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Articles and Updates from Phoenix Children's

August 30, 2022
COVID-19 Variants and Kids: What Parents Should Know
COVID-19’s Delta Variant and Kids: What Parents Should Know

This article was last updated on August 30, 2022

As COVID-19 cases rise in our community, many parents and caregivers are wondering how best to keep the babies, kids and teens in their lives safe. We spoke to the infectious diseases team at Phoenix Children’s to get answers to the most common questions they’re getting about COVID-19 in kids, how the Delta variant affects kids and more:

What is Phoenix Children’s seeing in terms of COVID-19 cases in children?

Phoenix Children’s is seeing a rising number of COVID-19 cases in children. This is in line with state and national trends. We are seeing more previously healthy, unvaccinated kids with COVID-19.

How can parents protect their kids from COVID-19?

To protect your child from COVID-19, it’s essential for them to get vaccinated as soon as the vaccine is made available to them. Ensuring herd immunity is a key factor in putting the pandemic behind us. In addition, we encourage everyone to follow proper hand-washing techniques and follow CDC mask guidance.

Do current COVID-19 vaccines protect against the Delta variant and the Omicron variant?

Each COVID-19 vaccine currently available offers protection against known variants. It’s important for people to remember that these vaccines are still reliable in terms of preventing hospitalizations. Even if you come into contact with COVID-19 after you’ve been vaccinated, your symptoms will likely be very mild, or you may even be asymptomatic. The vaccine is still doing its job at preventing hospitalizations and death.

Getting vaccinated will help prevent the emergence of new variants.

How can people protect themselves against the Delta variant and the Omicron variant?

Receiving the COVID-19 vaccine, when one is made available to you, is crucial in protecting our families and our community, and will be a key factor in putting the pandemic behind us. We also encourage everyone to follow proper hand-washing techniques and follow CDC mask guidance.

How does vaccinating adults help protect children?

As an adult, being vaccinated helps prevent unknowingly spreading COVID-19 to the children in your homes and in your community. Children who are too young to get vaccinated right now are protected by those of us who are eligible for the vaccine getting vaccinated.

Generally, infection rates in children tend to fall as more adults are immunized.

What COVID-19 vaccine is available for children? 

The U.S. Food and Drug Administration (FDA) has granted an emergency use authorization (EUA) for both the Pfizer-BioNTech and Moderna COVID-19 vaccines for children ages 6 months and older. Pfizer's vaccine has full FDA approval for those age 12 and older. The Moderna COVID-19 vaccine has full FDA approval for those 18 and older. The Johnson and Johnson/Janssen COVID-19 vaccine is available under EUA for individuals 18 years and older for whom other authorized COVID-19 vaccines are not accessible or clinically appropriate, and to individuals 18 years and older who elect to receive the Johnson and Johnson/Janssen vaccine because they would otherwise not receive a COVID-19 vaccine.

The FDA recently granted emergency use authorization to the Novavax COVID-19 vaccine for adolescents ages 12 to 17. Instead of an mRNA vaccine (Pfizer, Moderna) or a viral vector vaccine (Johnson and Johnson), Novavax is a subunit protein vaccine. It uses the same technology as other vaccines that are already in use such as the hepatitis B vaccine. In most situations, Pfizer-BioNTech, Moderna or Novavax COVID-19 vaccines are recommended over the Johnson and Johnson/Janssen COVID-19 vaccine.

Do children have stronger or milder reactions to the COVID-19 vaccine? What can parents do to ease these side effects?

Younger people tend to have more robust immune systems, which usually means stronger responses to all vaccines. Any side effect a child experiences from the vaccine – even rare side effects – are far better than children experiencing severe cases of COVID-19 that require hospitalization and intensive care.

There are rare cases of myocarditis, or inflammation of the heart muscle, that were reported in young people ages 12-29 years old after mRNA vaccines. The presentation seems to be very mild and all those patients recovered with no issues afterward. It is important to keep in mind that myocarditis is also reported as a complication of acute COVID-19, and experts are still recommending the vaccine since the benefits outweigh the risk of developing this mild reaction.   

People of any age who don’t experience a strong response to a vaccine are still building antibodies and receiving the proven protection vaccines offer.

Over-the-counter medications are a safe way to treat common vaccine side effects such as fever, chills or body ache.

COVID-19 tends to be less severe in children. Why is it still important for children to get vaccinated?

While it’s true that generally, children tend to experience milder COVID-19 symptoms than adults, children in the U.S. – especially those with underlying health conditions – have experienced serious complications and hospitalizations due to COVID-19.

Achieving herd immunity is a key factor in ending the COVID-19 pandemic. To protect everyone in our homes and in our communities, it’s essential that everyone receive the COVID-19 vaccine when one is made available to them.

Has this type of vaccine ever been used in children before? 

The same mRNA technique used in Pfizer’s COVID-19 vaccine – where the vaccine teaches our bodies how to make a piece of a protein and trigger an immune response – has been studied for decades. mRNA vaccines do not use the live virus that causes COVID-19, and mRNA never enters the nucleus of the cell, where our DNA is kept. The cell breaks down and gets rid of the mRNA soon after it is finished using the instructions.

Do children need booster shots for the COVID-19 vaccine?

The CDC recommends that anyone age 5 years and older should receive a booster dose at least 5 months after their initial vaccination series.

In addition, the CDC is strengthening its recommendation that those 12 and older who are immunocompromised and those 50 and older should receive a second booster dose at least 4 months after their first booster dose.

If my child had a breakthrough case of COVID-19, should they still get a booster?

The COVID-19 vaccines are designed to prevent serious hospitalization and death, and they offer more protection than the infection itself. If your child experienced a rare breakthrough case of COVID-19 after they were fully vaccinated, we encourage them to receive a booster shot when they are out of quarantine, their symptoms have improved, and they are age-eligible. This will provide added protection in the future.

Can children get long COVID?

Some symptoms have a quick onset and happen 2-8 weeks after the infection. Those are the symptoms related to MIS-C – which can sometimes be neurological in nature.

Other symptoms have a more lengthened onset. Brain fog and fatigue are potential neurological symptoms and can affect school and exercise performance. Anxiety and depression have also been reported following a COVID-19 infection.

However, these symptoms are not necessarily unique to Long COVID. We see fatigue and similar issues with other infections like mononucleosis or valley fever; and similarly, kids can experience anxiety and depression once they experience long-lasting symptoms.

We don't know exactly how long symptoms are lasting, but the encouraging thing is that in most cases, these symptoms are eventually resolving. They can vary from a few weeks to months in some cases. There are a lot of reports of improvement.

Why are these long-term symptoms happening?

There are two potential explanations. The first is that there is a lingering viral replication in the organs of the body that extends the inflammatory process. For example, when kids get COVID-19, a lot of their symptoms start in the gastrointestinal tract compared to adults, and the GI tract might act as a reservoir of the virus that continues to feed that inflammatory process.

The second possibility is that Long COVID might be an autoimmune manifestation of this disease, meaning it's driven by the immune system's reaction to the disease vs. the virus itself.

Regardless, we still need studies to evaluate either possibility.

What should parents do if their children are experiencing long-term COVID-19 symptoms?

The first stop should be your pediatrician. The best way to target this is to check with your pediatrician and get a referral to a specialist involved with whichever specific organ the symptoms could be attributed to (brain, respiratory system, etc.)

If the issue is mostly chronic fatigue and lack of energy, physical therapy may be helpful and something to discuss with your pediatrician to see if your child is a candidate.

The best way to avoid Long COVID  or any COVID infection  is to get vaccinated. Vaccines are proven to be safe and effective, and they are widely available in the community. Studies have consistently shown that the risk of Long COVID is higher in individuals who get the infection and were not vaccinated previously compared to the individuals who have a breakthrough infection after the vaccine.

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