During this town hall, held on November 16, 2021, Infectious disease specialist Michael Hori, MD, with Valley Medical Center and Mark Del Beccaro, MD, with King County Public Health answer the community’s questions about COVID-19 and vaccinations for children. Taylor Gaston, Program Manager for Policy and Government Affairs with King County Public Health, answers questions related to county-wide mandates.
COVID Stats as of November 16, 2021
World-Wide
- 253,793,000 documented COVID cases; 1.9 million children
- 5.1 million deaths; 150 children with 8,300 children hospitalized
- 7.5 billion COVID vaccines administered
The United States
- 47,145,861 documented COVID cases
- 761,426 deaths
Washington State
- 755,011 probable and confirmed COVID cases
- 41,723 hospitalizations
- 8,990 deaths
Unvaccinated individuals are:
- 3x more likely to get a COVID infection
- 12x more likely to end up in the hospital with COVID
- 13x more likely to die from COVID
Why should children be vaccinated, particularly if cases are often considered mild in children?
- The important word is “if,” if the case is mild, but there is a chance it might not be. Children have a lower chance of developing a severe case, but that’s not zero. There are states across the U.S. with children’s hospital’s that have had intensive care units full of children with COVID.
- Our children aren’t leading normal lives. It affects their development, their ability to stay in school, and their ability to be a kid. Every time there is an exposure at school, kids get sent home, tested, and can’t go back for several days. Having children vaccinated reduces their likelihood of getting and spreading COVID, which allows them to stay in school and continue thriving.
- Reducing fear and increasing social interaction. Right now, kids are spending less time around other kids because they’re afraid, and the only way to get past that is for enough people to get vaccinated so that we get the virus under control. Right now, every time someone gets a cold, they don’t know if they have COVID, or another seasonal virus, which only causes more anxiety and fear in families and children alike.
- Kids are not good at keeping their germs to themselves. Yes, children may only get a mild infection, but they spend time with people who cannot fight infection as well as a healthy five-year-old, including grandparents. As we head into the holidays, it is even more important to ensure children won’t pass a COVID infection on to family members, particularly those with severe or chronic illness, like cancer.
How can families feel confident that the vaccine is safe?
It’s important to start by pointing out that everyone has a right to make the best decision for their children and family, and we encourage you to spend time with your pediatrician, family practice doctor, or other provider that you trust.
- No medication is 100% safe. Many different medications are given to children to treat diseases, sometimes they’re mild and sometimes they’re very powerful, but they all come with the risk of side effects. Though rare, even common antibiotics given to children have the potential to lead to serious side effects. The risk of contracting COVID and being sick are significantly higher than having any side effects from the vaccine.
- We have more evidence of safety in this vaccine than any other vaccine in history. Billions of people have received the vaccine across the world and the effects are being studied and evaluated by organizations like the CDC, FDA, universities, and research centers every single day. They are all looking for evidence that these vaccines are not safe and so far, the benefits still greatly outweigh the risks. Many of the possible treatments and medications people have heard about, like Ivermectin, have been studied far less, been given to fewer people, and have much worse side effects than the vaccine.
- Related to myocarditis and heart problems: this is something many parents have fear about and appears most commonly in young males. A review of cases in King County by the CDC, showed almost every child who got myocarditis after receiving the vaccine got over it in a very short period of time, usually in less than a week. In addition, there were no serious long-term side effects in those children. The number of children who experienced this side effect is less than the number of children who have been hospitalized with COVID. This doesn’t mean it will not happen, but it does mean the chances are rare and if it does occur, it is likely to go away with conservative treatment.
- Related to fertility concerns: this is an unfortunate, but common myth. At the beginning of COVID, there was a scientist who thought the vaccine might share common proteins with the female reproductive organs, like the uterus. Since then, several other scientists have showed that is not at all true. That same scientist also believed that COVID wouldn’t be a big deal and would go away and not cause many deaths.
Billions of vaccines have been given across the world for over a year now and women are still getting pregnant and having healthy babies. In fact, pregnant people who are not vaccinated have a higher pregnancy death rate and higher loss of babies. We strongly encourage pregnant individuals to get the vaccine because not only is it a good way to protect yourself, but it also protects the baby by providing them antibodies that will help protect them from COVID.
What are the differences between the vaccine for children and the one for adults?
The Pfizer vaccine for children is about 1/3 the dose of an adult vaccine. This does not mean it’s less effective or that side effects will be different–it is simply because children are smaller. As children grow up, they’re exposed to a world full of infection at a rapid rate. Thankfully, they are also able to develop immunity very rapidly with a smaller amount of immunogen, which is why they do so well with a smaller dose of the vaccine.
If my child is 11, should I wait to get them vaccinated until they’re 12 so they can receive that adult dose, or will they still be equally as protected at the lower dose?
No, they should be vaccinated as soon as possible. Even if your child is 11 when they get their first dose and turns 12 before their second dose, they will receive the adult dose for their second and that is absolutely safe and okay to do.
Some immunocompromised adults receive a third dose to be considered fully immunized, is the recommendation the same for children?
Not yet, but it may be the case in the future. The reason it’s not currently recommended is because children haven’t been authorized to be vaccinated for very long, so we haven’t had an opportunity to study whether or not their antibody levels are going to drop. There is a good probability, they may need boosters sometime in the future, but right now, we just don’t know.
It is important to note that many vaccinations require boosters, especially many that children receive early in life. Even adult vaccinations, like tetanus, require boosters. As we age, our antibody levels drop, and vaccine boosters help to keep us safe by raising our antibody levels back up.
Are there any children who shouldn’t get vaccinated? What about children with disabilities?
The reasons for not having a child vaccinated are the same as an adult and often relate to severe allergic reaction to the vaccine or components in the vaccine. Children with a disability or developmental delay are at greater risk of getting severe COVID disease, particularly if they have underlying heart or lung problems. Research has shown that children with a disability who get COVID and are not vaccinated, also have a much higher risk of dying, so it is incredibly important to have them vaccinated.
The only other groups of children, outside of those with an allergic reaction, who should wait to be vaccinated, are those who have been treated for a COVID infection with an antibody treatment and those who contracted COVID and got multi-inflammatory system disease affecting their heart. These groups should consult with their pediatrician or pediatric cardiologist before having their children vaccinated. In general, a history of COVID is not a reason to not get the vaccine once you’re recovered.
When is the best time to get vaccinated if you or your child has recently had COVID?
Once a person, child or adult, is through their acute infection and is no longer having symptoms. Commonly, this is about 10 to 14 days, to ensure you’re no longer infectious. It’s also important to note that people who have gotten COVID and then gotten the vaccine once they were recovered, have the highest level of protective antibodies.
Has the Pfizer vaccine been linked to a pediatric appendicitis?
There is nothing in any of the literature or studies that shows that, but it’s a good example of how we look at data. Appendicitis happens pretty regularly, so it’s not unlikely for it to occur at the same time as something else, like getting a vaccine. If we see a child for a broken arm a few days after they received their vaccine, it does not mean the vaccine caused their broken arm, and the same can be said for appendicitis.
If the Pfizer and Moderna vaccines are so similar, why has only Pfizer been approved for children?
This is a great question, because it highlights just how cautious the FDA and CDC are being before choosing to approve these vaccines and how we can feel confident in their safety. The studies done by Moderna have been submitted, but are still being evaluated, which means they want more time and more data before it’s approved, which only increases confidence in its safety once approved.
How can people identify reliable information versus rumor?
These are all difficult questions, and they’re even more difficult when it comes to your child. That is why it’s so important to speak to a provider you trust, whether it’s your child’s pediatrician, your own provider, or another trusted individual– bring them your questions, even the ones you’re afraid to ask.
We know that sites like the CDC or Public Health are reliable, but we also know that not everyone feels they can trust those sites. In those instances, it is important to make sure the sources you’re using are verified. For instance, anyone can post anything on social media, like Twitter, regardless of whether or not it’s true, so it’s probably not the best place to get reliable health information.
How do businesses in King County know whether they are required to request proof of vaccine? Will children be required to show proof of vaccine?
Businesses and establishments that will be required to request proof or a negative test include:
- Restaurants and bars with indoor dining and 12 or more seating capacity
- Restaurants and bars with indoor dining and 12 or less seating capacity have until December 6, 2021, to comply with this order
- This does not include outdoor dining and does not include takeout or grab & go settings
- Examples of “grab & go” settings include things like a Starbucks inside a grocery store or a mall food court
- Indoor recreational events including professional sports, collegiate sports, performing arts, live music venues, theaters, gyms, conference halls, conventions, and community centers
- Any outdoor event with 500 or more people
Children under the age of 12 will not be required to show proof of vaccination or a negative test.
When businesses request proof of vaccine, do they also need to check identification, like a driver’s license?
Absolutely not. This is against anti-discrimination policy, so no business should ask for that if you are dining or frequenting that establishment.
The policy reads:
“Discrimination will not be tolerated in the implementation of this ORDER. Employers, their employees, and volunteers, must implement this ORDER equitably and may not:
• Scrutinize proof of vaccination more closely based on an individual’s race, national origin, religion, sexual orientation, gender identity, disability, age, or
• Refuse to accept valid proof of vaccination that is authorized by this ORDER, such as WHO approved vaccination from countries outside of the U.S. or photographs of CDC vaccination cards.
Employers, employees, and volunteers should provide reasonable accommodation for those with disabilities who attest to having completed their vaccination series but are unable to provide proof of vaccination due to a disability.”
What should business owners be aware of regarding the OSHA mandate to regularly test unvaccinated workers for COVID?
As of Nov. 21, 2021, the U.S. Court of Appeals for the Fifth circuit has ordered that OSHA take no steps in implementing or enforcing this mandate–so currently, it is on hold. In the meantime, it is up to the business or establishment whether they wish to implement this, but it is highly recommended that establishments follow the Emergency Temporary Standard, or ETS.
Will there by opportunities for financial support to help businesses affected by the mandate?
Absolutely! Currently, there are a few opportunities throughout King County:
- South King County Community Impact Fund: This is a recovery program that allows businesses to apply for financial compensation, ranging from $100,000 for the whole year or $250,000 for up to five years. This funding is available to restaurants and businesses in South King County.
- Small Business Stabilization Fund (Seattle Only): The City of Seattle recently announced a $2 million dollar fund for small businesses that allocates $2,000 for businesses, with some specialty businesses receiving an additional $1,000.
- Digital Equity Grants Fund: This closes on Nov. 30, 2021.
- Coalition Against Hate and Bias Grant Program: This closes on Dec. 8, 2021 and is perfect for businesses that have had problems with discrimination, as it addresses the equity issues centered around mandates and other effects of COVID.
- Small Business Loans: Offered through the U.S. Small Business Administration, amounts will vary.
