Children, pregnancy, and the COVID-19 vaccine

COVID-19 Vaccine

NORFOLK, Va. (WAVY) — As a parent or pregnant woman, your number one priority is your child. You want to protect them at all costs. That includes protection during the pandemic.

“It’s always important to protect people from a potential infection,” said Dr. Laura Sass, a pediatric infectious disease doctor at Children’s Hospital of the King’s Daughters in Norfolk..

Dr. Sass is also the medical director of infection prevention and control at CHKD. WAVY asked her why there is no vaccine available for children younger than 16 right now.

She points to the vaccine trials first.

“I’ve actually run clinical trials for medications in children, so you have to make sure that they’re safe. Generally you start off with the adults because they can consent for themselves, and then you move down to lower and lower age groups, because you have to have the consent of the child plus the consent of the parents,” said Dr. Sass.

She also says because COVID disproportionately effects adults, scientists focused vaccination studies on the population that is the highest risk. Not to mention, “Children also get other vaccines during their lifetime during some of these same time frames. You have to make sure that those also don’t interact with the COVID response.”

Dr. Sass says COVID vaccine trials for children as young as 12 are underway, or are just about ready to begin, for Pfizer and Moderna. WAVY.com has also learned of a small trial in the UK involving 300 children between the ages of 6 and 17 testing the Oxford-AstraZeneca vaccine. It’s all being done with safety in mind.

“The children are a protected population, just like pregnant women are, during clinical trials,” said Dr. Sass.

“Pregnant women are kind of considered a special population. They are special. They’re growing a new person,” said Dr. Renee Morales, an assistant professor with the EVMS OB/GYN Department.

Dr. Morales says she often talks with her patients about the risk versus the reward of the COVID vaccine.

“After reviewing the technology with the general population, the side effects are usually mild and they’re not expected to pass to the pregnant lady or her fetus in any given way. So, for some people they find a lot of comfort in having that vaccine to protect them if they were to become exposed. Other people don’t feel like they have enough risk of exposure for it to be helpful to them.”

Women are encouraged to get flu and tetanus vaccines while pregnant. Those vaccines are considered safe because they do not contain a live virus. Dr. Morales emphasizes there is no live virus in the any of the COVID vaccines either.

“The Tdap, tetanus, diptheria, and rubella vaccine, the flu vaccine, those are recommended for every pregnancy, and similarly the COVID vaccine does not have live virus in it, and so it is not expected to transmit any of the actual virus to the fetus or cause any problems like that. It’s actually a new technology called Messenger RNA technology, which is fantastic, because it essentially provides a blueprint. It doesn’t have any part of the virus and it provides a blueprint to the immune cells to show them what the virus looks like, and then your own body creates the house if you will, the blueprint, the replica of the virus. There’s no virus present at all. Once that replica is made, the Messenger RNA or blueprint is destroyed and so it’s not even present anymore. Then, your other immune cells are able to make fighter cells such that if you get the virus, if your body comes into contact with the virus again, it will already have the immune cells made to fight it. So, there’s not any virus in the vaccine at all. That’s one of the reasons why a lot of us feel like it is probably one of the safer options,” said Dr. Morales.

What is a concern?

“We do know that pregnant women are in a higher risk to have worse complications, so of the minority of people with COVID who do end up getting admitted to the ICU, or having more severe disease, more of them are going to be pregnant, and even of our pregnant ladies who might have other problems like obesity or diabetes, they have an even higher risk of having complicated COVID symptoms. Anybody with any extra risk factors, I would recommend probably getting the vaccine.”

Dr. Morales says she supports a woman’s right to choose what she feels is best for herself and her unborn child, especially while studies are underway monitoring pregnant women who already got the vaccine.

“We’re currently doing studies, and we have given the vaccine to lots of pregnant women and breastfeeding moms, too, because we do have a lot of frontline workers who fall into those categories. Also, people get pregnant. So, they get the vaccine and then they get pregnant in the interim, and so we do have studies that don’t demonstrate bad effects in those people. So, without knowing 100% that something would happen or could happen or has a higher probability of happening, I would fall on the side of vaccinating versus not vaccinating. I would also support somebody who chose not to and hand washing, not touching your face, wearing your mask, making sure you’re social distancing, making sure you are not coming into contact with a lot of people are all ways you can continue to protect yourself.”

However, with the information she has right now concerning COVID-19 vaccine options, Dr. Morales says, “Bottom line is I feel like we should go ahead and vaccinate our population, everybody, until we know a reason not to.”

Dr. Sass emphasized while the vaccine was developed kind of quickly, the technology behind it was not.

“The technology for the vaccine has been around since the 1990s. It just wasn’t used widespread. They actually, those companies, especially Moderna, they actually have been using this technology trying to develop vaccines for other coronaviruses that were pandemics. SARS- CoV1 and MERS. So, all they had to do was ramp back up what they were doing so they could then produce this vaccine. So, it went through the same clinical trials just like anything else would for Phase 2 and Phase 3. 70,000 people were in those clinical trials. That is a huge amount of numbers to be in a clinical trial.”

The timeline we are on for developing a vaccine for children is a good timeline in Dr. Sass’s opinion. She says it’s imperative to do this in an “organized and safe manner to make sure that there are no unanticipated side effects in younger children.”

“When you get someone to enroll in a clinical trial, you have to make sure they go through the entire process. Remember, these vaccines are given, for the Pfizer vaccine, 21 days apart. For Moderna, it’s 28 days apart, and so you have to wait until the entire cohort has finished that clinical trial, especially if you’re doing placebo groups, which means they aren’t getting the actual vaccine versus people who are getting the actual vaccine, and it takes time to get all of that information done. So, generally, everyone has to finish, you have to finish how long they decide their safety follow up is done…and then the FDA has to look at all the data independently to make sure that they approve and that it’s safe. That process takes time, and that’s the point. We want it to take time to make sure that we’re not having to take back the vaccine after we release it.”

Dr. Sass says she believes a reasonable timeline for a vaccine for children would be the end of summer or in the fall.

Copyright 2021 Nexstar Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

Senatara COVID-19 Infographic (Dec. 2020)

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