70% of Americans 18 and older. Pediatricians expect it will be even harder to persuade skeptical parents of younger children to get their kids inoculated. Many are concerned about the potential unknowns of a relatively new vaccine compared with the low risk of serious illness covid poses for children. A recent poll from KFF found 27% of parents of children 5 to 11 said they plan to get them vaccinated “right away,” while 30% said they would “definitely not” get the vaccine for their 5- to 11-year-olds. More than three-quarters of parents of children in this age group reported they were “very” or “somewhat” concerned that not enough is known about the long-term effects of the vaccine in kids.

Less than a third of parents (with kids aged 5-11) say they’re immediately eager to give their child the shots, with more than three-quarters expressing at least some concern about the side effects of doing so.  What does the science say?  Doctors Nicole Saphier and Marty Makary (both of whom are Fox News medical contributors) weigh in on this issue in a new Wall Street Journal op/ed.  Their take is nuanced and avoids dispensing one-size-fits-all advice on this front — even as they’ve both advocated vaccination among adults.  They begin by noting the “extremely low” risk of severe outcomes to children either way, pointing out how vanishingly rare COVID hospitalizations and deaths are within this demographic group:

The Centers for Disease Control and Prevention estimates that 42% of U.S. children 5 to 11 had Covid by June 2021, before the Delta wave—a prevalence that is likely greater than 50% today. Of 28 million children in that age range, 94 have died of Covid since the pandemic began (including deaths before newer treatments), and 562 have been hospitalized with Covid infections. Serious complications are so uncommon in this age range that of 2,186 children in the Pfizer vaccine study, no child in either the vaccine or placebo group developed severe illness from Covid. 

These are crucially important facts, and it would be wildly irresponsible to craft public policy involving children by ignoring them. Focusing on exceptionally rare tragedies — which are undeniably horrific for the families involved — is simply not a sound way to make public health decisions. This mentality would preclude or hugely delay needed off-ramps, setting rationality and data aside, in favor of fear. Obsessing on statistically-insignificant occurrences could justify insane policies like banning children from being passengers in cars, or outlawing swimming pools (more young kids die annually in car crashes and drowning accidents — and in some flu seasons — than from COVID). Overall, these doctors argue, vaccinating children against COVID is safe — with a few caveats:

It’s safe to assume that vaccinating a healthy child would take his extremely low risk of serious disease and drive it down even lower. There’s an important exception, though: If a child already had Covid, there’s no scientific basis for vaccination. Deep within the 80-page Pfizer report is this crucial line: “No cases of COVID-19 were observed in either the vaccine group or the placebo group in participants with evidence of prior SARS-CoV-2 infection.” That’s consistent with the largest population-based study on the topic, which found that natural immunity was 27 times as effective as vaccinated immunity in preventing symptomatic Covid. Natural immunity is likely even more robust in children, given their stronger immune systems. An indiscriminate Covid vaccine mandate may result in unintended harm among children with natural immunity.

As Makary has been saying for months, natural immunity is a major factor.  The doctors also write that some parents should err on the side of vaccinating their young children, with some additional evidence from other countries about what works:

As with adults, pediatric Covid deaths and hospitalizations tend to come among those with comorbidities. If your child has a medical risk factor for Covid illness (including obesity), or lives with someone who does, the vaccine’s benefit outweighs the risk…Vaccine complications in children can be mitigated by spacing out the doses. Complications are clustered after the second dose, and research on older patients shows that a longer interval between doses results in stronger immunity. Another recent study showed that delaying the second vaccine dose in younger adults not only resulted in stronger immunity but it also decreased the mild side effects following the second dose. Moreover, one Israeli study found that a single Pfizer dose alone was 100% effective against infection in children 12 to 15. Pediatricians may advise hesitant parents that one dose is better than none.

This analysis and information is useful to parents of young children. In short, these doctors advise that many kids would benefit from the vaccine, even though their collective risk profile is extremely, extremely low to begin with. Children with co-morbidities, or living with people with such conditions, would be well-advised to get vaccinated when the shots are approved. But there is not strong evidence in favor of vaccinating other young children — and especially those who’ve obtained natural immunity through prior infection.  These fact patterns and data argue in favor of flexibility and parental choice on this question, in consultation with family physicians.  They argue against top-down government requirements across the board.  I’ll leave you with my radio interview with Dr. Saphier, which delved into some of her recommendations in more detail — along with her reaction to the CDC director’s recent goalpost-shifting and factually-questionable comments on masking:

As we touch upon in our conversation, I’m glad some Democratic officials are starting to openly discuss exit strategies from (scientifically dubious) masking in schools — even if Gov. Murphy, whose electorate may have given him something of a wake-up call last week, has the sequencing backwards, given the relative risk involved:

Sources: TownHall: Doctors Weigh In: Should Young Kids Get the COVID Vaccine?