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Announcer: Welcome to Inside Pediatrics, a podcast brought to you by Children's Hospital of Alabama in Burmingham.

Host: I'm Conan Gasque. Pfizer's COVID-19 vaccine is now approved for use in children ages 5 to 11, and many parents have questions about getting their child vaccinated. Recently I spoke via Zoom with two pediatricians at Pediatrics East, a primary care practice in Trussville, Alabama.

Dr. Gigi Youngblood and Dr. Peily Soong answered some of the most common questions they are hearing. Here's my interview with Dr. Youngblood and Dr. Soong. Dr. Youngblood, we'll start with you. Why do we need to vaccinate younger kids? What, why is it so important to make sure that we vaccinate kids in this age range?

Gigi Youngblood, MD (Guest): There's definitely important reasons to vaccinate this age group. First and foremost, being vaccines are how we end this pandemic. They're crucially important for everybody affected by the pandemic. We are losing kids. We've lost over 600 kids and there's a significant portion of that, those pediatric deaths from COVID that were in this 5 to 11 age group. We are also seeing, you know, longer term issues in this age group, including things like MISC, which is a really potentially dangerous inflammatory condition that happens after COVID it also includes that inflammation of the heart muscle called myocarditis. So, we are seeing those things from COVID and these kids deserve protection just as much as everyone else.

Host: And I know that's one of the questions that y'all have been hearing. Certainly been hearing a lot of questions from parents so far, including perhaps how this vaccine is different from the vaccine that may be offered for people 12 and older. Dr. Soong, what can you tell us about how this vaccine differs from that vaccine?

Peily Soong, MD (Guest): So it is a, it's a different dose. It's a big thing. It's a smaller dose. It's about a third of the dose of the adult vaccine. The adult vaccine, and I want to say adults also for the 12 and above too is a 30 microgram dose. Whereas this one is a smaller dose. It's a 10 microgram dose. And it has been shown to be just as effective in terms of antibody titers, effectiveness as well, too.

When they looked at the studies on, on the kids that they, they did, the studies on, the antibody levels were about the same for, for the kids, 5 to 11 years old with this 10 microgram dose as they were with the teenagers at the 30 microgram dose. So, they felt that this dose should be just as effective at, at preventing a coronavirus and the study show that it is a very effective vaccine for kids 5-11.

Host: So, and hearing information like that should certainly be encouraging for parents who are considering whether or not to get their children vaccinated. Oh, another question that frequently comes up is side effects of the vaccine. Dr. Youngblood, what do we know about potential side effects?

Dr. Youngblood: Typically, this vaccine is very well tolerated. You can see small amount of kids in the study got fever. A good proportion had a little headache, little fatigue, pain at the site of injection, you can get redness and swelling at the site of injection. So, it's very similar what we're seeing in adults and probably even better tolerated in this age group, from the numbers we've received so far.

The biggest thing that I think parents are concerned about is myocarditis. That's the thing that is making the news. The only vaccine that's going to be available for this age group is the Pfizer vaccine. And there's not really been a increased risk of clotting associated with that. But the biggest thing to take home about really any age group and COVID vaccination is we have to remember that the big, scary things that are being, you know, listed as potential side effects with the vaccines, including clotting risk and myocarditis, which again is inflammation of the heart muscle; we see those at significantly higher rates associated with COVID infection then with the vaccine. So, you know, when you're trying to make this decision about side effects, sort of factor in that, you know, your kid may feel a little under the weather for a day or two after the vaccine, but in terms of big scary things, you are absolutely at a significantly lower risk of those big scary things if you take the vaccine versus if you take your chances with COVID. And the way virus keeps surging, you are picking a path. You're either going to get the vaccine or your child's going to get COVID at some point in time, unless you live in a bubble, which we know it's not good for kids.

Dr. Soong: I would like to add a little bit. Yeah, with the lower dose, of the vaccine they did actually see lower side effects to it about half as many kids were getting side effects to the vaccine, the biggest one was pain at the injection site, but the fevers, the fatigue, the headaches that, that you could see were also about half as less of kids were getting it with the lower vaccine.

So, it's a little bit better tolerated too based on the smaller dose or most likely it's based on the smaller dose. So, and there's a little bit less affecting the kids less in terms of side effects. And most of the side effects just lasted like the adults and the teenagers is one to two days and then they're back to normal too.

Host: Very good information for parents to have as they make their decisions going forward about vaccinating their kids. And of course, speaking of going forward, the holidays were coming up. Dr. Soong, we will stick with you. How important is it for parents to make sure that they get their kids vaccinated before the holidays?

Dr. Soong: So, like we were saying that, that we are seeing COVID cases in kids. As the winter months come on, we're anticipating that there could be another surge of coronavirus coming through. So, and when you've got holiday gatherings, we saw it last year when we had holiday gatherings, that's when we started seeing peaks of it.

So kids can spread COVID. And so it's important to get them vaccinated so they don't spread COVID. They don't spread it to people that have weak immune systems. They don't spread it to elderly people or people that have not been vaccinated. But, so it is important that you get it done before the holidays.

Host: Vaccination is of course a very important way of protecting your child against COVID-19. But as you're going through the process of getting vaccinated, Dr. Youngblood, you also need to take other measures at least for sure, up until a certain point, right?

Dr. Youngblood: Absolutely. So, you don't, I wish you've got magical protection as soon as that vaccine went into your arm with the first dose, but we know that while kids can certainly can a big boost with the first dose, and the minute you do get it, you start making that immune system response that's going to protect you. You're not going to reach that full effectiveness until somewhere between one to two weeks after your second dose. So, this is why it's so important that we get this in as soon as possible before the holidays.

And that until your kids have reached that maximum effectiveness, that they continue to use a mask in social settings, wash their hands. Honestly, I hope that we've all kind of developed that habit as a result of this pandemic and the frequent hand-washing will stay with us. And you know, if you're not feeling well or your child's not feeling well, or a family member is not feeling well, give full disclosure to those you love and stay away until we know more about what's going on with your child or with that loved one.

Host: So the approval has now been made and the next step is going to be for people to try to get vaccinated. I know one of the most common questions you all have been getting is where can people go for vaccinations? I know that Children's of Alabama and UAB will be offering them and more details will be forthcoming about that and how you can get the vaccination at both places in the near future. Dr. Soong, I guess for the time being the best thing for people to do is just reach out to their pediatrician, really for any questions that they might have regarding vaccinations.

Dr. Soong: Of course, we're always the ones that you trust and we take care of your kids. We see them grow up. We, we offer other vaccinations as well, too. And we've all been very versed of what's going on, through the whole pandemic. And it's always good to ask your pediatricians. We do know some, a lot of the nationwide pharmacies, Walgreens, CVS, Publix, will be giving out the vaccines too.

But a lot of local pediatricians will be getting vaccines and will be giving it to their patients as well, too. So, you can call your pediatricians up and see if they're offering it. Or, or, like I said, if you're wanting to go get it now, you know, just call your local pharmacy and see if they've gotten it as well.

Host: Once again, Dr. Peily Soong and Dr. Gigi Youngblood from Pediatrics East in Trussville, Alabama. Thanks so much for all your advice as we continue to make our way through this process. And once again, stay tuned to children'sal.org for the latest details on COVID-19.

Announcer: Thanks for listening to Inside Pediatrics. More podcasts like this one can be found at children'sal.org/insidepediatrics.