COVID-19 and vaccination for age ≤ 15

With the FDA emergency use authorization of the Pfizer-BioNTech vaccine for COVID-19 for age 12-15, and ongoing COVID-19 vaccine trials for younger ages, here is a thread for discussion of any COVID-19 and vaccination issues, questions, and experiences for children 15 years of age or younger.

https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-pfizer-biontech-covid-19-vaccine-emergency-use

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I’m so impressed w/ UNC Hosp. I saw the news break on CNN a couple hours ago so I had my 13 yr old check the app. UNC had already updated their app and he was able to get an appt for tomorrow afternoon! I didn’t think it would be this easy to get him an appt so quickly. He’s getting his shot the same place DH and I got ours. It’s a really smooth, efficient ordeal start to finish!

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My 12 year old is ready for his appointment on Friday. Big brother just returned home from college and all the kids are eager to hang out with the reunited clan and not worry so much about masking and distancing in the house. We will all be vaccinated with this last kid. And while we are still careful, we are looking forward to being more at ease in the world in 3+ weeks after second dose. He’s been worried about COVID after hearing about a friend’s illness and has gotten more hopeful with the FDA news on Monday.

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DS15 is at boarding school in Mass. I had signed him up on the state’s website a couple of weeks ago for notification of when he could book a vaccine appointment. I just got the link to book him and am waiting for a response from his school as to whether or not they can transport him. They have kept the boarding students locked down for months, but took the ones who were 16 and up to get vaccinated a few weeks ago, with parents’ permission of course.

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My 15 y/o D will get her first shot tomorrow. She had a moderate case of COVID back in March, so I’m expecting she might feel pretty crappy after the first dose.

Super excited to finally have our entire household vaccinated.

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We ended up going yesterday to a mass vaccine site with drive thru dosing for the first shot! All the cars had young teens getting theirs. And my fb feed is bursting with pics of kids 12-15 getting their vaccine. In 5 weeks we can start to get back to normal!

I’ll confess that I haven’t gotten my 12-15 year olds vaccinated yet. My husband and I leaped to get ours when able, but when I realized the EUA only had 1100 kids get the vaccine (and another 1100 placebo) it made me want to wait until the sample size was bigger. In the ideal world, I’d wait for two months after the second shot to satisfy my inner safety nerd (which would land us ~8/10), but would like the kids vaccinated before school starts next year. I sort of feel like I’m being irrational–how much different in response to vaccination are the 12-15 y/o bodies than 16? But…I can’t quite shake wanting to wait. (Hear me: it’s not if, but when. And if the number of infections here were higher, I think I’d recognize the luxury of my thinking and just get it done.)

There have been a VERY few reports of transient myocarditis in response to the vaccine (inflammation of the heart muscle). My 17 yr old got both doses Pfizer - had first dose the day he became eligible. But right now, if I had a 12-15 yr old, I would consider getting them only the first dose, and not the second, assuming that the older people in the household are fully immunized and there is no vulnerable household member.

Children’s immune systems are stronger (more reactive) than adults. Most children can be presumed to have an adequate response to just one dose of the vaccine. So I’d compromise at one dose of the Pfizer for them, for the time being, until we have more data.

In my mind, when one weighs the risks/benefits of immunization for 12-15 yr olds, it makes sense to consider one dose, for now. The benefit of the second dose remains the same, whether it is given three weeks or three years after the first dose. The only issue is that of course the person does not obtain the benefit from the second dose until after the second dose has been given.

Thanks for the article; I hadn’t seen it. I’d seen reports about transient myocarditis, but the last thing I saw was that they rate at which was seen was consistent with the rate in the general population, so it could just be correlation. I like that compromise, and it fits my family. I’m going to talk to my husband about this. Thanks again for posting!

https://www.nejm.org/doi/full/10.1056/NEJMc2102051

This study was to determine and compare antibody response to first dose of Pfizer vaccine in healthcare workers who hadn’t already had Covid, vs those who had recovered from real Covid infection. Incidentally, they reported nice antibody response in the Covid-naive workers 3 weeks after that first dose.

Meanwhile, since adolescents have more robust, reactive immune systems than adults, it’s reassuring. One might extrapolate that young teens would be very likely to have an adequate response to just one dose - while the myocarditis was usually seen after the second dose.

However, keep in mind that the decision to go with one dose in Israel for the young teens is being made in a setting where, because of the high number of Israelis 16 and up who are fully immunized, the number of new cases being diagnosed each day is very low - just 25 yesterday in a country of 9.2 million. If you’re living in a state with a high rate of immunization, seems to make sense. But if you’re living in a state with a low rate of immunization, and a high rate of infection currently, might make more sense to get the second dose, too. As you said, the rate of myocarditis in vaccinated teens may be no more than the background rate in the population.

I’m in CA. Adults in my neck of the state are 83% vaccinated (unsure if this is one or two doses, but I’m hoping the latter). Our R-eff is 0.8, and my kids are willing to keep masking even after the mandate ends 6/15. We’ll see how resolute they are about this when their friends are all mask-less…

I’d say that your area is pretty low-risk, so the one dose of Pfizer for now, seems like a reasonable idea, and you can revisit the decision on the second dose in a month or so when there is more data.

Based on the image included in that study:

It looks like (in the bottom section of the image) one dose of vaccine in those with no history of infection resulted in highly variable “Blocking of Binding of Receptor-Binding Domain to ACE2”, similar to history of infection before vaccination. However, previously infected people who got one dose of vaccine had uniformly high blocking of binding, except for one unlucky person.

You’re correct. However, in general, after infancy, young people tend to have better immune responses to immunization than older adults (which some of these healthcare workers surely were). In the setting of very low rates of infection, and considering that there is at minimum a three week wait before administration of the second dose (in which time we have more data), it is very appropriate to get the first dose in 12-15 yr olds now, and make a decision about the second dose later on. Not to mention the fact that we don’t yet have enough data on how much is enough in terms of antibody response. For all we know, that wide response to blocking of binding in the Covid-naive population after the first dose, may still have been enough to prevent infection in a large percentage of the cohort. Makes sense to get that first dose now, in any setting.