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Vaccinating children: answering 10 common questions

At the end of this year, Estonia begins vaccinating 5-11 year-olds against COVID-19. The first doses of Pfizer vaccine for children should arrive in December. The vaccination of this age group is coordinated by family physicians. 

To introduce the new stage of the vaccination, the Estonian Family Physicians Association and the Celsius Health School held an online briefing, where family physicians Marje Oona and Piret Rospu, and a paediatrician Eda Tamm answered questions about vaccinating children. 


Why to vaccinate children if their symptoms are mild, and they are rarely hospitalized? 

Generally, COVID-19 are mild for children. Some cases might be more severe, for instance during the short period of time, already 24 children have been diagnosed with multisystem inflammatory syndrome (MIS-C), and most of them were completely healthy before falling ill with COVID-19. Although, falling ill with COVID-19 is not as dangerous to kids as it is for adults and elderly, it doesn't mean, children are safe.

In addition, we'd like our children to get a good education, to be able to participate in after-school activities, and vaccination for sure helps achieve that objective.

Why is the children's dose different from adult's dose? 

The immune system of pre-teens is quite alert. So far, the clinical researches confirm that the smaller doses for 5-11 year olds develop the same level of antibodies as bigger doses for 12-17-year olds and adults. So instead of 30 mg, children's vaccine has 10 mg of active substance. It was found in clinical researches that this amount has 90% of efficiency for 5-11 year-olds. 

One of the ingredients in the vaccine for children is tromethamine, but vaccines for adults doesn't have it. What is it, and why is it included as an ingredient? 

This helps keep pH in balance. The amount of this ingredient is minimal, and studies have proven that it helps keep the vaccine more stable in the fridge. At the beginning we knew that Pfizer vaccine could be kept in the fridge for a very short period of time, but because of that additional ingredient we can keep the vaccine in the fridge for up to 10 weeks.

Is it true that only kids with chronic illnesses are in risk of falling ill with COVID-19?

For certainly not. Some of these cases are more severe than others, but among seriously ill children are also those who didn't have any risk factors. So this conclusion is not valid that only children with serious health conditions fall severely ill with COVID-19. 

Can children who've recovered from a coronavirus, fall ill again, and do they even need to get vaccinated? 

There are not many researches done about this topic, but there are some publications including data about the adults and children, and the comparison between the first time and the second time illnesses. The answer is: yes, you can contract the virus again. By this research, the shortest time period between two diagnoses, was 6 months, and the median was 9 months.  

The strength of the immune protection decreases in time. Also, new strains are constantly developing, and many countries have emphasized that the immune protections should be as strong as possible. To achieve this, booster doses are recommended for even those who've had COVID-19. The recommendation for children in these cases is the same as for adults: one dose after 6 months have passed from the diagnoses.

Do current vaccines protect you against new strains?

The difference between the initial strain and Delta variant is not actually big. Vaccination has been efficient against the Delta, but it decreases in time. However, the booster dose improves that protection a lot. So the vaccines are effective against the Delta variant. 

The current information about omicron is that people, who are vaccinated, are very likely protected against the severe cases of from a new strain. But there'll be more data within upcoming weeks, and then we'll have more information. 

Are there children, who shouldn't get vaccinated against COVID-19? 

Children with acute illnesses are not vaccinated. Generally, there are no children, who can't be vaccinated by any means. Children with the immune deficiency might not develop the full protection during the vaccination course, but it doesn't mean they shouldn't be vaccinated. People with immune deficiency need three doses of vaccine to develop the full protection, and the same rule applies to children with immune deficiency. 

Could corona-and flu vaccine be done together? 

Yes, it could. We do that for adults. At the same time, our experience is that children don't want multiple jabs at the same day. But against the flu, we have a vaccine that is given through their nose. 

Do children need a series of vaccination against COVID-19 in the future?

We don't know that now. If we have a look at the countries that were among the first ones to start vaccinating children, like the US and Israel, then among teenagers the immune protection has lasted longer than in older age groups. The older the people, the more they need booster doses. 

How do we know that some of the side effects doesn't develop in a few years time? 

Because no immune response can't last that long. The ingredients of the vaccine are decomposed and cleared from our bodies quickly. There's a start and a beginning for the immune system to get to know an antibody. So the side effects develop in a few days after the vaccination, and very rarely within a few months after the vaccination. 

The article is based on an online briefing held on the 1st of December. You can watch it (in Estonian) here.

Everything you should know about the COVID-19 vaccination

Vaccination is free of charge for all people living in Estonia, even without the national health insurance.
  • Vaccination is voluntary.
  • Vaccination is open to all people who are at least 5 years old.
  • Compared to COVID-19 illness, vaccination is safe, and generally, the side effects pass quickly.
  • Booster doses are available only for adults, and the time for a booster jab is 2 months after finishing the vaccination course with the Janssen vaccine, and 3 months after finishing the vaccination course with AstraZeneca, Pfizer/BioNTech and Moderna vaccines.
  • Booster doses for people, who are recovered from COVID-19 are recommended 6 months after their recovery or their last vaccination.
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