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Questions about the safety of child vaccinations and the need for booster shots have taken center stage as the widespread availability of COVD vaccines coincides with a recent statewide increase in COVID-19 cases.
According to data from the state Department of Public Health, approximately 36,000 children between the ages of 5 and 11 have received at least one vaccine — a number amounting to about 13 percent of the children in that age group in the state.
Dr. Tom Balcezak, Chief Clinical Officer at Yale-New Haven Health, said in a Thursday press conference that children have exhibited minimal side effects from the vaccines. And the side effects that occur, he said, tend to mirror those of adults — a sore arm, a fever, some chills.
Jody Terranova, assistant professor of pediatrics for the UConn School of Medicine, said that other than an allergy to a specific ingredient in the vaccines, there is no reason that a child should not be vaccinated.
Terranova, who is also president-elect and immunization representative for the Connecticut chapter of the American Academy of Pediatrics, said that children appear less likely to experience side effects than adults, although she said that in part that may be because few children have so far received a second dose.
Responding to reports of teenage males who have experienced inflammation of the heart in response to the vaccine, Balcezak said that this inflammation of the heart is more common with people who actually contract COVID. He also noted that children are still susceptible to severe and sometimes long-lasting effects from a COVID infection, including Multi-system Inflammatory Syndrome and long COVID.
A recent study in the New England Journal of Medicine found that about 11 in 100,000 young men between the ages of 16 and 29 developed myocarditis after the first vaccine dose.
“On balance there’s no question in my mind that the vaccine is safer than allowing your child to be unprotected and at risk for COVID,” said Balcezak.
According to the American Association of Pediatrics, data comprising 14 states, including Connecticut, found that 526 children between ages 5 and 11 were hospitalized with COVID between March 2020 and August 2021. Of those 526 children, 200 were listed as having had “severe disease.”
But Balcezak also said that despite the recent availability of the vaccine to children, it wasn’t yet time to get rid of masks in the schools.
“We do not have enough [penetration] into that population of kids 6-11 now to say that that population is protected,” he said. Balcezak said that the majority of positive tests that Yale New Haven Health was receiving were from children in that age range.
“We are seeing a lot of infections in those kids from 6-11. So unless and until we get to the majority of those kids vaccinated, I don’t think we can talk about taking masks off in schools.”
Terranova agreed. She said that it would be too difficult to know who had and had not been vaccinated, and therefore who should and should not be wearing a mask. She said there needed to be lower levels of community spread — to the point of being like the seasonal flu — before the masks could come off.
A recent letter to CT Examiner raised concern about the small size of the FDA trial that tested the vaccine on children: the trial included 2,268 participants who were between the ages of five and 11.
Balcezak said that even though sample sizes were small, he believed that the data clearly showed the efficacy of the vaccine. Terranova said that there wasn’t a reason to expect that children would have a different response to the vaccine than adults.
“I think, parents can still be reassured that this is the same vaccine that billions of people have gotten across the country,” she said. She added that over 1 million children between ages five and 11 in the U.S. had already received a first dose.
According to Balcezak, there has been at least one Pfizer trial that included children under the age of five. He said that studies were ongoing and that he expected a request for approval within the next year from the FDA to approve vaccines for children younger than 5.
COVID cases on the upswing
COVID cases have been on the upswing in the state of Connecticut in recent weeks. In the Ledge Light Health District, the case count reached 244 this week, nearly double the number last week and the highest since mid-September, according to weekly data from the district.
Balcezak said in the press conference that the immunity that the original vaccine provided decreases as time goes on.
“There certainly is some evidence that overtime immunity by the vaccine does wane. Over time, with all of the vaccines, there is a slight decrease in the protection that the vaccines give. Hence the reason for the booster,” said Balcezak.
Balcezak encouraged people to get booster shots once the Food and Drug Administration approved the boosters for all adults. The agency did so on Friday for both Pfizer and Moderna.
Dr. David Banach, the head of Infection Prevention at UConn Health, explained that the body produces anti-spike antibodies in response to the vaccine, which act as protection from the onset of full-blown illness.
“The vaccine stimulates immune cells like B-cells to produce antibodies and the antibodies are made, and then the antibodies themselves can wane over time. But those B-cells, the memory B-cells that are stimulated are still primed to provide protection if there’s exposure,” he said.
But Banach said that memory B-cells can also diminish overtime, leading to the need for a booster.
Balcezak said the decline in immunity isn’t unusual — other vaccines, like tetanus, also require periodic booster shots. He added that even though immunity does decrease, being vaccinated still protects people from getting severely sick.
Banach said that it may take time for B-Cells to build up antibodies to fight off infection. He said that this is why some vaccinated people will experience mild cases of COVID, but why it’s much more rare to see severe COVID cases in people who are vaccinated.
“The vaccines are extremely effective in preventing severe infection, but maybe less so in preventing mild infection,” said Banach.
Balcezak recommended that people get whatever booster was available, regardless of what vaccine they received originally.
“We have plenty of vaccine available, and we know that it’s safe and effective,” he said.