Exploring COVID-19 vaccines for kids

Over 18 months into the COVID-19 pandemic, and vaccines are now available for children 5-11.

Experts on the front lines of pediatric vaccine development and public health spoke to over 280 people during a Fearless Science Speaker Series webinar on November 9, 2021, hosted by the Morgridge Institute and moderated by Gabriella Gerhardt.

Panelists included Dr. James Conway and Dr. William Hartman, co-principal investigators of the Moderna KidCOVE COVID-19 vaccine study for children at UW–Madison, and Dr. Jasmine Zapata, chief medical officer and state epidemiologist for the WI DHS Bureau of Community Health Promotion.

The following is an abridged transcript of selected questions. A recording of the webinar can be viewed in full above.

Gabriella Gerhardt (GG): When will the vaccine be available for children 5-11?

James Conway (JC): Vaccine is already available. It’s been available over the last week…appointments are filling up quickly. But there’s going to be plenty of opportunity for all of our 5 to 11 year olds to get vaccinated over the next couple of weeks. It’s a two-dose regimen, so obviously most of the kids won’t be getting their second dose until we get into the December window.

GG: Can one of you comment on how does this vaccine work?

Jasmine Zapata (JZ): What the vaccine does is it significantly reduces the risk of contracting the disease being hospitalized and dying from COVID-19. There are many people who say, “I know someone who got the vaccine and they still got COVID anyway.” We know that happens in very rare cases. But there is striking evidence that shows—when we’re looking at the rates of our hospital beds being filled up ICU admissions, deaths right here in Wisconsin—those who are vaccinated have a significantly lower likelihood of getting a case of COVID-19 being hospitalized or dying from it.

GG: And how is the vaccine for children different than the vaccines for adults?

William Hartman (WH): For the Pfizer vaccine, it’s 1/3 of the adult dose. The other is sort of a preparation tweak that they made, so that the vaccine will be able to be stored in in regular refrigeration temperatures for up to 10 weeks. It eliminates that need for the for the super cold -80 storage, that the adult vaccine has required.

GG: How was that dosage determined?

JC: As we were getting rolling with adults, they tested high, medium and low doses to see which one gave the appropriate immune response that was balanced with acceptable side effects. And so the same thing happened in children, where in each of these age groups, they’ve looked at different dose sizes, and basically tried to achieve a dose that gave the same immune response and protection that the adults got with the full dose, balancing with those side effects…it’s a very deliberate process. I think we have the benefit of having had hundreds and hundreds of millions of adults that have already received these vaccines.

GG: Can you give us an inside look at what a vaccine clinical trial looks like?

WH: These are double blind, placebo controlled clinical trials. We had thousands and thousands of people signed up, and from there, they’re selected almost at random from that list of potential kids. We try to make the population of the kids that are selected look like the population of the United States, so that we have enough communities of color that are that are represented. The trial itself goes on for 18 months. There’s a couple of long days in there for the participant… where they have to get to go through some blood tests, they have to get a nasal swab, and then go through all the screening questions to make sure that, number one, they understand the trial completely, and that the parents know what, what they’re signing up for. And then the follow up is just to make sure that everything is safe, and everything is good.

GG: Let’s ask the big question that people are asking — is the vaccine safe?

JC: In very, very, very, very rare circumstances, that inflammatory or immune response is even more vigorous. But that risk far outweighs the risk of what happens with this unpredictable disease. And so we would by no means be in a place where we are of strongly recommending this vaccine for everybody if we didn’t know all the things we know about this disease. This disease, this pandemic is now a disease of the unvaccinated. Period full stop.

WH: The risk of myocarditis if you contract COVID-19 is 16 times higher than the baseline rate of myocarditis in people without COVID-19. Though, it is something that parents should consider, they have to know about it, they have to know that this risk is there, but that it’s an extremely rare occurrence.

JC: When we talk about this mild flu-like illness that some people get after the vaccine, that’s because your muscles and everything sort of your achy and get inflamed. And you know, so while it’s rare, it’s not completely surprising that in a small population, that there may be some inflammation in the heart muscle. While the word myocarditis sounds scary, I think people need to understand that as you activate the immune system, there is some inflammation that goes along with that in a small population of people. But that that is considered by far to be a worthwhile risk compared to the risk of the disease itself.

JZ: I kind of think about it like this. If there was if my child was at a school with 3000 kids, if I knew that many of them got the vaccine and did not have any issues with myocarditis, that’s still a good number. So even though it’s small, that information can make us feel very comfortable and confident that these vaccines are safe.

GG: What is your advice to adults making decisions for children in their care?

WH: Well, I’ve got five kids, my, my four older boys, ages 13 to 18 have all been vaccinated. They’ve had no problems. This afternoon, I’m bringing my nine year old daughter who’s thrilled to finally get her vaccine so that she can feel safer, she can feel a little bit more free at her grade school.

JZ: I believe that it’s important to have ongoing conversations about this with anyone that you’re talking to—ongoing conversations, there’s not just one conversation. And not only talking about the physical benefits of it, but it’s important to have conversations just about how COVID is impacting children’s mental health. There should be regular check-ins with children about everything related to this. One of my favorite things I saw on social media was a picture of when kids are going to get the vaccines, it has a superhero background, saying “You’re a superhero, because you’re helping us to get through this pandemic together.”

JC: Kids are not stupid, they have paid attention, and have had their radar up and have learned a lot throughout all of this. They have learned to be worried and to be careful and to be nervous. And unfortunately, that’s not a normal thing for kids to have to go through. The relief that they feel when they have an opportunity to return to some level of normal is really palpable.

GG: Let’s take a little shift here and talk a little bit about vaccines for kids under five. Where does the clinical trials on that stand?

WH: We’ve begun those trials with Moderna at University of Wisconsin. It’s going to take us probably through December and early January to collect all the data and getting that to Moderna. But we’re probably looking at February before a shot for this group would be available.

GG: How about for pregnant women Does a vaccine during pregnancy confer any immunity to a developing fetus?

JZ: Yes, the vaccine is definitely safe and it is recommended for pregnant people. It’s awesome because that immunity can have benefits for the developing fetus. And some of the antibodies have been shown to even go through the breast milk to help the young babies. In fact, you are at more risk when you get COVID-19 and you are pregnant—we are starting to see many, many, many adverse outcomes, from maternal deaths to stillbirth to complications to prematurity with pregnant people who get COVID-19. So, it is very important that if you are pregnant, you talk with your health care professional and go ahead and get a vaccine.

GG: Any final remarks?

JC: I think that people need to understand that getting immunized has actually become the norm…I am heartened by the fact that, you know, over time, people have finally started to recognize that the science is real, that this pandemic is not going away without a collective effort, and that the best protection you have for you and your family is to get vaccinated.

JZ: I’m hopeful for our future, and kids being able to be vaccinated is definitely something that adds to that hope…I’m just speaking from my heart, and in our last minute that we have left. Some people say, “only this many children died from it.” Now let’s let’s get very specific, there were 94 children that died this year, up through October. Every single child’s life matters, especially if it’s something that is preventable. When one child dies, that is too many. So we know that the benefits of getting the vaccine out the benefits outweigh any potential long term risks. And from what we can see now there are none. Because if that’s your child, this would be a whole different conversation.

WH: One thing that I do have to point out as a person who has run a lot of these clinical trials here, how amazing University of Wisconsin has been, and aggressive they have been in getting these trials up and running, recruiting, making sure that we have therapies here on site for the people of Wisconsin, especially those in Dane County here. But the office of clinical trials really deserves a lot of kudos for their tremendous work through this entire pandemic.