Kids need the vaccine, doctors across the state urge

Billings’ pediatrician Kathryn Lysinger made sure a news crew was there when her 12-year-old son got his COVID-19 vaccine.

She “strongly” recommends parents get their kids get the Pfizer-BioNtech COVID-19 vaccine.

“Which is why I put my poor son on display and had a TV camera in his face when he got his vaccine,” Lysinger said, who works at Billings Clinic. 

The Pfizer vaccine was approved for 12-to-15-year-olds May 10 and adolescents became eligible for the shot in some Montana counties just a few days later. As of May 21, about 15% Montana’s kids 12 to 17 years old had gotten at least their first dose.

On May 25, Moderna said in a news release it’s vaccine was highly effective in its adolescent trial participants. The company will share its results with the U.S. Food and Drug Administration in early June.

The way out of the pandemic was always going to be a vaccine, Lysinger said. She wants parents to know the vaccine is safe. However, an unending tide of misinformation has hammered parents. 

Mysterious actors tried to pay social media influencers to smear the Pfizer vaccine. Online users took data from the Centers for Disease Control and Prevention’s Vaccine Adverse Event Reporting System to make unsubstantiated claims about how many children had died from the vaccine. The system contains voluntary and unvetted reports of vaccine injury and is frequently the subject of misinformation, according to First Draft, a nonprofit coalition that investigates online information.

Pediatricians such as Lysinger feel they make the most progress educating parents in the doctor’s office. But the pandemic presented barriers to those direct interactions, Lysinger said.  

“I would love it if I could talk to every family and say ‘You need this vaccine, here’s this vaccine,” Lysinger said.

Kids can get sick

Lysinger encountered patients who said they’d gotten vaccinated but had concerns about their kids getting it. This is based in part on the misbelief that the coronavirus is harmless to children, and the vaccine could have unknown long term effects, she said. 

The vast majority of complications from a vaccine will present in the first six weeks after it is received, Lysinger said. With COVID-19 it isn’t clear when doctors will understand how the disease affected those who contracted it. Some kids never regained their sense of smell and taste, she said. 

“When the virus causes you to lose your taste and smell that means it’s invaded your neurological system,” Lysinger said. “People don’t recognize we don’t know the long-term consequences.”

While most children will experience mild symptoms after contracting COVID-19, at least 279 died from the disease between March 2020 and March 2021. Almost 14,000 were hospitalized, Lysinger said. 

Another concern is the possible link between COVID-19 and multisystem inflammatory syndrome in children. The syndrome is a condition where different body parts can become inflamed including the heart, lungs, kidney, brain, skin, eyes or stomach. 

On May 17, the CDC did announce it was investigating a small number of young people who presented with mild cases of myocarditis, an inflammation of the heart, after getting the vaccine. However, Lysinger said all those cases responded to treatment and it is not yet clear it is tied to the vaccine.

“Right now the cases are rare and do not appear to be any more common than would be expected at baseline,” Lysinger said. “Meaning that there are always a certain number of people diagnosed at any one time with cardiomyopathy and it doesn’t appear to be more common in vaccinated individuals versus unvaccinated. This is very reassuring.”

She encouraged parents to check out resources such as the Children’s Hospital of Philadelphia for resources about the COVID-19 vaccine.

Don’t want to be a “guinea pig”

John Cole is president of the Montana chapter of the American Academy of Pediatrics. He works at Sunny View Pediatrics in Kalispell, in Flathead County where Health Officer Joe Russell said in a recent interview he hoped at least 40% of residents would get the vaccine, but doubted the community would reach 70%. 

It’s very frustrating, Cole said. A lot of people in the area are distrustful of authority and health care professionals and are hearing different information that isn’t true, Cole said.

“I find we need to build trust and build relationships with people to allow them to trust our recommendations. I find that we do that one-on-one when we are in the exam room,” Cole said. 

The main concern he’s heard from parents is that the technology used in the vaccine is untested. The Pfizer vaccine is a messenger RNA vaccine and while the version created to protect people from COVID-19 is new, the technology was first used in 2003 when scientists started searching for SARS vaccine, Cole said. 

A mRNA vaccine is different from the vaccines that shoot a weakened or inactive germ in our bodies to trigger an immune response. 

Instead, an mRNA vaccine is a set of instructions for your body that tells it how to make a piece of a Spike protein. Spike proteins are found on all of the different variants of the COVID-19 virus. Making proteins is a natural process that your body does trillions of times a day. The instructions are broken down and your body gets rid of them.

Once the protein is made, your immune system recognizes it as a protein that doesn’t belong in your body, and this triggers an immune response. 

Now your body knows what a spike protein is and it doesn’t like it. If you are then exposed to the COVID-19 virus your body will see the spike protein on the surface of the virus and attack right away. 

“Since your immune system’s been primed by the vaccine, it will get rid of the virus before it can even get you sick,” Cole said. 

Fast, not shoddy

The development of the COVID-19 vaccine was called Operation Warp Speed, which was a terrible name because it made it sound like doctors cut corners, Cole said.

“I’ll be honest when this was all coming out in the fall in October, November and I was hearing about the vaccine, I was hesitant, I think it would be inappropriate for no one to question it,” he said.

However, he’s looked at the data from the clinical trials and is confident in the safety and efficacy of the vaccines.

Infectious disease specialist Megan Srinivas gave an analogy for FDA’s Emergency Use Authorization during a May 26 American Medical Association webinar to discuss misinformation about the COVID-19 vaccine. Srinivas is a translational health policy researcher at the University of North Carolina who resides and practices in Iowa.

Srinivas asked people to think about the last time they got their car registered. The process is the same every year, Srinivas said. But it still takes a month for the registration sticker to go through the mail. What holds up the car’s registration is the bureaucracy, the paperwork, Srinivas said. Both Pfizer and Moderna are in the midst of that process and Srinivas said she anticipated both vaccines would have full approval in just a few months. 

“But it’s really because of the paperwork that’s just been taking awhile to get caught up to where the science is,” Srinivas said. 

‘Playing the dice’

Dr. Neil Ku is an epidemiologist at Billings Clinic and leader of its infectious diseases department. The way he looks at vaccination is very different from the way a parent views it and the decision to get vaccinated is a personal one, he said. 

However, the risks presented by contracting COVID-19 are far greater than those posed by getting vaccinated, he said. 

“I’ve heard, ‘I think it’s better to get immunity through infection rather than through a vaccine,” Ku said. “Certainly I can understand why people would consider that given what they heard in the news about the Johnson & Johnson vaccine, and the occasional anaphylactic reactions, but on the other hand, you’re playing dice.”

No studies support the idea that immunity through infection is better than immunity through vaccination, he said. But, getting infected is much riskier, he said. 

Children can also be reservoirs for the disease, even if they don’t come down with serious symptoms, Ku said. Everytime the virus finds a host, it has the potential to become more dangerous, he said.