Oregon pediatrician on vaccinating kids 12-15 against COVID-19

The FDA announced Monday that it has approved the Pfizer COVID-19 vaccine for kids ages 12 to 15. There are a few more steps in the approval process, both at the federal level and at the state level, but it’s possible that shots for this younger age group could be available in Oregon as early as Thursday.

Pediatrician Dr. Ryan Hassan spoke with Think Out Loud Tuesday. He practices in Happy Valley and is on the medical advisory board of Boost Oregon. Here are some key questions Dr. Hassan answered, edited for clarity and brevity:

What do we know from clinical trials on young people?

The vaccine seems to work pretty much just as well and just as safely, in younger kids 12 and up as it does in older people. So no surprises there and really good news that we can now safely, with the knowledge of that safety, move forward vaccinating younger kiddos.

What about the even larger age group of kids 2 -11 years old?

Those trials are well underway and Pfizer will probably be seeking approval for their use in the coming months. I’ve seen estimates as early as September potentially for kiddos at the two and up age group to be receiving the vaccine.

How were they able to make the vaccines so quickly?

Normally it takes a couple decades, 20 to 25 years to put a vaccine from idea to on the market. And in this case, we created these vaccines in under a year. So I think that’s a big concern is: were things rushed or were steps skipped along the way. And the good news there is that, the answer to that is no, that we didn’t skip any steps, that nothing was rushed. We just expedited the process.

So there were a lot of factors that allowed us to go more quickly get these vaccines on the market than we would expect. And that’s just the nature of a pandemic. There was a sense of urgency. We needed to get this done. We already were able to shave years of pre-clinical research off the vaccine manufacturing and production because we had data from SARS and MERS viruses which are also coronaviruses and vaccine research that have been done on those viruses. And then the whole process was able to happen much more quickly because of the billions and billions of dollars that were funneled into the project through Operation Warp Speed in the U.S. and similar projects in other countries that allowed the manufacturers to conduct the phase one through three trials very quickly overlapping and actually start producing vaccine before the vaccines were even approved for use. So they’re actually producing them at cost because they had a guaranteed market for them.

What would you say to parents who say they’re not sure about the necessity of this vaccine for younger kids because of what they see as less risk for them from COVID-19?

The bottom line is that we are not good at evaluating risk as humans. It’s just not the way our minds work. We are scared of things that are visual and that we see. We’re more scared of shark attacks than we are of car crashes. But car crashes are the second leading cause of injury in the United States, so we don’t really have a good perception of what is actually dangerous.

It is true that the COVID virus is significantly less dangerous in younger kids. It’s less likely to cause serious symptoms and very less likely to cause death. But there are several children who have died of COVID. There are several children who’ve been hospitalized from COVID. And of course, even if you have a mild illness, you know, you’re still looking at a 14-day quarantine, which is really, really challenging. Especially if you’re working parent with limited access to childcare.

And then of course, the other thing is that we’re not just protecting our kiddos were also protecting our loved ones who our children interact with. So the parents, the grandparents and other family members who are still going to be vulnerable to this disease. It’s important to remember the vaccine doesn’t protect 100%. So just because you have two vaccinated grandparents, your unvaccinated child has a low risk — but still a real risk — of possibly getting those people sick. So it’s not a zero risk for children being exposed to COVID. And the vaccine, of course are going to be some risks of side effects, but we know that they are significantly, astronomically, lower than any comparable risk of getting COVID itself. So yes, your risk of COVID in a kid causing problems is pretty low. But your risk of the vaccine causing problems is significantly lower. So if you have these two options, to take the vaccine is the safer choice.

Have you encountered extreme forms of COVID-19 hesitancy?

I have had patients last year, well before there was even a vaccine available of any kind, telling me they weren’t going to get the COVID vaccine. Which is something because you didn’t have any information about the COVID vaccine at that time. So it just goes to show that, there is a lot of hesitancy that is just based in fear, which has been driven by just a very pervasive kind of anti-vaccine propaganda.

The coronavirus vaccine is the first vaccine ever made that had an anti-vaccine movement before the vaccine even existed. So there’s certainly people who have unfortunately been exposed to that had been drawn into that and some of the fear-mongering that’s been going on.

So how much overlap is there between general opposition to vaccines and the COVID-19 vaccine specifically?

I think it’s very similar to the influenza vaccine in a sense, because flu vaccine is another shot that has the same science, same data and is probably one of the most important vaccines that we can get because flu kills hundreds of thousands of people in the U. S. each year. But there’s about 50% of the adult population in the US that just doesn’t get the flu vaccine each year. So it’s there’s a lot of hesitancy around flu vaccine. And I’ve seen a similar level about around COVID. And I think a lot of that is just because one of just because of the novelty of it, because it’s so new. So any time there’s something new, there’s just going to be more fear about it.

And then of course, there’s just so much politicization of the pandemic in general. So a lot of people’s own ideological and sacrosanct beliefs about themselves and about their own identity and their place in the country and the role of government ... all of these kinds of ideas certainly play a part in their perceptions about the vaccine.

How do you talk about vaccines with your younger patients?

The vaccine, essentially, it gives your body an antigen, or sometimes I’ll just say just a protein, or a part of a disease depending on, you know, the patient’s level of understanding. And that will allow your body to recognize it and attack it and create an immune response. And then your body’s immune system will then remember that antigen or part of the disease. And then when it sees the actual disease in real life later on, it will be able to attack and destroy it and keep you from getting sick or reduce your chances of getting as sick.

The vaccine itself does a minimal amount of work in the body. It’s really your body that creates the immune response and helps protect you against the disease. And it’s the same for every single vaccine we’ve ever made.

What could widespread vaccinations of kids under 16 mean for the coming school year?

I mean, really optimistically, we could go back to a world where we can hang out with people and not wear masks. We could have normal social interactions. We can go into a post-pandemic world where we can once again, see the people we care about and interact with each other normally. I have a lot of hope as well that if we can stay focused, if we can encourage people to vaccinate and make sure we’re trying to deliver the vaccine equitably to as many people as we can, and still take the appropriate public health precautions of making sure we’re keeping the restrictions in place that we need until such time that we no longer need them ... then I think we could very well get there very soon. And that’s very exciting to me. I would love to be able to go and see some more friends again and hang out in the park.

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