COVID-19 Vaccination for Children -

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Last updated: 2 Dec

COVID-19 Vaccination for Children

Contributed by: Dr Leo Hamilton

COVID-19 Vaccination for Children
Later this year, COVID-19 vaccines for children under five will be approved. Should your child get it? Does a child need it?

My clinic (Kids Clinic @ Novena) gives children vaccines daily, and we have no doubts about their safety and life-saving effects. My family and I have received our COVID-19 vaccines without hesitation, and COVID-19 vaccines have prevented many infections and deaths. But for children under 5, there is some reason for reluctance.

First, is the Covid-19 Vaccine safe?

This question is relatively easy to answer; yes, it is as safe as the vaccines for adults. The current trials have not shown any surprising side effects. Long-term risks, of course, can’t be known, but there is no reason to believe the COVID vaccine will have long-term risks any more than vaccines for whooping cough or pneumococcal disease that we give routinely.

Does the Covid-19 Vaccine Work?

COVID vaccines were initially shown as 90% effective, but that was for the early strains. Moderna’s vaccine was only 51% effective in preventing COVID-19 among children six months to two years old. And according to preliminary data in the clinical study of the Pfizer vaccine, the efficacy was estimated to be around 73%.

Currently, the Expert Committee on Covid-19 Vaccination is reviewing Health Science Authority’s vaccination recommendations for children aged six months to four years. It is reported that the Moderna vaccine will be available in October 2022, while the Pfizer vaccine is expected to be available by the end of the year according to the Ministry of Health.

Is the Covid-19 Vaccine Needed?

Omicron has been a transmissible but mild infection for nearly all healthy children. The vaccine in adults does not prevent Omicron infection or spread significantly. It does lower the risk of serious illness and death in high-risk groups, but small children are rarely at high risk. COVID overall has been mild in children. In the United States, the CDC reported the hospitalisation rate in children during the peak of Omicron to be 14.5 per 100,000. Only 0.0145% of small children with COVID needed to be hospitalised. From the start of COVID to April 2022, out of almost 73,000,000 in the USA under 18 years, only 980 children had died of COVID, a rate of 0.0013%. While COVID can be serious, it has been much more dangerous to adults.

Does the Vaccine Wear Off?

Yes. Another well-known vaccine concern for adults is that immunity fades over time – that’s why adults get three doses now, and high-risk adults may get four doses. Whether immunity will fade quickly or not in children is unknown, but likely antibody levels will decline within a few months after finishing the vaccine.

So Why Get It Now?

The main reason will be if your child is at high-risk or if you live closely with someone who is. If the dominant COVID strain changes, the vaccine may be much more effective.

Should I Give My Child the COVID Vaccine?

Talk to your doctor about the risks and benefits. The vaccine will be safe and provide some protection. If your child has had COVID, it may not be useful. Overall, if you want the vaccine, there is no safety reason to not get it, but it is unlikely based on the current dominant COVID strain to be helpful or necessary. If you want to wait and see how COVID changes, it is also likely OK to wait.
About Author
This article is written by Dr Leo Hamilton, who is a US board-certified Paediatrician since 2003. Dr Leo relocated to Singapore in 2011, caring for expat and Singaporean children from newborns at delivery to teenagers. Beyond his background in Hematology/Oncology, he has an interest in asthma, behavioural issues (primarily ADHD), teen health, and modern management of routine childhood illnesses such as ear infections, bronchiolitis, and pneumonia.

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