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Debating whether to vaccinate your kids against COVID? Here are some things to know.

The risk of myocarditis from a coronavirus infection is much greater than it is from the COVID vaccine, according to research.

Jill Holm-Denoma, left, holds her nearly 6-year-old son, Tyler, after he received a COVID-19 vaccination from Emily Cole, a registered nurse at National Jewish Health, during the pediatric vaccine rollout Wednesday, Nov. 3, 2021, in east Denver. Several dozen children were the first in the Mile High City to receive a vaccination against the coronavirus. (AP Photo/David Zalubowski)
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As the latest phase in Colorado’s COVID vaccination campaign rolls forward, about 17% of kids ages 5-11 have received at least a first dose.

Those numbers are increasing daily as more parents snap up appointments now that federal regulators have given the green light to COVID vaccinations in kids as young as 5. But doctors say they are also encountering plenty of parents who are hesitant to vaccinate their children, citing concerns about known and unknown side effects.

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National polling shows that about 35% of parents say they either won’t get their 5- to 11-year-olds vaccinated or will do so only if it’s required. That percentage appears to be growing. Meanwhile, around 33% of parents say they want to wait and see.

Pediatricians say the data overwhelmingly supports vaccination, which they say will provide a benefit to both the kids getting the shots and to the community as a whole.

“You’re either a stop in the chain of transmission or you’re a propagator in the chain of transmission,” said Dr. Sam Dominguez, a pediatrician at Children’s Hospital Colorado. “And the more stops we have, the better off we are as a community, as a state, as a nation, and as a world.”

Here are some things to consider if you’re weighing whether to get your kids vaccinated.

The pandemic has never been more dangerous to young school-aged kids than it is right now

Colorado’s COVID case rates are at levels not seen since the spike of last winter. But what’s different this year is that kids ages 5 to 11 are leading the surge.

Case rates for children 5 to 11 are the highest of any age group in the state. They are also far higher for the age group than they have been at any point in the pandemic.

A chart by the Colorado Department of Public Health and Environment shows COVID-19 case rates by age group in 2019. (Provided by CDPHE)

To Dominguez, this is a crucial piece of information. The high rates of spread among younger kids show that parents can expect their kids will eventually be exposed to the SARS-CoV-2 virus, which causes COVID. That means the potential risks of vaccination need to be weighed against the risks that come with getting sick from COVID — parents can’t count on their kids dodging the virus.

“There was this perception early on that kids weren’t getting infected with SARS and could not transmit SARS,” he said. “And that is absolutely not true.”

The risk of heart problems from the vaccine is rare

On the risk of vaccination, there’s one big one on parents’ minds, Dominguez said. The vaccine has been shown to increase the risk for a heart issue called myocarditis, an inflammation of the heart muscle. Myocarditis can be serious and can lead to hospitalization.

Myocarditis cases related to the vaccine are most common in teenage boys. Data from the Centers for Disease Control and Prevention puts the risk among the highest-risk of that group, boys ages 16 and 17, at about 69 cases of myocarditis for every 1 million second doses of vaccine given. (Myocarditis is far more likely after the second dose of vaccine than the first.)

Among teenage girls, the risk never climbs above eight cases of myocarditis per 1 million second doses given.

A slide from a Centers for Disease Control and Prevention presentation shows the risk of COVID vaccine-related myocarditis by age group. The slide was presented at the Nov. 2, 2021, meeting of the Advisory Committee on Immunization Practices. (Screenshot by John Ingold, The Colorado Sun)

The risk of myocarditis in preteen kids is unknown. There were zero cases of myocarditis reported in the clinical trials for children ages 5 to 11.

But Dominguez said myocarditis in general is more common in teenagers than it is in kids ages 5 to 11.

“We think that likely the biology is different and that likely this age group is at lower overall risk of developing myocarditis,” he said.

The dose of vaccine being given to kids 5 to 11 is also only one-third the size of the dose being given to older kids and adults, likely lessening the risk, Dominguez said.

COVID comes with a much bigger risk of heart problems

In addition to vaccination, all kinds of other things can cause myocarditis, including viral infections like COVID. And research shows that COVID is many times more likely to cause myocarditis in kids than the vaccine is.

A study that the CDC published in September found that 0.133% of kids under the age of 16 who got sick with COVID developed myocarditis. For kids and young adults ages 16 to 24, the rates were slightly lower, about 0.098.

To put this on par with the vaccination numbers, it means that about 133 out of every 100,000 kids who get COVID will develop myocarditis, while, even for the kids most at risk from vaccine-related myocarditis, only about 6.9 out of every 100,000 who get a second dose of vaccine will develop myocarditis.

Dominguez said the myocarditis related to vaccination is different from what COVID causes. Those who develop myocarditis after vaccination recover quickly, according to federal data. More than 90% of doctors treating patients with vaccine-related myocarditis report that those patients are fully recovered or likely fully recovered after three months.

Myocarditis related to COVID can be longer-lasting, Dominguez said.

“It’s very different, quantitatively and qualitatively,” he said.

A separate CDC study, published in July, modeled the benefits of vaccination as opposed to the myocarditis risk. For boys ages 12-17, it estimated that every million doses of vaccine will prevent 5,700 COVID cases, 215 hospitalizations and 71 ICU admissions.

COVID also has other serious risks for kids

Myocarditis isn’t the only major problem kids can face if they get sick with COVID.

There’s the potential for “long COVID,” the mysterious ongoing symptoms of COVID that can persist for months. Dominguez said researchers are still trying to peg the incidence rate but noted that a Children’s Hospital clinic for kids with long COVID is full and has a waiting list.

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There’s also the risk of something called MIS-C, multisystem inflammatory syndrome in children. Colorado has seen more than 100 cases of the potentially life-threatening condition.

A June study from researchers across the country put the rate of MIS-C at 316 per every million COVID infections.

The Colorado Department of Public Health and Environment says 0.24% of Colorado’s COVID deaths have occurred in people age 19 or younger. That would put the number of deaths around 21. (The state does not release exact numbers for pediatric deaths because of health privacy concerns.)

Long-term hidden vaccine side effects are really unlikely

Dominguez said another major concern he hears from parents is that the vaccine may have some hidden, long-term side that won’t be known until much later.

But Dominguez said this is highly unlikely. COVID vaccines have been administered at a mass scale for nearly a year now, and Dominguez said what happens with adults is usually predictive of what will happen with kids.

“We don’t often see new things develop in kids that weren’t present in adults,” he said.

Meanwhile, vaccine side effects are usually fast-appearing things. They don’t lie dormant and then pop up many months or years later.

“All of the adverse events that we see from vaccines usually happen within the first two months, post vaccine,” he said.


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