Some recent developments in the COVID-19 situation amongst the younger generation has stirred a little more worry in parents. Along with rising reported cases of COVID-19 in children, schools are now fully in session for both primary and secondary students. For parents who are still uncertain about their children between the age of 5 to 11 being vaccinated, let’s hear the expert opinion of Dr Kama Azura Binti Jamil, Consultant Paediatrician at Aurelius Hospital Nilai, on this.
Q1: If a child is asthmatic or epileptic, is it advisable for him or her to be vaccinated, seeing some children experienced adverse events following immunisation (AEFI)?
Children with asthma is found to be at a higher risk of developing severe diseases if they contract COVID-19. This leads to increased risk of hospitalisation and even death. As such, it’s even more important that they receive their COVID-19 vaccine as soon as possible—these are the very people who should prioritise getting the vaccine.
Children with epilepsy are also encouraged to get vaccinated against COVID-19. There are currently no studies to support that the vaccine leads to severe diseases. One common post-vaccination side effect that parents are usually worried about is fever, because it could lead to a fit in their epileptic children. However, the fever usually only lasts between 1-2 days, and it can be treated by giving their children paracetamol within the first 24 and 48 hours after the vaccination.
Generally speaking, COVID-19 vaccines are advised for both asthmatic and epileptic children.
Q2: When PICKids started, only Pfizer-BioNTech vaccine (Comirnaty) was offered. Recently, Sinovac’s CoronaVac vaccine has also been approved. How do we choose between the two for healthy children and those with underlying conditions?
In Malaysia, Pfizer-BioNTech vaccine is the primary vaccine that is offered to children aged 5 to 11 years old. They have gone through a lot of studies with over a million children having received the vaccination. They are proven to have a 90% efficacy with minimal side effects.
Meanwhile, Sinovac’s CoronaVac vaccine is suitable for children aged 5 to 11 who are not able to receive Pfizer-BioNTech vaccine for health reasons, such as those who have a severe allergic or anaphylactic reaction to the Pfizer vaccine.
My advice to parents is to go with whichever vaccine that is eligible first to your children—even if they have an underlying condition—because both vaccines protect against severe outcomes.
Q3: If a child has a weak immune system, how does being vaccinated affect him or her?
If a child has a weaker immune system, then he or she should definitely get the vaccine, because they are more prone to severe diseases from the Coronavirus. Parents might worry how their children’s immune system may respond to the vaccine, but they are still very much advised to get the vaccine because their condition might worsen, or even more serious diseases might develop if they contract COVID-19.
Q4: For an immunocompromised child, is it necessary to take the second dose?
Immunocompromised children are typically those who are cancer patients, organ transplant patients, or patients who are receiving high dosages of steroids, and as such their immune system is weak.
Hence, it is even more vital that they are protected from COVID-19 by having the two doses of vaccination. In fact, the Centers for Disease Control and Prevention (CDC) actually recommends that immunocompromised individuals should receive 3-4 doses of the vaccine, but the decision on whether to receive additional doses should be best advised by the patient’s doctor.
Q5: How about for a child who has comorbidity, how safe will it be for them to be vaccinated?
It is safe for children with comorbidities to receive the vaccine, as studies have confirmed this. The more severe side effects would be anaphylaxis or allergic reaction—however, this applies to every individual regardless of their age or whether they have comorbidities.
There were worries about the Pfizer vaccine causing myocarditis as well, which is the inflammation of the heart, but studies have soon debunked them as only about one in a million will develop this condition post-vaccination. However, if you contracted COVID-19 itself, there is a bigger chance of developing myocarditis—about 450 in a million—than if you received the vaccine.
So, if your child has comorbidities and if you’re unsure if they should get the vaccine, go ahead, it is safe!
Q6: Recent researches have warned that children who were infected with COVID-19 have a higher risk of diabetes. What does this mean for children who have now recovered?
This research is still debatable, because the study only included a small number of patients and ignored the other factors that caused diabetes. They still need to involve a higher number of patients to confirm whether contracting COVID-19 can really lead to diabetes.
However, it’s important to note that diabetes can happen to children even if they do not have COVID-19, so it is still important to monitor for signs and symptoms of diabetes in your children, just like any other potential health issues.
Q7: What are the signs or symptoms to look out for the onset of diabetes?
The usual symptoms of diabetes among children are excessive thirst as well as excessive urination. They will also go through weight loss due to the breakdown of fat and excessive acid in the bloodstream. They are also presented with nausea, fatigue, moodiness and in certain cases, there will also experience a loss of vision.
Q8: Would being vaccinated also increase the risk of a child having diabetes in the future?
No, there are no studies that prove this. The vaccines are generally safe for children as long as they are not allergic to them.
Q9: For a child who has fully recovered from COVID-19 and have not been vaccinated before, how soon should he or she be vaccinated after recovery?
Yes, children should and can get vaccinated after they no longer exhibit symptoms, and when they are done with quarantine. Studies have shown that getting the vaccine after recovering from COVID-19 can boost your immunity against it even more.
Q10: There’s been a sharp rise in COVID-19 cases in children in recent months. Will there be long term effects on their health?
The issue with long COVID is that there is still no way to properly diagnose it. Most long COVID patients usually complain about feeling lethargic, headaches, loss of interest and motivation, mental disturbances.
But the most worrying long COVID effect on children is MIS-C (Multisystem Inflammatory Syndrome in Children). For this, we will really need to pay closer attention, because there are patients who suffer from inflammation of their organs post-COVID-19 infection—this can potentially lead to death if not detected early, even for asymptomatic cases.
Getting the vaccine may not 100% prevent you from getting COVID-19, but studies have found that children who had received at least one dose of the vaccine found that occurrences of MIS-C were rare and far less likely than for children who developed COVID-19 and were not vaccinated.
Source: Dr Kama Azura Binti Jamil, Consultant Paediatrician at Aurelius Hospital Nilai
Disclaimer: The information provided in this article is for informational purposes only and should not be considered as medical advice from Motherhood. For any health-related concerns, it is advisable to consult with a qualified healthcare professional or medical practitioner.
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