COVID-19 | Mount Sinai Today

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.

During the COVID-19 Pandemic, You Should Still Get the Seasonal Flu Shot

Sep 30, 2021 | COVID-19, Your Health

Every fall, doctors, health care providers, and public health experts begin reminding everyone that it’s critical to get the flu shot. This year, as we continue to cope with COVID-19, it’s even more important.

There are a number of reasons why the ongoing pandemic means you should make sure to get your flu shot as soon as possible, according to Waleed Javaid, MD, Professor of Medicine at the Icahn School of Medicine at Mount Sinai and an expert on infectious diseases.

For starters, if you become infected with COVID-19, getting the influenza virus as well can make a difficult situation even worse. Doctors saw patients in this situation at the beginning of the pandemic, and they know the combination of these two infections can make it more difficult to recover and can exacerbate some of the most serious symptoms, including difficulty breathing.

“COVID-19 and the flu are not a good combination,” Dr. Javaid says.

Fortunately, we have vaccinations for both the flu and COVID-19 that will help prevent you from experiencing the worse of either virus. In fact, the U.S. Centers for Disease Control and Prevention (CDC) strongly recommends that you receive the flu shot if you are eligible—even if you are fully vaccinated against COVID-19. And if you have not yet received the COVID-19 vaccine, or are eligible for a booster dose, you do not need to space out dosing, the CDC says you can receive both shots on the same day. The COVID-19 vaccine and the flu shot do have similar, mild side effects, which include fever, body aches, headache, and nausea. So, if you are concerned about side effects, the vaccines can also be taken on different days.

Face masks—which have become a wardrobe staple since the start of the pandemic—may do double duty by helping to reduce the risk of contracting both COVID-19 and the flu. But Dr. Javaid notes that additional measures are still warranted. This includes proper hand hygiene, avoiding those who have a respiratory illness, and getting your flu shot.

The CDC recommends getting a flu shot as early as September or October. But if you miss this window, it is not too late. You can get the shot as long as the flu is circulating, which is normally through early spring.

Another reason reducing the incidence of seasonal flu this year will be especially important is that it can be difficult to distinguish between the flu and COVID-19, according to Dr. Javaid. The symptoms are almost exactly the same: fever and chills, cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, headache, sore throat, and congestion or runny nose. You can read more about these similarities from the CDC. One potential difference is that if you are infected with COVID-19, you may experience a new loss of taste or smell. The similarities could result in confusion as doctors try to diagnose patients.

Of course the flu shot doesn’t guarantee you won’t get the flu. But the CDC estimates the vaccine each year typically reduces serious cases of the flu by 50 to 60 percent. For those who get the flu even though they have gotten the vaccine, the shot helps reduce the severity of the illness and avoid hospitalizations.

For those who may be wondering, there is no evidence that the flu shot can make you more susceptible to getting COVID-19. That being said, if you are infected with COVID-19 or the flu, the timing of your vaccination may need to be adjusted. If you are in this situation, Dr. Javaid says, you should contact your health care provider, who can advise you on the latest recommendations.

Vaccine Facts: COVID-19 Vaccines Are Safe—and Essential—for Pregnant Women

Sep 23, 2021 | COVID-19, Featured, OB/GYN, Vaccines, Women's Health, Your Health

For those who are pregnant or considering getting pregnant, there are so many health questions, from “Is caffeine okay?” to “Can I still exercise?” But during the COVID-19 pandemic, some are also wondering if the COVID-19 vaccines are safe to take.

In this Q&A, Joanne Stone, MD, MS, Director of Maternal Fetal Medicine at the Mount Sinai Health System, explains the dangerous risks of COVID-19 during pregnancy, shares the facts on why you should get the vaccine, and offers reassurance for those who may be worried.

New Guidance on COVID-19 Vaccines: In April 2023, the Food and Drug Administration and the Centers for Disease Control and Prevention announced some major changes for COVID-19 vaccines. Click here to read more about what you need to know.

Update: The Centers for Disease Control and Prevention on September 29, 2021, strongly recommended COVID-19 vaccination either before or during pregnancy because the benefits of vaccination outweigh known or potential risks. Read more from the CDC

If someone is pregnant, or trying to get pregnant, should they get vaccinated?

Yes, if you’re pregnant, or thinking of getting pregnant, or even if you’re breastfeeding, this is absolutely the time to get the vaccine. I would not wait one extra day. I would get it today because there’s a lot of data that shows the vaccine is very safe and it’s not associated with miscarriage or infertility. Also, it’s the most important way to prevent COVID-19 infection.

Joanne Stone, MD, MS

Are pregnant people especially at risk for COVID-19?

Pregnant women who get COVID-19 infection are at a much higher risk for adverse outcomes, such as severe disease and even maternal death. There’s also higher risk for complications, including preeclampsia, which is high blood pressure in pregnancy, as well as increased risk for the baby, including preterm delivery. For all these reasons, the risks of COVID-19 infection are much higher for both mom and baby. So it’s extremely important to prevent this disease during pregnancy through vaccination plus other measures like mask wearing and social distancing.

What else should patients know about the vaccines and pregnancy?

Patients should understand there are a lot of myths out there that have not proven to be true. For example, there’s no increased risk of infertility if you get the vaccine prior to getting pregnant. Pregnant people should also know that there are complications associated with COVID-19 in pregnancy, and these complications that can be prevented by getting the vaccine. Also, the vaccine has been studied extensively. All the major organizations involved with women’s health care—including the Society for Maternal-Fetal Medicine and the Centers for Disease Control and Prevention—are strongly advocating that people who are pregnant get the vaccine.

Face Masks Are Still a Fact of Life, Here’s What You Need to Know About Safe Use

Sep 20, 2021 | COVID-19, Your Health

Woman who is alone on street, takes mask off while outside

Now, almost two years into the fight against COVID-19, face coverings have become a necessary addition to our everyday wardrobe. Along with proper hand washing and social distancing, their use has helped to prevent the spread of COVID-19. As the pandemic goes on and the effort to get people vaccinated continues, the U.S. Centers for Disease Control and Prevention (CDC) has issued additional guidance about face coverings. Importantly, the CDC now clarifies that while some outdoor, unmasked activity is relatively safe, both unvaccinated and vaccinated individuals should continue masking when indoors to protect themselves and others from the highly contagious Delta variant.

Krystina Woods, MD, Hospital Epidemiologist, Medical Director of Infection Prevention, and Deputy Chief Medical Officer at Mount Sinai West, explains the care and use of masks over the long haul and why those vaccinated against COVID-19 still need to mask up.

Why is it important that vaccinated people continue to wear face coverings?

We now know that vaccinated people can both become infected with COVID-19 and pass it on to others. And because of that, in certain settings, it is extremely important for even vaccinated people to wear masks.

Is it still less risky to be unmasked while outdoors? If so, why?

When you’re outdoors, there’s better ventilation. So, for example, if there is someone nearby who has been infected with COVID-19, the amount of virus can be diluted by all the freely moving air, making it less likely that others will be infected.

It is also important to remember that part of the thinking about being unmasked outdoors is that you’re unmasked while still being socially distant. If you are in a really, really large crowd; the protection is not going to be as good. You are much safer choosing to take your mask off outdoors if you have the ability to have a little bit of distancing.

So, being unmasked when on an early morning walk through a sparsely populated Prospect Park is okay, but if you’re window shopping on the weekend on a packed street in SoHo, throw on a face covering.

If my risk of severe illness is low, why should I continue to take precautions once I am fully vaccinated?

We need to continue to be careful. You don’t always know what the health problems are of those around you and, there’s a certain amount of civic responsibility that we have to each other.

None of us live completely isolated and, over the last 18 months, we’ve all felt what it is like to have to isolate ourselves from those we care about. So, we need to be careful about the fact that there are still people who have not gotten vaccinated, those who are not eligible for vaccination—like children—, and those who are otherwise vulnerable—like the elderly and immunocompromised. We have a duty to protect those amongst us who do not have the protection of vaccination.

Should I upgrade to a better face mask?

I wouldn’t see this as a necessity. The most important thing is that the face mask is multi-layered and fits well. If you are using a cloth mask, it is a good idea to double mask by using a surgical mask underneath the cloth mask. In place of that, a regular surgical mask is sufficient. However, if someone feels more comfortable wearing an N95 or its international equivalent (the KN95 or KF94), they certainly can—just make sure the masks are legitimate. The CDC has advice on how to identify counterfeit masks.

How do I know if my face mask has a proper fit?

Your mask should not fall off of your nose as you’re talking and it should fully cover your nose and the mouth. Additionally, it should not have large gaps around the perimeter of the mask—around the sides or the top and bottom. And, you should be able to tolerate wearing the mask for an extended period of time without feeling uncomfortable.

How should I take care of my cloth face masks?

Reusable masks should be washed at least daily, by hand or in your regular washing machine. And you can put them in the dryer, or hang them up to dry. If you have a disposable face mask, throw it away after wearing it once. And always wash your hands after handling or touching a used mask. The CDC has a lot more information about masking here.

Get more COVID-19 information from Mount Sinai

Vaccine Facts: Immunocompromised People Should Get a Third Dose

Sep 9, 2021 | COVID-19, Featured, Vaccines, Your Health

Immunocompromised people have a reduced ability to fight infections and are more vulnerable to severe COVID-19. That is why the U.S. Centers for Disease Control and Prevention (CDC) is recommending that people with moderately to severely compromised immune systems receive an additional dose of the Pfizer-BioNTech or Moderna vaccine.

In this Q&A, Meenakshi Rana, MD, Associate Professor of Medicine (Infectious Diseases) at the Icahn School of Medicine at Mount Sinai, and the Director of Transplant Infectious Disease, explains why immunocompromised people, who make up almost three percent of the U.S. population, should get this third vaccine dose and why it is important to take other protective measures.

What did the CDC recommend?

The CDC and the Advisory Committee on Immunization Practices took an important action to prevent COVID-19 infection in our immunocompromised population and among transplant recipients. They now recommend that people who are moderately to severely immunocompromised receive an additional dose of an mRNA COVID-19 vaccine, either Pfizer or Moderna, at least 28 days after the completion of the initial series. The Food and Drug Administration (FDA) now allows for the additional dose for these people as well.

To be clear, this is not considered a booster dose. A booster dose is given to a patient whose immunity to the vaccine may have waned over time. This is considered an additional dose, given to immunocompromised patients to improve their initial response to the vaccine series. These patients are essentially receiving a three-dose mRNA vaccine series instead of a two-dose series.

Who is considered immunocompromised and should get the third dose?

Meenakshi Rana, MD

Immunocompromised patients are a very large and heterogeneous group. For the purposes of an additional COVID-19 vaccine, the CDC has defined a specific moderately to severely immunocompromised group, which includes:

Patients who have been receiving active cancer treatment for tumors or cancers of the blood
Patients who had a solid organ transplant, such as a heart, lung, liver or a kidney, and currently take immunosuppressive medications
Patients who had a bone marrow transplant within two years or had a bone marrow transplant and are currently taking immunosuppressive therapy, or patients who receive CAR T-cell therapy.
Patients who have advanced or untreated HIV
Patients who have another medical condition that require high-dose steroids or immunosuppressive therapy for that medical condition

If you think you fall within this category, it’s important that you speak to your physician to determine if you are eligible for an additional dose of mRNA COVID-19 vaccine.

Why is the CDC taking this action?

Patients who are considered moderately to severely immunocompromised are more vulnerable to COVID-19. They are more likely to have severe disease, and more likely to be hospitalized with COVID-19. In addition, there has been data suggesting that moderately to severely immunocompromised patients may not have as strong an immune response to the initial COVID-19 vaccine series, and we have seen breakthrough infections in vaccinated immunocompromised patients, occasionally requiring hospitalization. The CDC also now has data suggesting that a third vaccine would be safe.

What should I do if I think I am affected by this action by the CDC?

If you think you are considered moderately to severely immunocompromised, talk to your doctor to see if you are eligible for an additional dose of COVID-19 vaccine. The CDC recommends that you receive a third dose with the same mRNA vaccine. For example, if you received an initial Moderna vaccine series, then you should complete your series with an additional third dose of the Moderna vaccine.

What if I am immunocompromised and I received the Johnson & Johnson vaccine?

When the CDC made this recommendation, they did not have enough data on whether immunocompromised patients who received the J&J vaccine would have an improved response after receiving an additional dose of the same vaccine. For this reason, we are currently awaiting more guidance from the CDC on what to recommend for these patients.

If I am immunocompromised, what else should I do to protect myself?

In addition to receiving an additional dose of an mRNA vaccine, you should continue to practice all those protective precautions that we’ve been discussing: social distancing, hand hygiene, and masking. It’s also very important that all of those around you, your family and your friends, are all vaccinated.

The FDA has also authorized the use of a medication, known as a monoclonal antibody, for what is termed “post- exposure prophylaxis.” That means, if you are exposed to a loved one or family member with COVID-19, this medication can be given to you to prevent COVID-19 and progression to severe disease or hospitalization with COVID-19. You should call your physician to see if you are eligible.

Should I get an antibody test to see if I am eligible for the third dose?

We are not recommending that you get an antibody test for this purpose, because we don’t know what level of antibodies is considered protective. We recommend that if you are considered immunocompromised, you should receive an additional vaccine dose, regardless of antibody response.

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.

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