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What You Need to Know About COVID-19 Vaccines for Children Ages 5 to 11

Oct 28, 2021 | Children's Health, COVID-19, Vaccines, Your Health

The moment many parents have been waiting for is approaching: Federal regulators are expected to decide soon whether to authorize COVID-19 vaccines for children ages 5 to 11. Vaccines for kids ages 12 to 15 were authorized in May.

The Food and Drug Administration (FDA) first authorized COVID-19 vaccines for adults in December 2020, and the safety and efficacy of vaccines has been widely discussed ever since. But those with young children still have many questions.

In this Q&A, Roberto Posada, MD, a pediatric infectious disease specialist in the Jack and Lucy Clark Department of Pediatrics at Mount Sinai Kravis Children’s Hospital and Professor of Medicine (Infectious Diseases), and Medical Education, at the Icahn School of Medicine at Mount Sinai, answers some of the questions most commonly asked of pediatricians and explains why the vaccines are extremely safe and highly effective.

How effective is the new Pfizer vaccine for children ages 5 to 11?

The new vaccine is highly effective at protecting children from severe COVID-19 disease. The studies, which included more than 4,000 children, showed children developed essentially the same level of antibodies that result in 90 percent or higher protection in adults.

How safe are they?

The vaccines are extremely safe, the same as with adults. There were minor side effects, such as pain at the site of the injection, fatigue, and headache. Importantly, there were no serious adverse events at all related to the vaccine among the more than 4,000 children that were part of the studies.

What about concerns about rare cases of heart inflammation in young men and boys?

Myocarditis is an inflammation of the heart, and a side effect that has been seen very, very rarely, mostly in young adult males. It was not seen in the recent studies of young children; there were no cases, and although the studies were too small to estimate what the rate might be in the general population of children, we expect it to be lower than in adolescents.

Will children experience any side effects from the vaccine? What can I do about that?

It is very likely that children who receive the vaccine, just like adults and older children, will experience pain at the site of the injection or headache. Those are expected to go away within a day or so. Acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) can be very helpful in managing the symptoms. Parents should follow the guidance of their pediatrician as to how to administer those medications to their children.

If my child had COVID-19, do they still need to get a vaccine?

Anyone who already had COVID-19 should still get the vaccine. That’s because cases of a second COVID-19 infection can happen in people who already had a first infection. The vaccine provides more protection against subsequent infections for people who already had COVID-19.

What are the benefits of vaccinating children ages 5 to 11 against COVID-19?

First of all, vaccinating young children protects them from getting seriously ill from COVID-19. We know that children have a lower risk for developing severe COVID-19 infection compared to adults, but that doesn’t mean they cannot develop severe COVID-19 infection. In fact, as an infectious disease specialist, I have seen children in the intensive care unit with complications of COVID-19. In addition, we know that even if children don’t get very sick themselves from COVID-19, children who have COVID-19 can pass it on to other people—to their parents, their siblings, their grandparents, and to kids and other people at school. So vaccinating children can also protect our community at large, including people that are at higher risk from COVID-related complications.

What if my child is afraid of injections?

It is not uncommon for children to be afraid of injections. Pediatricians have been giving vaccines for decades. Our staff are experienced in working with children who are afraid of injections. They will work with you and your child to make sure your child can get immunized in a safe manner.

Can the vaccine affect the fertility of my child?

It’s a very common misconception that the COVID-19 vaccine can affect fertility. There’s no evidence at all that the COVID-19 vaccine has that effect.

My child is 11 and about to turn 12. Should I wait and get them the adult vaccine?

We recommend that children get vaccinated at the first opportunity. Studies show that children age 11 responded very well to the pediatric formulation of the vaccine.

How do I get more information?

Parents who want to get more information about the COVID-19 vaccine for their children should contact their pediatrician for specific advice.

How Do I Keep My Kids Safe When They Return to School In Person?

Updated on Jun 30, 2022 | Children's Health, COVID-19, Your Health

As the Delta variant surges, and the timeline for vaccinating children under 12 remains uncertain, concerned parents are wondering how to keep students safe. But there are smart strategies for school children of all ages that can help protect them in the classroom.

In this Q&A, Roberto Posada, MD, a pediatric infectious disease specialist in the Jack and Lucy Clark Department of Pediatrics at Mount Sinai Kravis Children’s Hospital and Professor of Infectious Diseases and Medical Education at the Icahn School of Medicine at Mount Sinai, shares the best ways to help keep kids safe from COVID-19.

Given the current concerns about COVID-19, should parents be worried about sending their kids back to school?

I think it’s important for kids to go back to school not only for their education, but also for socialization and healthy development. But it’s also important to take precautions to make sure they return to the classroom in a safe way. If in-person learning is done safely, the benefits will outweigh the risk. According to the Centers for Disease Control and Prevention, children have been less affected by COVID-19 compared with adults. But kids can develop serious illness, especially those with underlying medical conditions, such as obesity, diabetes, and asthma; those with certain genetic, neurologic, or metabolic conditions; or those with congenital heart disease. In general, the best way to protect children is to make sure adults in the household are vaccinated.

What advice can you give to worried parents about keeping their kids safe at school?

It’s important to continue the things we’ve been practicing for the last year and a half: The main thing is that children over the age of two should wear a mask when they go to school. Children should also be encouraged to wash their hands, either with soap and water or with alcohol-based sanitizer frequently. Children should be encouraged to practice respiratory etiquette, which means coughing or sneezing into their elbow and washing their hands after coughing or sneezing. And they should be taught to maintain a safe distance at all times.

In addition, parents shouldn’t send their kids to school if they have a fever, cough, abdominal pain, or any symptom whatsoever of an illness, including COVID-19.

How worried should people be right now about the increasing cases of COVID-19?

The number of COVID-19 cases has been going up for the last several weeks in the United States, mostly due to the Delta variant. Vaccination is very important. Every child aged 12 and older should be vaccinated. The vaccine is safe, and in some cases it fully protects against COVID-19; in some cases people who are vaccinated may still get COVID-19, but usually it’s a much milder disease.

Is there any guidance for older vaccinated kids that you would recommend to parents?

What I want to stress is that even people who are fully vaccinated should be wearing a mask whenever they’re inside, whether they’re in school, on public transportation, in a store, or anywhere indoors. That applies to adults, as well. The reason is that even people who are fully vaccinated may have breakthrough infections, and they can still pass on the infection to other people. So by wearing a mask—in addition to getting the vaccine—you’re helping decrease cases in your area, which is what we all want.

When do you think the vaccine will be available for children 11 and under?

The original timeline was for this to be available in the fall. So let’s hope that’s going to be the case.

Is there anything else people should know about keeping their kids safe from COVID-19?

Any parent who has a particular concern about their child due to a chronic medical condition medical condition should talk with their pediatrician to come up with an individualized plan.

My Child Is Anxious About Returning to School In Person. How Can I Help Them?

Updated on Jun 30, 2022 | Children's Health, COVID-19, Mental Health, Psychiatry, Your Health

With the start of the new school year, many kids may be relieved to return to in-person learning. But others may feel more anxious.

In fact, experts at the Mount Sinai Adolescent Health Center anticipate that this transition may be especially challenging and anxiety-provoking.

Rachel Colon, LCSW, a social worker at the Center who treats young people ages 10-26, says that her case load has nearly doubled as adolescents seek help for anxiety and depression.

Rachel Colon, LCSW

“Young people are feeling a great deal of anxiety about returning to school,” she says. “They don’t know what they’re stepping into, who their friends are, and they’re nervous about the lack of predictability in an environment that has always been safe and provided routine.”

Ms. Colon offers some steps you can use to help your kids with the transition to in-person learning this school year:

Have lots of conversations with your kids; keep the lines of communication open.
Empathize with your children; let them know they are not alone if they feel anxious.
Reach out to your child’s school to ask what steps are being taken to familiarize students with their surroundings.
Look for signs of withdrawal, isolation, stomach aches, headaches, irritability. These can be signs of depression and/or anxiety.
If your child is headed to a new campus, or stepping up from middle school to high school, offer to take a walk to school before the first day of school.

Heading back to school can be stressful even in normal times. Over the years, the Mount Sinai Adolescent Heath Center has compiled a list of seven things for kids and adults to do to start the year off right. Click here to see them on the Center’s kid friendly blog.

One potential new issue this year is that kids may feel they have lost touch with their group of friends, or that they don’t belong, and masks, while a critical safety tool, may make things more difficult.

“Many kids are telling me they don’t have a friend group anymore. They don’t know how their classmates will look,” she says. “With the potential requirement of masks, this will likely compound social anxiety because it’s hard to read expressions when a person is masked. Are they happy or sad? Are they smiling at me? Though masks are a crucial safety tool right now, kids really need simple cues—like a broad smile—to maintain social relationships.”

The Mount Sinai Adolescent Health Center is a comprehensive, integrated health center that provides nonjudgmental and confidential care to young people ages 10-26 in New York City—all at no cost to patients, regardless of insurance or immigration status.

Learn more about the Mount Sinai Adolescent Health Center

Check out seven back-to-school tips from the Mount Sinai Adolescent Health Center

What You Need to Know About Heart Inflammation and the COVID-19 Vaccines

Updated on Jun 30, 2022 | Children's Health, COVID-19, Vaccines, Your Health

A woman talking to her young male patient in medical office

Researchers at the U.S. Centers for Disease Control and Prevention (CDC) are investigating a link between COVID-19 vaccines from Pfizer-BioNTech and Moderna and heart inflammation in young men and boys.

Kristin Oliver, MD, MHS, a pediatrician and preventive medicine physician at the Mount Sinai Health System and an Assistant Professor of Pediatrics, and Environmental Medicine and Public Health, at the Icahn School of Medicine at Mount Sinai, explains what parents, guardians, and young adults need to know about this rare side effect.

What is the situation as you see it?

The COVID-19 mRNA vaccines from Pfizer-BioNTech and Moderna have been linked to cases of myocarditis, which is an inflammation of the heart, and pericarditis, which is inflammation of the sac-like covering around the heart. Myocarditis and pericarditis can happen after an infection from different viruses, including SARS-CoV-2—the virus that causes COVID-19. They are more commonly seen in males.

How common is this side effect?

Myocarditis and pericarditis can be serious but, fortunately, these side effects to vaccination are very rare. While we don’t know the precise rate of these side effects in relation to COVID-19 vaccines, we do know that it is more commonly seen in men and boys and after the second dose of the vaccine. Signs of myocarditis and pericarditis tend to become visible within four days of the vaccine dose.

Keep in mind that as of July 2021, more than 52 million doses of the COVID-19 vaccines have been administered in the United States to people ages 30 or younger, and the CDC has only confirmed about 600 reports of myocarditis or pericarditis in connection with vaccination in this age group. The cases connected to receiving the COVID-19 vaccine have also been mild. So, the benefits of COVID-19 vaccination in this group still outweigh the risks of getting myocarditis from the vaccine.

What are the signs of myocarditis/pericarditis?

People with heart inflammation experience chest pains, difficulty breathing, heart palpitations, and excessive sweating. These symptoms may also be accompanied by stomach pain, dizziness, coughing, unexplained swelling, and even fainting. If a recently vaccinated person shows symptoms of myocarditis or pericarditis, they should seek medical attention.

The most common side effects from COVID-19 vaccination are pain at the injection site, fatigue, headache, fever, chills, muscle pain, or joint pain. These vaccination side effects can be managed with over-the-counter medication and rest.

What do you say to families who are concerned about this serious, but rare, side effect?

I’m honest with families when I talk about it, and I understand that it’s disappointing to learn about this connection. But because it happens so rarely and because COVID-19 infection can have serious consequences in adolescents and young adults, the benefits of vaccination still outweigh the risks.

In making any medical decision we are weighing the potential risks and benefits. Remember, the risks of COVID-19 infection in this age group are real and so are benefits of COVID-19 vaccination. Data from the CDC estimate that if we vaccinate one million males between the ages of 12 and 17, we will prevent: 5,700 cases of COVID-19, 215 hospitalizations, 71 ICU stays, and 2 deaths in this group.

But I always recommend that parents talk with their pediatrician about any concerns. Pediatricians know what’s important to you and your family and have lots of experience giving vaccines and answering these questions.

Get more COVID-19 vaccine information from Mount Sinai

What You Need to Know About COVID-19 Vaccination in 12- to 15-Year-Olds

May 13, 2021 | Children's Health, COVID-19, Featured, Vaccines, Your Health

Schools, playgrounds, and, most of all, our children will soon be better protected against COVID-19, thanks to the latest news from the U.S. Food and Drug Administration (FDA). The agency has announced that the Pfizer-BioNTech COVID-19 vaccine is safe and effective for children between the ages of 12 to 15 and authorized emergency use of the vaccine; the CDC also recommends the vaccine in this age group. You may have questions about this new development. Kristin Oliver, MD, MHS, Assistant Professor of Pediatrics, and Environmental Medicine and Public Health, at the Icahn School of Medicine at Mount Sinai, has answers.

How effective is the Pfizer-BioNTech COVID-19 vaccine in children aged 12 to 15?

All indications are that COVID-19 vaccination is highly effective in children ages 12 to 15. In the trial, the vaccine prevented 100 percent of COVID-19 cases among participants who got the vaccine. It’s important to remember that the results we see in clinical trials—called efficacy—may be slightly better than what we see when the vaccine is out in the world—effectiveness. People in the clinical trials always get the vaccine exactly as indicated, but this isn’t always the case in the real world. Once we start immunizing more and more people over time, we’ll have a better sense of the vaccine’s effectiveness for ages 12 to 15, but I expect this will also be really high.

Is it safe?

The COVID-19 vaccine is safe for children ages 12 to 15, just as it is for people 16 and older. In addition, the FDA will continue to monitor safety for another two years.

Researchers at the CDC are investigating a link between COVID-19 vaccines from Pfizer-BioNTech and Moderna and heart inflammation in young men and boys. Myocarditis and pericarditis can be serious but, fortunately, these side effects to vaccination are very rare and the cases connected to receiving the COVID-19 vaccine have been mild. So, the benefits of COVID-19 vaccination in this group still outweigh the risks of getting myocarditis from the vaccine.

Will our children experience any side effects from the vaccine?

We can expect children to have side effects similar to what we’ve seen in adults. The most common are pain and swelling at the injection site, tiredness, and headaches. In the study fewer than one in five 12- 15 year olds who get the shot, had a fever. The good news is that these side effects usually only last for a couple of days and can be treated with over-the-counter medication.

Remember: these types of side effects are a sign that the body’s immune system is responding to the vaccine, which is a good thing. We have seen more of these side effects to the COVID-19 vaccination than, say, the tetanus booster or HPV vaccine. For that reason, you might want to have your child take the vaccine on day when you know they can take is easy the next couple days.

Are there some 12- to 15-year-olds who should not take the vaccine?

Anyone who has had an allergic reaction to any component of the vaccine, or who had an allergic reaction to the first dose of the vaccine, shouldn’t take it.

But peanut, egg, and other food allergies are not a contraindication. If your child has any of these allergies, they can take the vaccine. If you have any questions about your child’s allergies and COVID-19 vaccine, check with your pediatrician.

If my child had COVID-19, do they still need to get a vaccine?

The U.S. Centers for Disease Control and Prevention has said that everyone who can get a COVID-19 vaccine should do so, even if they’ve already had COVID-19. In general, we don’t know how long protection against the virus lasts after an infection, or how well previous infection prevents infection with some of the new variants. In our efforts to keep everyone healthy, the recommendation is to get vaccinated.

What are the benefits of vaccinating children ages 12 to 15 against COVID-19?

Vaccines are an important tool in protecting us from developing COVID-19. It is exciting that children ages 12 to 15 can now get vaccinated—and it is important that they do so. While it is true that younger people are less likely than their elders to get seriously ill and die from COVID-19, they are not immune to the virus. Children can, and have, contracted the virus, gotten seriously ill, and even died. So the first benefit of vaccination is to protect them from the virus and its complications. Additionally, we know that children can transmit the virus to others who are more at risk for serious complications. By vaccinating young teens, we can help prevent that transmission as well as protect grandparents, babysitters, and other more vulnerable people who are in their orbit.

Get more COVID-19 vaccine information from Mount Sinai

Should I Wait to Have My Child’s Vision Checked?

Oct 26, 2020 | Children's Health, COVID-19, Ophthalmology, Your Health

This academic school year—in addition to the usual school supply lists and purchasing of new shoes—parents must think about COVID-19 positivity rates, appropriate face coverings, and reliable in-home internet access. Whether your child will be learning in the school room or remotely, their eye health is important and should not be overlooked. Douglas R. Fredrick, MD, Professor of Ophthalmology and Pediatrics at the Icahn School of Medicine at Mount Sinai, explains what parents need to know about their child’s vision.

Should I wait until after the COVID-19 pandemic to get my child’s vision checked?

Please do not delay having your children examined. It is important to make sure their vision is sharp and their eyes are healthy. Most of our sensory connection to the world is through our eyes. Children who do not see properly can have difficulty developing academically and socially. If we catch and correct vision problems early, we can improve children’s day-to-day life and functioning in school. We can also detect eye conditions that could lead to further problems down the line.

While COVID-19 is still of great concern, Mount Sinai Health System has gone to extraordinary lengths to make sure every patient receives the best possible care in a safe environment. We have developed stringent protocols to protect your family and our community. For instance, face coverings are mandatory and social distancing is enforced throughout the Health System. Additionally, we disinfect continually and regularly test our staff for COVID-19.

How often should I have my child’s eyes checked?

The American Academy of Ophthalmology and the American Academy of Pediatrics recommend that pediatricians and family practitioners examine the eyes and check vision in newborns, age two months, six months, one year, then annually until age six, then every other year until age 18. Most pediatricians check vision every year during their annual exam, and many school districts perform screening each year, beginning at age five or six.

What are the signs that my child has vision issues?

If you notice your child squinting or tilting their head to see objects that are far away, rubbing their eyes after reading, or if their eyes drift toward the nose or outward—as though they are trying to see their ears—you should schedule an appointment with your child’s pediatrician for a vision exam. The same is true if your child complains about fuzzy or foggy vision. I also recommend that parents check in with their child’s teacher as they may see vision impairment related behaviors in the classroom.

My child is struggling with vision issues. How can I help?

The first step is to see your child’s primary care provider who will check for any other health conditions that may be contributing to your child’s difficulties. If the pediatrician finds decreased vision on a screening exam or has any other concerns, they will refer you to a pediatric ophthalmologist. These ophthalmologists have additional training in caring for children and often have specialized equipment and child-friendly offices.

During the examination, the ophthalmologist will do a thorough exam of your child’s eye—probably using dilating eye drops. If the doctor finds that your child is nearsighted or has another vision issue, they may prescribe glasses. If the examination is completely normal but your child is still having a problem with reading or learning, your primary care provider may refer you to an educational specialist or school learning specialist to test for learning disorders and make recommendations.

My child will be learning remotely this school year and I am concerned about eye strain. I’ve heard that blue light glasses can help with this issue. Is this true?

Blue light glasses are special eyewear that block or filter the high-energy blue light coming from computer, tablet, and phone screens. It is not clear that they help with eye strain or eye disease. A recent study performed at the State University of New York School of Optometry found that these glasses did not decrease eye strain with “near work”—activities that require near vision such as reading, writing, and watching television.

While it won’t hurt to use these glasses, there are better ways to reduce eye strain. For instance, have your child hold their reading material, laptop, or tablet at the appropriate distance and make sure they have enough light to see—but not so much it causes glare on the screen. It can also help to have your child take breaks every 20 to 30 minutes when they are doing screen work. I recommend giving your child a task that gets them on their feet and their eyes off the screen, like feeding your pet or taking out the trash.

Should I limit how much time my children spend on screens?

All children will be spending more time with their eyes on the screen this year than in the past and that is going to make it hard to limit screen time to the typical recommendation of two hours a day. This year, instead of enforcing strict limits, try to keep track of what they’re doing with their screen time. Although most of their screen use should be educational, you’ll need to allow time for play—both to relax and to enable them to have social time with friends. Physical activity should also be a part of their daily routine. The key is finding a balance. For more on how—or whether—to limit your child’s screen time, read this blog post from Mount Sinai pediatrician Micah Resnick, MD.

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