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COVID Vaccines for Kids Under 12: A Breakdown of What You Need to Know

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Children as young as 5 are now eligible for coronavirus vaccines after clearing both the Food and Drug Administration and Centers for Disease Control and Prevention.

Full-strength Pfizer shots were already recommended for anyone 12 or older, but pediatricians and many parents have been anxiously awaiting protection for younger children to stem infections from the extra-contagious delta variant and help keep kids in school.

So what can parents expect and when? Here's what we know so far.

When could COVID vaccines for kids under 12 begin?

In some parts of the country, shots had already began as of Wednesday, but in the Chicago area, that timeline looks a bit different.

Because the children's doses are smaller and in different containers, the doses must be shipped to both the state and city.

Vials of the lower-dose Pfizer vaccine for kids are headed to the Chicago area any day, health officials say.

Chicago Department of Public Health Commissioner Dr. Allison Arwady said that while next week will be a big week for vaccinating children, the shots could begin as early as Thursday.

"I think it's likely that by this weekend if everything goes as planned, we'll probably maybe as soon as Friday, maybe even Thursday, you know, we may start vaccinating," she said during a Facebook Live Tuesday. "And, you know, a lot of it will probably be more next week realistically."

A number of places across the city are already offering appointments for vaccinations that are scheduled to start this weekend and early next week.

Walgreens and CVS will begin administering COVID vaccines to children under 12 years old this weekend, with appointments already being offered as of Wednesday.

Both Chicago and Illinois' health departments have also released a list of places parents can check for available vaccinations.

See a full list here.

As the FDA plans to meet soon to discuss the next eligible age group, children ages 5-11, for the Pfizer coronavirus vaccine, doctors at Advocate Children’s Hospital have been talking with families and parents, listening to their questions and concerns. NBC 5's Lauren Petty reports.

What are the potential side effects for children?

As COVID-19 vaccines for kids ages 5-11 begin, some parents have expressed concerns over the side effects that might come with the child-size shots.

Doctors, however, overwhelmingly assert the benefits of vaccinating children are clear and outweigh the risks.

While a small portion of children suffer from severe disease, it's less likely for children to develop serious complications compared to adults.

Fully vaccinating 1 million kids ages 5 to 11 would prevent 58,000 COVID infections, 241 hospitalizations, 77 ICU stays and one death, according to a modeled scenario published by the Food and Drug Administration last week. Up to 106 kids would suffer from vaccine-induced myocarditis but most would recover, according to the agency.

Children are experiencing less side effects overall, according to Dr. Jackie Korpics with Cook County Health.

But when children do encounter side effects, they're typically similar to the ones experienced by adults and usually after the second dose, too.

Dr. Daniel Donner, a pediatrician with Novant Health, said fewer kids could be developing side effects because the COVID-19 shot for the age group is one-third the size of the dose compared to the one for adults, according to WCNC, the NBC affiliate in Charlotte.

"It could be because of the lower dose," he said. "They are less likely to have those startup side effects -- feeling tired, having fevers, just not feeling well in general -- for that 2-3 day period after the shot."

Pfizer conducted a trial involving more than 3,000 children who received its vaccine and found the shots were well-tolerated.

The most common side effects were mild and comparable to those seen in a trial of teens and adults ages 16 to 25. Common side effects include injection site pain (sore arm), redness and swelling, fatigue, headache, muscle and/or joint pain, chills, fever, swollen lymph nodes, nausea and decreased appetite.

A separate trial conducted by the Food and Drug Administration produced similar results.

Side effects were generally mild to moderate, occurred within two days after vaccination, and most went away within one to two days, the agency said.

Federal regulators say they are monitoring for rare heart inflammation conditions, myocarditis and pericarditis, which have appeared in a very small number of young adults who received either the Pfizer or Moderna vaccine. There were no cases of myocarditis in Pfizer’s trial for kids, but officials said the trial may have been too small to detect the rare heart condition.

What do we know about the vaccines in kids from the trials?

Federal health regulators said child-size doses of Pfizer’s COVID-19 vaccine appear highly effective at preventing symptomatic infections in elementary school children and caused no unexpected safety issues.

In their analysis, FDA scientists concluded that in almost every scenario the vaccine's benefit for preventing hospitalizations and death from COVID-19 would outweigh any serious potential side effects in children. But agency reviewers stopped short of calling for Pfizer's shot to be authorized.

Most of the study data was collected in the U.S. during August and September, when the delta variant had become the dominant COVID-19 strain.

The FDA review found no new or unexpected side effects. Those that did occur mostly consisted of sore arms, fever or achiness.

However, FDA scientists noted that the study wasn't large enough to detect extremely rare side effects, including myocarditis, a type of heart inflammation that occasionally occurs after the second dose.

The agency used statistical modeling to try to predict how many hospitalizations and deaths from COVID-19 the vaccine would prevent versus the number of potential heart side effects it might cause. In four scenarios of the pandemic, the vaccine clearly prevented more hospitalizations than would be expected from the heart side effect. Only when virus cases were extremely low could the vaccine cause more hospitalizations than it would prevent. But overall, regulators concluded that the vaccine's protective benefits “would clearly outweigh" its risks.

Do children need to be vaccinated from COVID?

While children run a lower risk of severe illness or death than older people, COVID-19 has killed more than 630 Americans 18 and under, according to the CDC. Nearly 6.2 million children have been infected with the coronavirus, the American Academy of Pediatrics says.

Doctors at Advocate Children's Hospital said last week that while cases in children tend to be less severe than those seen in adults, "more children are being hospitalized with severe COVID-19 infection than was seen earlier in the pandemic."

The group also warned that multiple cases of a life-threatening COVID-19-related condition called the pediatric multisystem inflammatory syndrome have been reported in the Chicago area and experts still don't know the long-term effects of COVID-19 on kids.

How will the U.S. begin vaccinations for kids?

Last week, the White House announced children ages 5 to 11 will soon be able to get a COVID-19 shot at their pediatrician's office, local pharmacy and potentially even their school, detailing plans for the expected authorization of the Pfizer shot for elementary school youngsters in a matter of weeks.

The Biden administration has purchased enough kid-size doses — in special orange-capped vials to distinguish them from adult vaccine — for the nation’s 5- to 11-year-olds. If the vaccine is cleared, millions of doses will be promptly shipped around the country, along with kid-size needles.

More than 25,000 pediatricians and primary care providers already have signed up to get the shots into little arms.

Is it only the Pfizer vaccine that will be administered in younger children?

Both Moderna and J&J's vaccines can only be used on people 18 and older, though Moderna also is studying its shots in elementary school-aged children.

Moderna said last week that a low dose of its COVID-19 vaccine is safe and appears to work in 6- to 11-year-olds.

Moderna hasn't yet gotten the go-ahead to offer its vaccine to teens but is studying lower doses in younger children while it waits. The company said Monday, however, that it will delay filing a request for emergency-use authorization of a lower dose of the vaccine for 6- to 11-year-olds following recent guidance from the FDA.

U.S. regulators are delaying their decision on Moderna's COVID-19 vaccine for 12- to 17-year-olds while they study the rare risk of heart inflammation, the company said Sunday.

The FDA told the company Friday evening that its review could last until January, Moderna said.

Heart inflammation is an exceedingly rare risk of both the Pfizer and Moderna vaccines, and it more commonly seen in young men or boys. It’s difficult for clinical trials to detect such a rare problem. And public health officials have repeatedly stressed that COVID-19 itself can cause heart inflammation at higher rates than the rare cases caused by the vaccine.

Researchers tested Moderna's two shots for the 6- to 11-year-olds, given a month apart, with each containing half the dose given to adults. Preliminary results showed vaccinated children developed virus-fighting antibodies similar to levels that young adults produce after full-strength shots, Moderna said in a news release.

The study involved 4,753 children ages 6 to 11 who got either the vaccine or dummy shots. Moderna said that like adults, the vaccinated youngsters had temporary side effects including fatigue, headache, fever and injection site pain.

The study was too small to spot any extremely rare side effects, such as heart inflammation that sometimes occurs after either the Moderna or Pfizer vaccines, mostly among young men.

Pfizer and Moderna are studying vaccinations in even younger tots as well, down to 6-month-olds. Results are expected later in the year.

Is the dosage for children the same as teenagers and adults?

Is the Pfizer vaccine that is being evaluated for younger children the exact same vaccine that teenagers and adults received?

According to Chicago Department of Public Health Commissioner Dr. Allison Arwady, the answer is no.

While the vaccine has "the exact same ingredients" and will follow the same timeframe between doses, "it is only going to be a third the dose."

"This is because younger children have a smaller body mass and in studies, they had the same level of antibodies and protection," Arwady said. "But the lower dose makes it less likely that the 5-to-11-year-olds will have side effects."

Arwady noted that the change in dosage will also require smaller needles and different vaccine vials.

"So we won't have people pulling adult and children doses out of the same vial, there is a separate process for child vaccines," she said.

What should you do if you still have questions?

Illinois health experts acknowledged that many parents will likely have questions surrounding COVID vaccinations for children.

The state's top doctor and other pediatric health officials urged parents to discuss the decision with their doctors and ensure that any other information comes from reputable websites.

"As the state's top health officials, and as a board certified pediatrician and mom, I am urging every single parent and guardian to do this for their child," Illinois Department of Public Health Director Dr. Ngozi Ezike said. "Make a plan to get them vaccinated for COVID-19."

"I also know that there are many parents out there who aren't quite ready to be the first in line to get their kids vaccinated and who might still have questions," Pritzker said. "That's OK. There are experts who can provide you with answers and I urge you to talk to your own doctor."

NBC Chicago/Associated Press
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