Many parents are hesitant, so we asked doctors to weigh in on the most common concerns.

Now that a COVID-19 vaccine has been green-lighted for children 12 and older, many parents are wondering whether it's safe or even necessary to get their teens vaccinated. Experts in pediatrics, infectious disease, and childhood immunization insist the science is clear: the benefits far and away outweigh any risks.

But what about allergies? What about long-term effects? Why not wait and see?

There are plenty of opinions in the blogosphere and on social media about childhood vaccines in general and COVID-19 specifically. Unfortunately, the naysayers are often guided by faulty information or a misunderstanding of the science, expert say.

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What to know about the Pfizer vaccine for kids

Days after the US Food and Drug Administration (FDA) expanded emergency use of the Pfizer-BioNTech COVID-19 vaccine for kids ages 12 to 15, an advisory panel to the US Centers for Disease Control and Prevention (CDC) recommended it for the prevention of COVID-19 in this age group. The panel voted 14-0 with one recusal. It's a vigorous endorsement based on an extensive review of the benefits and harms.

The vaccine consists of two doses delivered three weeks apart, just like it is for adults. It's the same dosage, too. Kids in the 12 to 15 age group are "immunologically similar to adults," Christina Johns, MD, a pediatrician and senior medical advisor at PM Pediatrics in Annapolis, Maryland, tells Health. "So that's not a concern." (Sixteen- and 17-year-olds were previously included under Pfizer's emergency use authorization.)

Parents' misgivings about vaccinating their teenagers

Right now, parents are very much divided on whether their children should get COVID shots. A Kaiser Family Foundation (KFF) survey conducted in April found 30% of parents of kids 12 to 15 intended to get their child vaccinated right away. But 26% are taking a wait-and-see approach, and 19% indicated that they'll only do it if their child's school requires it. Another 19% are firmly opposed—they say they definitely won't get their kids vaccinated against COVID-19.

The survey revealed a similar pattern among parents of kids 5 to 11 and children under age 5. (No vaccine is currently available for kids 11 and younger, although clinical trials are underway.) Parents' attitudes about vaccinating their kids generally reflect their own experiences and intentions, KFF noted.

Separately, a recent 50-state survey from researchers at Northeastern, Harvard, Rutgers, and Northwestern Universities suggests moms are more hesitant about getting their kids vaccinated than dads. Twenty-seven percent of mothers indicated that they are extremely unlikely to vaccinate their kids, versus 11% of fathers, according to survey results published online. Attitudes also vary across income, education, and political affiliation.

So why are some parents not fully onboard or completely against the COVID-19 vaccine for their kids?

"Honestly, I'm hearing it all," says Dr. Johns. Some parents are comfortable with the science and they're curating information from trusted channels, she says, while others just aren't sure; they have some concerns; they're nervous. "And then there are a bunch of people who have really bought into some of the stuff that they've heard online," she says.

We asked researchers and clinicians to set the record straight on common misperceptions that may be giving parents pause. Here's what they told us.

"The vaccine is not necessary for kids because they don't get COVID"

While kids as a group are less severely affected than adults, Dr. Johns says there are children who do get serious cases. And a growing number are developing "long COVID," which can cause headache, fatigue, problems focusing, or other lingering issues, she adds. Data presented to the CDC's Advisory Committee on Immunization Practices (ACIP) show that adolescents as a group, ages 12 to 17, are much more likely to be hospitalized with COVID-19 than influenza. The analysis is based on data from flu outbreaks over the past decade.

Vaccinating children protects them from serious COVID-19 infections and complications, including MIS-C, a rare but dangerous illness in children exposed to COVID. "We are still continuing to admit children to a pediatric intensive care unit who are critically ill, who may wind up having long-term damage to their hearts from this post-infectious inflammatory condition," Dr. Johns says.

Plus, the more people who are vaccinated, the less opportunity there is for the virus to replicate, circulate, and mutate, she points out.

Getting vaccinated would also be a step toward giving kids some normalcy, Julie Boom, MD, professor of pediatrics at Baylor College of Medicine at director of the immunization project at Texas Children's Hospital in Houston, tells Health. "Parents really need to realize that getting your teen vaccinated is going to help not only your teen return to normal daily activities but help our communities and nation return to life as we knew it pre-COVID," she says.

"The vaccines were rushed, and they might not be safe"

Sure, it might seem like they were rushed. After all, the pandemic was in full throttle this time last year, and now close to half of the US population has had at least one dose of a COVID vaccine. Still, there's no evidence that manufacturers cut safety corners in devising or testing the new vaccines. Pfizer's COVID-19 vaccine, like the Moderna and Johnson & Johnson vaccines, made its way through clinical trials and FDA scrutiny just as any other vaccine would.

What did happen was Operation Warp Speed, a concerted effort launched by the federal government last year to reduce red tape, not scientific rigor. The process was accelerated, not rushed, Litjen (L.J.) Tan, PhD, chief strategy officer at the Immunization Action Coalition, a Saint Paul, Minnesota-based nonprofit that educates health care providers and the public on child, teen, and adult immunization, tells Health.

Tan, an expert in microbiology and immunology, adds that the vaccines didn't come out of thin air. They're the product of two decades of preclinical studies and researchers' past experience developing vaccines for two prior coronaviruses: SARS (severe acute respiratory syndrome) and MERS (Middle East respiratory syndrome).

"The long-term effects aren't known yet"

What we know about the vaccine's side effects comes from clinical trials begun in July 2020 as well as ongoing monitoring. Pfizer enrolled more than 46,000 volunteers in its phase 3 trial, including 2,260 young people ages 12 to 15.

Among teens, adverse reactions were generally what you'd expect: pain at the injection site, fatigue, and headache. Chills, muscle pain, fever, joint pain, and swelling or redness at the injection site were less common.

For an unknown side effect to emerge at this point "would be extremely unusual," Dr. Boom says. Tan adds that most vaccine side effects appear within the first 60 days of receiving a vaccine.

While the CDC is looking into a few reports of heart inflammation (called myocarditis) in adolescents and young adults after a second mRNA vaccine, it's too soon to know whether there's any direct connection with the vaccine. The number of reported cases following vaccination does not differ from the number that would have been expected to occur anyway, per the CDC. In other words, it could be coincidence and nothing more. Meantime, the investigation continues.

"It could affect kids' fertility"

Worries that a COVID vaccine might make teens infertile is a myth running rampant on social media. Scientists say there's no basis for making such a claim. It cannot affect current or future fertility, either in females or males.

The Pfizer vaccine is a so-called mRNA vaccine. It merely teaches our cells to make spike protein, the same protein found on the surface of SARS-Cov-2. Our immune systems respond by making protective antibodies. Ultimately, if you are exposed to the virus at some future time, your immune system will know how to fight it off.

But there's no mechanism to transport mRNA into the nucleus of a cell, where genes are made. "That's not biologically possible," Tan points out, so it simply cannot affect eggs or sperm or cells of the reproductive organs.

"It could put my child at risk of a serious allergic reaction"

"Actually, the anaphylaxis rates are incredibly low with the tens of millions of people who have been vaccinated," Dr. Johns observes. No cases of anaphylaxis—aka, a severe allergic reaction—were reported among 12- to 15-year-olds in the Pfizer clinical trials.

Reasons not to get vaccinated include a known history of a severe or immediate allergic reaction to any component of the vaccine or to a prior dose of the vaccine. The CDC advises health care providers to have personnel, supplies, and epinephrine at the ready to manage any such reactions.

It's why your kid should be observed for 15 minutes (or 30 minutes if there's any history of allergy) after getting the vaccine, the same way adults are observed after getting their shots.

"It's better to wait for full FDA approval"

Currently, all of the vaccines authorized for use against COVID-19 in the US have an EUA—emergency use authorization. But just because they haven't gone through the traditional FDA approval process doesn't mean they haven't been rigorously tested.

The EUA process simply made it possible for the FDA to clear the vaccines for use during the COVID crisis based on the best available evidence, weighing both the potential benefits and risks.

"You're splitting hairs when you use the words approval versus authorization," Tan argues, noting that the vaccines have undergone the same rigid research and development submission of clinical trials data that are necessary for licensure.

Noting that thousands of kids in the US have been hospitalized and more than 300 have died due to COVID-19, the American Academy of Pediatrics (AAP) is recommending COVID vaccination for all eligible children 12 and older. In a prepared statement, AAP President Lee Savio Beers, MD, emphasized the upside: "Vaccinating children will protect them and allow them to fully engage in all of the activities—school, sports, socializing with friends and family—that are so important to their health and development."

The information in this story is accurate as of press time. However, as the situation surrounding COVID-19 continues to evolve, it's possible that some data have changed since publication. While Health is trying to keep our stories as up-to-date as possible, we also encourage readers to stay informed on news and recommendations for their own communities by using the CDC, WHO, and their local public health department as resources.

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