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Dr. Howard Balbi, Good Samaritan Hospital Director of Pediatric Infectious Diseases and Associate Chairman of Pediatrics, answers your questions about children and COVID-19 vaccines.

How can parents help their potentially shot reluctant kids understand the importance of the COVID-19 vaccination? 

Children are often more aware of circumstances than we give them credit for. They have been affected by COVID-19 as much, if not more, than adults. Their world has changed from one where they played freely, attended and participated in sports events, and went to school without masks, social distancing, or quarantine. 

Parents need to understand and believe in the importance of the COVID-19 vaccination to explain it to their child. While we hoped COVID-19 would be short-lived and disappear, it seems that it will be around for quite some time. Children, as well as adults, need to understand that to better control this infection it requires several precautions, including mask wearing, hand washing, social distancing when appropriate, and vaccination. When all of these factors come together, we may move closer to returning to normal.

For kids who are afraid of needles and/or shots, what can parents say or do to help ease those fears?

No one likes needles or shots and needle phobia is very real. There are a variety of techniques for easing fear or discomfort such as distraction, rewards, or simply hugging the child or holding his/her hand. It is a matter of knowing your child and understanding what works best for them. Try to avoid using the word "shots,” which might scare a child or make them feel uncomfortable. 

It is difficult to erase the image from a child's mind when you tell them: "You are going to the doctor, and they are going to give you a shot if you are not good." When it is time to receive a vaccine, the child will associate it with pain and something bad. It is always best to be honest with the child and agree that while the vaccine will be uncomfortable or feel like a pinch, it will go away quickly. Do not underestimate a child's fear and make sure you provide comfort.

What kind of side effects are kids experiencing with COVID-19 vaccine, and are those effects in line with what adults have reported (fever, chills, achiness, etc. for up to 24 hours after the vaccine)?

Children are experiencing mild side effects such as arm soreness, low-grade fever, headache, and fatigue with COVID-19 vaccines. The side effects appear to be even less common in the younger age group (5 to 11-year-olds) as their dose is one third the dose being used in older children and adults. The side effects usually last less than 24 to 48 hours.

If so, should parents plan their child's vaccination dates around things like sports practices and school when being sick might be problematic?

Avoid vaccinations around important events such as holidays, vacations, school examinations, or sporting events, if possible. While adverse effects from most vaccines are mild, it is best to avoid the risk of not your child not being his or her best during these special events. While the majority of children do very well after vaccinations, many people do not want to take this risk.

Along the same lines, should parents warn their kids they might feel ill after vaccination?

Most children do not feel ill after the vaccination, so I do not think it is necessary to "warn" them about possibly becoming “ill.” I believe in being honest with children. You can let them know that they might have a little soreness at the injection site, or their arm might hurt a little, or they may not feel well just as it would after any other vaccine.

I would assure them that the symptoms will go away quickly if they do develop them. I would avoid words like “becoming ill” or “sick,” which might frighten them. If the child asks specific questions, such as, “Will I feel tired after the vaccine,” or “Will I have a fever after the vaccine?” I would definitely be honest with them and explain that it is a possibility as it is with any vaccine.

If the child does feel ill after vaccination, how should a parent explain those symptoms to them?

Side effects can occur after any vaccine. COVID-19 vaccinations can also cause adverse effects as we have seen in adults and children alike. Symptoms appear to be less common in children but they can occur. If the child develops any of the expected side effects such as soreness at the injection site, fever, headaches or fatigue, it can be explained to the child that it is probably from the vaccine.

These adverse effects usually last less than 24 to 48 hours and respond to medications such as acetaminophen or ibuprofen. Your child should be reassured that you will continue to monitor symptoms closely and that they should feel better within 24 to 48 hours. If the symptoms are more severe, you should notify your child's health care provider.

Is there anything else you think a reader should know on this subject?

While COVID-19 vaccines are new in children, millions of adults have received the vaccines in United States and worldwide. The vaccines have had a good safety record and have been very efficacious in preventing hospitalization and severe disease. Because of advancements in health care and reporting systems, this vaccination has been more closely monitored than any other vaccine in history. 

COVID-19 infections can be very serious and associated with high hospitalization and mortality rates. While children seem to have milder symptoms and less hospitalizations and deaths, even one child lost to a vaccine-preventable disease is too much.

While these questions focus on COVID-19 vaccines, it is important to remember that we are entering the flu season, which is also associated with a high number of hospitalizations and deaths in the United States.  Everyone should be making every effort to receive their flu vaccines this year. You can receive the flu vaccine and COVID-19 vaccines during the same visit.

View CDC COVID-19 vaccine recommendations for children and teenagers

View CDC flu vaccine recommendations

Explore pediatric services at Catholic Health

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