Since the announcement by the Ministry of Health that children from age 5 to 11 are now eligible to register for COVID-19 vaccination, many parents have given this a lot of thought. The pros and cons to subject our little ones to the vaccine, and some of our uncertainties and fears are sure to arise. As such, Motherhood Story talks to Consultant Paediatrician and a Paediatric Infectious Disease and Immunology Fellow from the Ministry of Health Malaysia, Dr Sangeetha Siniah, MBBS (Manipal), MRCPH (UK), on this topic to put some of our uncertainties to rest. Image credit: Dr Sangeetha Siniah, MBBS (Manipal), MRCPH (UK), Consultant Paediatrician and a Paediatric Infectious Disease and Immunology Fellow from the Ministry of Health Malaysia Detailed information is shared on the ingredients of the vaccine and what the functions are, and how we can help our young children through the process. #1. How safe is the COVID-19 vaccination for young children? At the time of sharing, the only approved Vaccine for children 5-11 years old is the Pfizer- BioNTech. The COVID-19 vaccination for children 5-11 years has been approved by the US CDC and FDA, and subsequently approved in Malaysia by the NPRA (National Pharmaceutical Regulatory Agency) after a review of all the clinical trial data which were conducted, to ensure the safety and continuous monitoring of the vaccine before authorising it for use. #2. When might a child be advised against taking the COVID-19 vaccination? This is taken from the CDC and Clinical guidelines on COVID-19 vaccination in Malaysia for those who absolutely should not get the Pfizer- BioNTech. However, it is always important to speak and discuss with your treating doctor if you are unsure. \tIf you have had a severe allergic reaction** to any ingredient in the Pfizer-BioNTech COVID-19 vaccine (such as polyethylene glycol), you should not get this vaccine. \tIf you had a severe allergic reaction** after getting a dose of the Pfizer-BioNTech COVID-19 vaccine, you should not get another dose of an mRNA vaccine. **A severe allergic reaction can cause a rapid heartbeat, difficulty breathing, swelling of the throat, or a generalised rash or hives. A person with a severe allergic reaction needs to be treated with epinephrine (often given as an EpiPen\u00ae) and should seek immediate medical attention. #3. Is there any difference in ingredients or dosage of the vaccine given to this age group as compared to the teen and adult dosage? There is not much difference in the ingredients for children and adults\u2014the Pfizer-BioNTech contains: \tMessenger ribonucleic acid (mRNA) - Provides instructions the body uses to build a harmless piece of a protein from the virus that causes COVID-19. This protein causes an immune response that helps protect the body from getting sick with COVID-19 in the future \tLipids (fats) - Work together to help the mRNA enter cells \tSugar, salt and acid stabilisers - Work together to help keep the vaccine molecules stable while the vaccine is manufactured, frozen, shipped, and stored until it is ready to be given to a vaccine recipient There is, however, a difference in the dosage. The dose is lower for children 5-11years old. \tChildren ages 5\u201311 years - Pfizer paediatric COVID-19 vaccine (10mcg dose) \tAdolescents 12 years and older - Pfizer adult COVID-19 vaccine (30mcg dose) Both groups are given 2 doses, 21 days apart . The dose depends on the age, and not the weight. #4. How can I decide which vaccine is more suited for my child, Pfizer or Sinovac? 1. The approved and recommended Vaccine in Malaysia: \tFor children ages 5-11 years: Pfizer-BioNtech only for now. We are awaiting further data regarding the use of Sinovac in this age group as it is approved in certain countries. \tFor children ages 12-17 years: \t \tPfizer-BioNtech \tSinovac only in teenagers without co-morbidities or allergy problems, or otherwise deemed unsuitable for the Pfizer-BioNTech. However, this should be discussed with the respective treating or administering doctors as the data is limited. Whenever making a decision about vaccination for your children, always refer back to your respective doctors and get information from verified sources. #5. What are the side effects to watch out for in the days following their vaccination? General side effects: \tPain at the injection site (upper arm) \tFeeling more tired than usual \tHeadache, achy muscles or joints \tFever and chills are also possible **These side effects are usually temporary and generally clear up within 48 hours. There is concern about myocarditis (inflammation of the heart) post COVID vaccination. Here are some pointers: \tThe reports of myocarditis post vaccination are rare, mild and recover quickly. \tBased on the latest published study, the risk of myocarditis in teenagers who got infected with COVID-19 is 37 times higher than those who were not infected. \tIt is important to seek medical attention immediately within a few days post vaccine ( especially post 2nd dose) if your child experiences chest pain, shortness of breath, feeling the heart beat (beating fast, fluttering or pounding). \tOur local Clinical guidelines on COVID-19 vaccination for adolescents has a detail management plan for treating myocarditis post COVID-19 vaccination. #6. Can children experience any long-term effects of this vaccine? All vaccines and the ingredients usually only have temporary short term side effects and do not have long term effects, because the vaccine administered is a small amount and does not stay in the body for long. Once the vaccine is delivered, it depends on our own immune system to help generate a good response towards the vaccination for long lasting protection. #7. Are there any risks of allergic reactions in kids? If the kids have a history of severe allergy like mentioned above, this must be disclosed to the healthcare staff. However, all children will be monitored post vaccination to look out for any sudden allergic reaction. #8. Is there any way to prep a child before being vaccinated? Image credit: Canva Prior to getting vaccinated it is always good to explain or role play the entire process at home so they would not be afraid when getting the vaccine or the fear of injections. It is also good to explain why the vaccine is important (i.e. it prevents the child from getting COVID; they could restore their normal routine without the fear of the virus; and to protect the surrounding people so they won\u2019t get very sick). #9. Should I still let my child take the flu vaccination? Image credit: Canva Yes, getting the yearly Influenza (FLU) vaccine is still very important. Just like COVID-19, Influenza virus can make a child very ill. The flu vaccine is available to children six months and above , and it is especially important to children who are not yet eligible for the COVID-19 vaccination for added protection. #10. What is the recommended interval for a child in getting another vaccination? E.g. flu shot The COVID-19 vaccine can be administered together with other vaccines. However, if there is any acute illness, it is best to postpone vaccination until they have recovered. Happiness is Happy and Healthy Children We hope more mummies out there will benefit from Dr Sangeetha's insights on COVID-19 vaccination for young children. Do share our article with your other mummy friends and family members, so that they too can gain more peace of mind hearing from an expert's point of view. For more interesting stories and fun recipes, stay tuned to Motherhood Story!