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What to know about vaccine-related heart issues and other insights on the coronavirus vaccine and kids

Colorado doctors answered reader questions about side effects, efficacy, the Delta variant, and how to keep kids safe before they can get vaccinated

Josiah Jansen, who works in the pharmacy at Presbyterian St. Luke's Medical Center in Denver, holds up a vial of Pfizer's coronavirus vaccine on Wednesday, Dec. 16, 2020. (Jesse Paul, The Colorado Sun)
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These are trying times for Colorado’s parents.

The coronavirus pandemic still rages for those who are not vaccinated, now driven by the most transmissible form of the virus the state has ever seen. Vaccination rates are ticking up across the state. But vaccines are not available for kids under the age of 12, and, for the parents of older children, concerns about the safety of the vaccines abound.

When the staff at Tepeyac Community Health Center, a clinic with two locations in Denver that serves primarily Latino patients, surveyed parents about vaccination, they found strong adult interest in getting vaccinated. But, when it came to their kids, parents were less certain.

Only 45% said they would get their children vaccinated, said Dr. Pamela Valenza, a family physician at Tepeyac and the center’s chief health officer.

“People have concerns in two predominant areas: safety, (including) long-term safety concerns, and the immediate side effects,” Valenza said.

To help Coloradans navigate these concerns, The Colorado Sun held a virtual event Tuesday where Valenza and two other local experts — Kaiser Permanente pediatrician Dr. Matthew Daley and Denver Health critical care pulmonologist Dr. Anuj Mehta — answered reader questions on vaccine safety and efficacy, and how to keep kids safe while they remain unvaccinated.

Here are some of the highlights. Answers have been edited for length and clarity. The full video of the event is embedded below or can be viewed on our Facebook page.

What should you know about the risk of heart problems from the COVID vaccine?

Federal officials last week announced a likely association between one type of coronavirus vaccine and a greater risk of a rare heart condition called myocarditis in adolescents and young adults. Despite that association, the officials said the benefits of vaccination continue to outweigh the risk, even for kids.

Daley reviewed the data related to heart risk, in his role as a member of the national Advisory Committee on Immunization Practices, or ACIP.

Dr. Matthew Daley

“It appears that that’s pretty rare, and by rare I mean in the range of about 12 cases of mild carditis for every 1 million vaccine doses,” he said. “It does appear to be a little more likely in males than females and a little bit more likely in young adults and adolescents so sort of 12 to 29 years of age. And so, you know, this is scary for sure for a parent. … But fortunately, this appears to be relatively mild.

“What often happens is somebody will get chest pain, three or four days after their second dose, they go and they seek medical care appropriately, and then they might be observed in the hospital for a day or two, or they might not be hospitalized. But it appears that it’s mild, and it appears that those individuals fully recovered from this and go back to all their regular activities. That’s still scary, and I get that, but it does appear rare, mild and completely resolved, although we need to keep our eye on it.

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“So then, what does that mean to parents who are trying to weigh risks and benefits? … COVID itself can really mess up your heart. It can give you myocarditis; it can give you other significant problems with the heart. In addition to the problems with the lungs that we’ve heard about. That’s more common from getting the disease than the vaccines so that’s thing No. 1. And then thing No. 2 is just that we know that COVID can cause deaths in kids.

“So when the ACIP took a step back and looked at all the benefits and all the risks they sort of said, ‘For every 1 million kids we vaccinate, we’re going to prevent thousands or tens of thousands of cases. We’re going to prevent hundreds of admissions to the hospital from COVID, and then there’s kids that are dying from COVID and those deaths are preventable by the vaccine,” Daley said. “So that’s why we think that the benefits of vaccination still strongly outweigh the risks.”

How should you weigh the unknowns about the long-term risks of the vaccine versus the benefits?

Parents have been hit with a lot of conflicting information during the pandemic about the risks their kids face.

While it is true that children are statistically less likely to suffer a severe illness from a coronavirus infection, that doesn’t mean kids have escaped the pandemic unharmed. Valenza notes that 17% of all identified coronavirus cases have been in kids and young adults aged 19 and under. There have been more than a dozen coronavirus deaths in people 19 or younger, according to state Health Department data.

People 19 and younger currently make up more than 5% of those hospitalized in Colorado with COVID-19.

To Valenza, this backdrop is important because it’s a reminder of what the vaccines are working to prevent. And, she said, the safety data available so far supports the decision to get vaccinated.

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“We know the vaccine is relatively safe from all the trials that we’ve done,” she said. “We know that there might be some short-term, self-limited side effects. As far as long-term, we’re talking years of data. We just don’t have that. And so we can’t give those answers to parents, or to patients, and so talking about the risk . . . we mentioned the risk of hospitalization, the risk of severe hospitalization, the risk of death.

“Pretty much anyone you talk to from larger societies, immunization societies, the American Academy of Pediatrics. All of them have come to the conclusion that the risk of getting COVID far outweighs any potential risks that we have with the vaccine.”

Valenza said there is no evidence that the vaccines harm children’s growth and development, or harm fertility. In fact, she said, plenty of patients have become pregnant after getting vaccinated.

Dr. Anuj Mehta. (Provided by National Jewish Health)

Mehta said 99% of side effects related to vaccines show up within the first six weeks after immunization. There have now been hundreds of millions of doses of the vaccine administered across the nation. People who participated in the original clinical trials received their first doses a year ago.

He said parents also need to consider in their risk analyses the long-term unknowns that come with catching COVID.

“Some parents might say, ‘Well, you know, kids aren’t getting really sick,’” Mehta said. “That’s true, compared to adults; they’re less likely to get severely sick. But you don’t know what’s gonna happen in six months after a COVID infection.”

Daley said the most common side effects in kids are similar to those in adults — headache, muscle aches, fatigue. He gave advice on when parents should seek out medical care for their children following vaccination.

“I think parents are really good at trusting their gut instinct, and if their kids are experiencing those similar side effects, but it doesn’t feel too severe to them and their kids are able to go about their regular activities pretty well, then I think that’s OK to stay home,” Daley said. “But if it rises above that threshold, as a parent just try to trust your gut instinct and contact your primary care provider.”

Dr. Steve Groshong prepares syringes of the Pfizer-BioNTech COVID-19 vaccine during a drive-through vaccine clinic in the parking lot at National Jewish Health on January 29, 2021 in Denver, Colorado. (Kathryn Scott, Special to The Colorado Sun)

How do you keep your kids safe while they are unvaccinated?

All three of the doctors emphasized the need for parents to take precautions while their children remain unvaccinated.

“If you’re vaccinated and you have unvaccinated kids at home, you potentially could be one part in that transmission of getting the virus to somebody else who is unvaccinated,” Valenza said. “And so really (think) about those who are around you. Are you around other people who are vaccinated? Are you around others that are unvaccinated? Continuing with mask-wearing, mask-wearing with the  kids, continuing infection control by washing hands.”

Daley said unvaccinated children appear less likely to spread the virus than unvaccinated adults.

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“If you’re vaccinated, you’re way less likely to get infected at all,”  Daley said. “And it does appear that you’re way less likely to spread it to anybody else. That doesn’t mean it’s impossible, but it’s very, very, very unlikely. … Kids are going to play a part in transmission, whether to other kids or to their teachers who are unvaccinated. But, in general, kids are less contagious than adults. So I would still think unvaccinated adults are the most contagious in our community, followed by unvaccinated kids.”

Mehta said his children will continue wearing masks until they are able to get vaccinated, even though they may no longer be required to by state or local health orders.

“When we think about masks, there are mandates, which are political, and there are recommendations, which are driven by science,” Mehta said. “And recommendations for masking indoors still remain that anybody who is unvaccinated should mask indoors.”


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