Editor's note: This article was sponsored by the Washington State Department of Health.
When the COVID-19 booster vaccine for 5- to 11-year-olds received the green light in May, infectious disease physician Shireesha Dhanireddy, M.D., signed her son up to receive a booster dose right away.
One of the reasons Dhanireddy was eager to provide her son with the additional health protection afforded by the booster was that she didn’t want a COVID-19 infection to ruin his much-anticipated summer sleepaway-camp plans. The best way to protect against waning immunity is a booster dose.
“It’s so disruptive for children to be sick, isolated and away from friends,” says Dhanireddy, who is the medical director of UW Medicine’s Infectious Diseases Clinic. “Providing that extra boost of protection allows kids to participate in activities and be active physically.”
And the pandemic has greatly hampered this age group’s social development, she adds. Providing that extra layer of protection can help them stay healthy while allowing them to reengage with their peers. The benefits also transfer to the parents, who may have to stay home from work to care for a sick child — and possibly catch the virus, too.
“There are implications for the whole family’s health,” says Dhanireddy.
The booster enhances the body’s immune response
Public health officials now recommend that children ages 5–11 receive a COVID-19 booster five months after completing the two-dose Pfizer-BioNTech vaccine series. Children who are immunocompromised should receive their booster at least three months after completing their primary series.
With the booster, kids are receiving an additional 10 micrograms of the Pfizer vaccine, or one-third of the adult dosage. So far, the Pfizer vaccine is the only approved option for this age group.
While the vaccine is highly protective against severe illness, hospitalization and death, its protection wanes over time. Similarly, protection conveyed as a result of an active infection diminishes over time. Such protection decreases because the virus is constantly evolving to dodge the body’s immune response. The booster helps increase protection and enhance the body’s ability to fight off the virus.
While it’s unclear exactly how long the antibodies triggered by the booster dose will last and how well they’ll prevent a symptomatic infection, data from a recent small clinical trial shows that the third dose of the vaccine results in a thirty-sixfold increase in omicron-variant-fighting antibodies.
The booster vaccine works by giving the child’s body instructions to create an immune response. “What remains in the body is your own immune response,” Dhanireddy explains. “What was in the vaccine is gone, and your own immune system is ready to go.”
There is also some evidence that suggests vaccination reduces one’s risk of developing long COVID, a condition that can result in lingering symptoms such as brain fog and chronic fatigue in both children and adults. One study indicated that as many as 52 percent of teens and young adults ages 16–30 may experience lingering symptoms for as long as six months following a COVID-19 infection. The U.K. Office for National Statistics estimated that 12.9 percent of children ages 2–11 years and 14.5 percent of children ages 12–16 still experienced symptoms five weeks after infection. A recent study of more than 13 million people found a 15 percent reduction in long COVID among vaccinated people.
“Knowing how debilitating long COVID is makes this a significant finding,” says Dhanireddy.
Physical and mental health benefits
Since the onset of the pandemic, more than 4.8 million U.S. children ages 5–11 have been diagnosed with COVID-19; 15,000 have been hospitalized, and more than 180 have died, according to the Centers for Disease Control and Prevention (CDC).
During the omicron surge, the hospitalization rate of children in this age group was about twice as high among unvaccinated children as vaccinated, according to an April CDC report. Of those hospitalized, 30 percent had no underlying medical conditions, and 20 percent spent time in an intensive care unit. Children with obesity and diabetes are more likely to experience severe symptoms from COVID-19 infections, the report confirmed.
But even a mild case can sideline kids, suspending them from their regular activities and contact with friends. “I think it’s a big deal at this age,” says Dhanireddy. “I want them to go to birthday parties and do that stuff again.”
The extra protection that comes from the booster dose might encourage hesitant parents to provide more social opportunities for their young children. It may also reassure families that include a member who suffers from a weakened immune system. People who have compromised immunity are less protected by the vaccine, which means they depend more on others around them to protect themselves from infection. “We still have vulnerable people in our community,” says Dhanireddy. “We need to be thinking of them, too.”
Should I wait or do it now?
Some parents might be wondering if it’s best for their child to get the booster now or wait until the start of the new school year in the fall. Given the current surge in cases and the unpredictability of the virus, it’s smart to provide protection now, Dhanireddy advises. That’s also her advice for parents who might be waiting to time the booster before a vacation. The bottom line: If your child is eligible now, don’t hesitate.
“In the moment, we should be doing the best for kids and get them protected right now,” says Dhanireddy.
It helps to consider the COVID-19 vaccine in a different way than we do most childhood vaccinations, which are “one and done.” Instead, Dhanireddy encourages parents to think about COVID-19 as a disease that will require frequent preventive boosters. Ideally, we will one day get into a more regular cadence of vaccination, as with the annual flu vaccine.
Even with the boosters, there are still roles for indoor masking and pretesting, particularly for gatherings such as sleepaway camps and for other events during which the virus could easily spread, Dhanireddy adds.
While the lingering precautions and necessity to keep vaccinating can be frustrating, it’s important to put things in perspective. Yes, cases are still high, but the number of hospitalizations is falling. Kids are back in school and participating in extracurricular activities. Slowly but surely, progress is happening.
“We are inching our way back to our lives,” says Dhanireddy. “We are going back to some of these things, and that is encouraging.”
To make a vaccine or booster appointment, visit Vaccine Locator or Vaccines.gov, or call the COVID-19 information hotline at 833-VAX-HELP. Patients should not be charged for the COVID-19 vaccine regardless of insurance coverage status.