Pediatricians: We need to bust these myths about kids and COVID vaccines
No, there’s no evidence COVID-19 vaccines can impact a teen girl’s fertility.
And yes, actually, your kid can get really sick from COVID.
This is the kind of misinformation a group of West Michigan pediatricians say they're struggling to dispel with parents and children, ahead of FDA’s expected authorization of Pfizer’s vaccine for those 12 and older. (Data from trials involving kids as young as five could come by the end of the summer, according to reports.)
“This is a population that is really important when it comes to trying to get past the pandemic, and avoiding more novel variants from surfacing,” said Dr. Rosemary Olivero, pediatric infectious disease physician at Helen DeVos Children’s Hospital, speaking at a Spectrum Health press conference Tuesday.
“And I'm personally elated, I'm so happy that we have this access [to the COVID vaccine for children.] But I think we really have a lot of work to do in terms of educating the public.”
The evidence so far
Dr. Liam Sullivan, an infectious disease physician at Spectrum Health, pointed to what he called “impressive” and “very, very encouraging data” from Pfizer’s Phase 3 trial, which included more than 2,200 adolescents ages 12 through 15.
The results, which were first announced by Pfizer in late March, found 18 cases of COVID in the placebo group, versus zero cases in the vaccinated group. Those who received the vaccine also showed a robust immune response one month after getting their second dose, the company said, on par with older participants in a previous trial.
And the shots were “well tolerated, with side effects generally consistent with those observed in participants 16 to 25 years of age.”
While this adolescent trial involved far fewer participants than previous major COVID studies have, Dr. Olivero says the results are still valid.
“Keep in mind that that study was really, again, looking at safety and efficacy,” she said. “But we already had efficacy and safety data from 30,000 adults that were in the previous trial. So it does change the numbers a little bit, and what needed to be recruited for those younger audiences. But because of the numbers that they were able to achieve in that study, there were sufficient numbers to then produce the safety and efficacy results that they published. So, yes, it was big enough to reliably report what they did just this past month.”
Pfizer submitted those results to the FDA in April, requesting an Emergency Use Authorization. The FDA is widely expected to grant the EUA, with some reports saying as early as next week.
Meanwhile, more “critically ill” kids hospitalized for COVID this spring
But before doctors can convince parents the vaccine is safe for their kids, they first have to persuade them that it’s even necessary. Many still feel like kids can’t really get that sick from COVID, Olivero said.
“We have seen that pediatric hospitalizations in the state of Michigan have increased, with some children as young as infants, up to older teenagers even, getting critically ill from COVID-19. The numbers aren't huge, but we know that the potential for children to get sick is incredibly high.”
As of Tuesday, 50 pediatric patients were in the hospital for COVID, according to state data. Michigan hit a record in April, with 70 children admitted.
Then there’s MIS-C, or multisystem inflammatory syndrome, a rare but serious complication children can have after the initial COVID infection has passed.
“It’s nothing to be trifled with,” said Dr. Sullivan. “Truth be told, we're seeing a little bit in adults now. And they're very, very sick people. And it's a very real syndrome.
“And I think talking to parents about the potential risk for MIS-C after a COVID-19 infection...is another way to help motivate them to get their children vaccinated. Because I don't think any parent wants to see their kid in the hospital going through something like that.”
Michigan has reported 106 confirmed cases of MIS-C to the CDC, as of April 29, with ages ranging from less than a year old to 20. Nearly 70% of all cases were admitted to the ICU. The state isn’t reporting an exact number of MIS-C deaths, only that there have been “5 or fewer.”
A widespread, and wrong, belief about fertility impacts
Dr. Olivero says there’s one main concern she hears from teenage patients who are “nervous about getting vaccinated” for COVID: the myth that the vaccine could hurt their fertility later in life.
“We hear from the community that it really centers around these myths about the mRNA vaccines potentially impacting fertility,” she said. “And I just want to say that those myths have been busted. They are not true. And unfortunately, it is really hurting our ability to combat the pandemic with the vaccine.”
According to the Henry Ford Health System, the myth started with a German epidemiologist who hypothesized that the vaccine “might make women’s bodies reject a protein that’s connected to the placenta," therefore making women infertile.
“He thought this because the genetic code of the placenta protein, called syncytin-1, shares a hint of similarity with the genetic code of the spike protein in COVID-19. If the vaccines caused our bodies to make antibodies to protect us from COVID-19, he thought, they could also make antibodies to reject the placenta. “This, however, was a theoretical risk that was completely disproven in the clinical trials and continues to be disproven in real time as more women of child-bearing age become fully vaccinated. “‘It’s inaccurate to say that COVID-19’s spike protein and this placenta protein share a similar genetic code,’” says D’Angela Pitts, M.D., a maternal fetal medicine specialist with Henry Ford Health System. “'The proteins are not similar enough to cause the placenta to not attach to an embryo.'”
Dr. Pitts also pointed to the many women, including her own patients, who have gone on to get pregnant after getting the COVID-19 vaccine.
“We are about five months into giving the Pfizer and Moderna vaccines to literally millions of vaccine recipients,” said Dr. Olivero. “And there's been no impact on fertility, either from natural COVID-19 infection or from the mRNA vaccine. So we really have no concerns that getting a vaccine as a teenager would have any impact on your fertility.
“And certainly, being able to survive COVID-19 will affect your ability to have a family in the future. So I think that this is really a no brainer…”
Big picture: vaccinating kids could reduce COVID to something more like the flu
Eventually, once it receives full FDA approval, Sullivan and Olivero say they see COVID-19 vaccines becoming a standard school requirement, like other childhood immunizations.
Because how many kids ultimately get a COVID vaccine in the coming weeks and months will have massive implications for whether we can successfully contain the virus, said Dr. Liam Sullivan, an infectious disease physician at Spectrum Health. Just look at the seasonal flu, he said.
“One of the big drivers of influenza epidemics every year are kids,” he said. “They're in school together all day long... And then they go out into the community, they see their parents, grandparents, etc. And that's one of the biggest drivers of influenza epidemics every year. So it's absolutely essential that we get as many children vaccinated as possible to reach herd immunity.”
Even if herd immunity proves to be out of reach, as a growing number of experts believe it may be, widespread childhood vaccinations will play a critical part in keeping the virus from causing “severe disease in huge parts of our population,” Dr. Olivero said.
“So I wouldn't think about a 15 year-old getting vaccinated to get them through the next year. I would think about it as: this is a lifelong phenomenon that we are going to have to deal with.”
COVID could become much more like the seasonal flu, Olivero said: a disease that hasn’t been fully eradicated, but is managed with annual vaccinations that save lives and keep the health system from getting overwhelmed.
“And the way that we are going to get there is by vaccinating and causing milder disease across the board,” she said.