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Teens, kids 12-15 and the COVID-19 vaccine: What parents should know

With children ages 12 -15 years and teens ages 16 years and older now eligible to receive the COVID-19 vaccine, parents may have questions about the vaccine and what to expect afterward. Here, Dr. Angela Dangvu, a pediatrician in the CHOC Primary Care Network, answers some common questions about the vaccine, teens and kids.

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Dr. Angela Dangvu, a CHOC pediatrician
What vaccine will my teen or child receive?

At this time, the Pfizer vaccine is the only vaccine authorized for use in teens ages 16 and older and children ages 12-15 to prevent COVID-19. It is administered in two doses three weeks apart, injected into the arm muscle.

The Pfizer vaccine, as well as the Moderna vaccine, which is authorized for people ages 18 years and older, is an mRNA vaccine. When the vaccine is injected, mRNA – a strip of genetic material – enters a body’s cell and prompts the cell to build copies of spike proteins. These spike proteins are the bumps that protrude from the surface of coronavirus particles. The body’s immune system then learns to spot these spike proteins and produces antibodies that block the virus from entering healthy cells in the future.

Studies show that vaccine recipients achieve immunity about two weeks after receiving the vaccine’s second dose. Scientists are still learning about how long that immunity will last.

I have younger children. What is the status of vaccine research in children younger than 12 years old?

To date, Pfizer and Moderna have enrolled children as young as 6 months in clinical trial studies. Janssen and Astra Zeneca also have plans to study their vaccines in younger age groups.

Is the vaccine safe for teens and kids? Are there other risks for teenagers and children that might not be present for adults?

The Pfizer vaccine is absolutely safe for children ages 12-15 years and teens ages 16 years and older. In clinical trials, enough teens and children participated to show that the vaccine is safe for 12-year-olds and older. We have no reason to expect that children would tolerate the vaccine less favorably than adults would.

If children and teens are less likely to get sick from COVID-19, why do they need a vaccine?

Even though it is rare for children to get seriously ill from COVID-19, children who are 12 years and older have needed hospital care for COVID-19. This is especially true for children and teenagers with underlying health conditions such as weakened immune systems, obesity or chronic lung conditions. Having the vaccine may also give parents, teens and kids alike peace of mind to return to more typical activities like in-person instruction and participating in sports, which is great for mental health.

Are there any teens or children who shouldn’t get the vaccine? Should I talk to my pediatrician before scheduling the appointment?

There is no category of children or teenagers who shouldn’t get the vaccine, unless they have a known allergy to one of the vaccine’s components. Because it isn’t a live vaccine – a vaccine that uses a weakened form of a germ to prompt an immune response – people with weakened immune systems, either from illness or medication, may still receive the vaccine. There have been reports allergic reactions to the vaccine, but these occurrences are very rare. Vaccine recipients are monitored for 15 minutes after receiving the injection in case of any allergic reaction, and anyone with a history of severe allergic reactions to foods or medications (who carry an epinephrine auto-injector) are monitored for 30 minutes. Children and teens with other types of allergies beyond any vaccine component can feel safe receiving the vaccine.

Children or teens who recently received other vaccinations should wait two weeks before seeking the COVID-19 vaccine.
Parents are always encouraged to speak with their teen’s or child’s pediatrician if they have any questions or concerns.

Will the COVID-19 vaccine affect my child’s fertility?

Definitely not. Because it is an mRNA vaccine (see explanation above), the vaccine does not get incorporated into or change the DNA of the body’s cells in any way. There is no reason to worry that the vaccine will affect fertility or future offspring.

The COVID-19 vaccine was developed quickly. Should I be concerned about that?

No. The vaccine was developed quickly because scientists received additional money and resources to support from the government. This allowed scientists to follow all the typical processes but overlap some steps, which sped up the process. Also, it was easy to find volunteers to participate in clinical trials because many were excited by the possibility of receiving the vaccine. None of these factors compromised the quality of the trials, and the same processes for safety and effectiveness was followed. 

I’ve read about COVID-19 variants. Will the vaccine protect my teen or child against them?

We are still learning about how effective the vaccine is against variants. While there may be some decrease in immune response, the vaccine is still largely protective. An important step in fighting variants is to ensure as many people as possible get the vaccine. The more people who get sick – even mildly – with COVID-19, the more opportunity is presented for the virus to continue to mutate.

My teenager or child already had COVID-19. Should they have the vaccine?

Yes. We don’t know how long the immunity lasts from natural illness, and the vaccine is made to create a longer lasting immune response.

What if my teenager or child has COVID-19 now?

Your child or teen should wait until they are feeling better and no longer need to isolate based on guidelines from the Centers for Disease Control.

What if my child has received convalescent plasma treatments?

Your child or teen should wait 90 days to get the vaccine after receiving convalescent plasma or monoclonal antibody treatments. Your child’s pediatrician can help you determine when it’s appropriate to get the vaccine.

Can my child take their normal medications before the COVID-19 vaccine?

Your child should continue to take their normal medications as prescribed.

Can my child take acetaminophen, ibuprofen or an antihistamine before the COVID-19 vaccine to offset any potential side effects?

No. It is best to avoid preventatively administering these medications – either before the vaccination or right afterward if no side effects are present – because there is a chance they can decrease the immune response.

Do I need to accompany my child to the vaccination?

Yes. Anyone under 18 must have a parent or legal guardian present to receive the vaccine.

What should we bring to my teen’s COVID-19 vaccination appointment?

Bring photo ID, such as one from school or the government, and a document verifying your child’s date of birth, such as a birth certificate or a medical visit summary with their name and date of birth. There’s no need to bring your child’s vaccine records, as they will receive a card specific to the COVID-19 vaccine. It would be helpful if the teen or child wears a short-sleeved shirt, as the injection is administered into the arm.

What should my child expect at the COVID-19 vaccination appointment?

After checking in and taking care of paper work, the teen or child will be asked some questions about their health. The shot will be administered into the arm. After receiving the shot, the teen or child will be monitored for 15 minutes to ensure no adverse reactions. They will also receive a card indicating when they received the vaccine and information about the vaccine.

What should I do with their vaccination card?

Take a picture of it just in case and store in a safe place. There is no need to laminate it.

Do we really need to come back for a second COVID-19 vaccine?

Yes. Clinical trials that led to the Pfizer vaccine’s licensing incorporated two doses. So, the determined efficacy is based on two doses and we don’t yet know how effective one dose alone is. The Johnson & Johnson/Janssen vaccination is administered in one dose, but at this time it is only approved for people ages 18 and older.

What are the side effects of the COVID-19 vaccine? Are there any different side effects for kids?

The most common side effects are fever and feeling achy or tired. Any side effects should be relatively short-lived and ease within 24 hours. Because teens and children have more robust immune systems, it’s possible that they may feel these side effects more strongly than adults would. This is a sign that their immune system is mounting a response against the virus.

If side effects do appear after the COVID-19 vaccination, what can I use to treat them?

It is fine to treat side effects once they surface with over-the-counter pain medicine. Either ibuprofen or acetaminophen is fine, so long as the child hasn’t had previous reactions to these medications.

Should my child stay home from school after the COVID-19 vaccine?

If they have a fever, the teen or child should stay home. Beyond that, so long as they are feeling well, there is no need to limit activities.

What if my child is exposed to COVID-19 after they’ve been vaccinated?

Once two weeks have passed since their second dose, they have reached full immunity and there is no need to self-isolate after exposure to someone with COVID-19. Monitor them closely, however, to ensure they aren’t developing symptoms. If COVID-19 symptoms surface, begin self-isolation and contact your pediatrician.

After receiving both COVID-19 vaccine doses, can my child stop wearing a mask?

No. It’s important that they continue to take precautions against COVID-19. Though they are highly effective, the vaccine is not 100 percent effective, and while among a group of people, it’s impossible to know who is and who isn’t vaccinated.

How will the COVID-19 vaccine change socializing for my child?

Teens, children and families alike can definitely have more peace of mind about the safety of resuming more typical activities, which will be wonderful for mental health. In group activities, kids ages 12-15 and teens 16 and older should still continue to wear masks. In one-on-one activities where a child or teen and their friend are fully vaccinated, they can feel comfortable removing their masks so long as no one in either household is high-risk and unvaccinated.

Should I be concerned about having my older vaccinated teen or child around their younger siblings who are not vaccinated?

No. These children were already interacting with each other in the same household before one received the vaccine. The entire family can take comfort in knowing that one more person in household who has been vaccinated offers more protection for the whole family.  

Get more information from CHOC experts about COVID-19 and kids.

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