Should I give my child the COVID vaccine? How this pediatrician made the decision

As vaccine eligibility becomes an option for kids over 5, I’ve received questions from many friends about whether I will vaccinate my 6 yr old. The answer is: Yes, I will.

Here’s how I made my decision.

Image courtesy of Unsplash (CDC)

Why did you decide to give your child the vaccine?

As a pediatrician, & as a scientist, I have long been an advocate of vaccination. I would never recommend something to a patient that I would not choose for my own kids. Many parents remain concerned about how to balance risk, myself included, and I spent a lot of time reading and discussing with other physicians. We all want to make the best decision for our kids.

The truth is, every pediatrician I know is getting their child vaccinated. 

What Factors Did You Consider?

In brief: safety, effectiveness and the relative unknown risks of the vaccine vs the disease.

Yes, the 5-11y group studied was smaller, but when I think about it in the context of how many of these have been given out now in other age groups, I am reassured. The pediatric dose is lower than the adult dose, and still generates a comparable antibody response but with fewer side effects. It is clearly effective at preventing severe illness.

When I think about this decision, I also keep in mind the relative risk of severity. I am lucky: my kids are low risk. But a third of hospitalized cases occurred in healthy children, and COVID is now in the top 10  leading causes of death in the pediatric population. Importantly, COVID is also a weird disease, with an inexplicable randomness. Even when we know risk factors, we are not always able to predict who will have a severe course (in either adults of children), who will have no symptoms, and who will end up with long COVID, MIS-C or other complications.

The other important factor is morbidity. Death isn’t the only outcome to consider, although many thought leaders and physicians in the media focus on it as a hallmark of a “good” intervention. Yes, hospitalization and death matter, of course they do. But even when children survive, there is the question of how well they recover after a complication like MIS-C, myocarditis (which is caused by the disease at a higher rate than the vaccine), ICU admission, artificial ventilation. Even mild COVID infection results in missed school, and can cause long COVID and impact brain function. 

What about the long term risks of the vaccine itself?

This is always a reasonable question to ask of any intervention. Historically, vaccine side effects (even the rare ones) are picked up within 6 weeks of receiving the shot. Myocarditis, for example, typically manifests within days of receiving the immunization.

Vaccines are not known to cause “long-term” consequences, although the potential for one is a common anti-vaccination trope. In my decision, I am primarily weighing concerns about short-term vaccine side effects against the short and long-term risks of the infection, not just for my 6yo but for the unvaccinated higher-risk people in our bubble (younger siblings). Based on my research, the balance comes out in favor of the vaccine, especially given how little we still know about COVID.

I’d rather choose a vetted vaccine that is truly unlikely to have any long-term ramifications than an unusual, unpredictable disease that already shows mid-length complications.

Are you nervous?

I’m a parent. Of course! I want to make the right decision for my child. But I really do think the science is reassuring here and am not conflicted about my decision at all. 

Caveat: I put these posts together as a service because I feel strongly that parents deserve accurate info. It takes time & effort but I enjoy it. I receive wonderful appreciative messages most of the time, which is obviously rewarding. Disagreeing with me is fine. But being disrespectful or unpleasant is not. I expect my toddler to be respectful, civil and kind. Doesn’t always work for her…but she is a toddler.  I have the expectation that my readers and followers can manage respectful, civil & kind. Recognize that I’m talking about MY decision, for myself & my family, because I feel it might be helpful to others to hear how a pediatrician approaches this question. But every person should make their own decision, in conjunction with their healthcare provider about this (and everything, frankly).