Ask the Expert: Children and the COVID-19 vaccine

With access to the COVID-19 vaccine widely available, parents have plenty of questions about next steps: Are older children eligible for vaccination? Is it safe? What about younger children? Is it safe to take a summer vacation? What about outdoor activities where masking isn't possible, such as swimming lessons?

Aaron CarrollView print quality image
Dr. Aaron Carroll. Photo by Marina Waters

Inside IU talked to Dr. Aaron Carroll, professor of pediatrics at the IU School of Medicine and director of mitigation testing for IU's Medical Response Team, to answer those questions and more.

Question: The Centers for Disease Control and Prevention has approved the vaccine for children as young as 12. Is it safe?

Answer: As a pediatrician, vaccinating kids is what we do. In fact, the vast majority of vaccines we give are to babies and small children. And yes, the death rate from COVID-19 in children is low, but we've seen all kinds of strange symptoms; they can still become ill and still transmit COVID-19 to others. When you compare the risks and the benefits of the vaccine, the benefits massively outweigh any risks.

Q: How can parents or caregivers help kids prepare for their vaccine?

A: You can help kids feel more comfortable about getting a vaccine by talking to them beforehand about what to expect and offering them support and encouragement while they get their shot. Make sure you choose a vaccine site that offers the Pfizer vaccine, which is the only COVID-19 vaccine in the U.S. currently authorized for ages 12 to 17.

Parents or guardians can either go with their child to get the vaccine or provide written authorization that their child can receive the vaccine. And don't forget that the Pfizer vaccine requires a second dose -- given three weeks after the first dose -- for the recipient to be considered fully vaccinated.

Q: What side effects might kids experience after getting their vaccine?

A: Side effects from vaccines are normal signs that your immune system is building protection. After getting the COVID-19 vaccine, some kids may experience the same side effects that we see in adults, such as pain and swelling at the injection site and muscle aches, headache, fatigue, fever, chills and nausea throughout the rest of the body.

These side effects are mild and typically only last for a day or two. Some people have no side effects, which is OK too.

Q: Once my kids are fully vaccinated, what activities are safe for them to do?

A: Keep in mind that "fully vaccinated" for COVID-19 means it's been at least two weeks from the time of your final dose of vaccine (for kids, that would be the second dose of the Pfizer vaccine). After that, the CDC says it's generally safe for you to resume the activities you did prior to the pandemic -- without wearing a mask or physically distancing.

Of course, you'd still need to comply with any applicable federal, state or local rules, as well as those set by individual businesses. I'd still encourage everyone who's vaccinated to keep washing their hands frequently and to monitor themselves and their kids for symptoms of COVID-19 -- especially if you or they have been in contact with someone who's tested positive for the virus. Fully vaccinated people who develop symptoms still need to get tested.

Q: What if my kids are younger than 12? What is safe for us to do with unvaccinated children?

A: Everyone wants a cut-and-dried answer, or for the CDC to post a list of "do this, don't do that." Here's what I've been saying: The CDC gives nutritional advice too, but they don't tell you what to eat for lunch. Basically, what we have now is advice for what is less safe versus more safe.

For example, you want to take a summer vacation? Weigh the risks. Driving in a car versus taking an airplane: safer. Spending time outside versus spending time inside: safer. Spending time with family and a few friends versus being in crowds of people: safer.

There is no perfect safety in life; it's about weighing the risks. And even if you're flying, you can be pretty safe if you're careful. Wear your mask, try not to spend too much time close to big crowds at the airport, be careful what you touch and use hand sanitizer.

And just a reminder: CDC recommendations say unvaccinated people should self-quarantine following a trip, and maybe even get tested.

Q: What about outdoor activities for younger children? Say, swimming lessons or summer day camp?

A: In general, outdoor activities with smaller groups are very safe. It goes back to weighing the risks and your comfort level, and thinking about risk on a larger scale.

If you think about it, swimming is dangerous. There's a risk of drowning, but you're letting your children do it. So it's more about following good rules for safety and thinking through the risks than any kind of clear rules for "you should do this, but never that."