TWV Podcast Episode 486: Covid-19 Vaccines for Children

On this episode of The Whole View podcast, Stacy and I continue last week’s discussion updating the covid-19 vaccine science, to address the mix and match vaccine study, as well as the new data that was published for the vaccines in children. Stacy and I also give an update on how our own boosters went.

Table of Contents[Hide][Show]

Listener Questions
Key Takeaways
Recommended Reading and Listening
Citations

We first discuss the topic of vaccines and boosters in pregnant and lactating people and then dig into the science of mixing and matching vaccines. I spent many hours reading this fascinating study and was able to make subtle distinctions between which vaccines appear to have the best efficacy, and which ones have the least side effects if mixed. Then we dive into the long awaited data on the study in children aged 5 to 11, and the super impressive results of preventing symptomatic infections in 90.7% of participants (which is freaking amazing!) while having an excellent safety profile. Finally, we also discuss the mechanisms behind menstrual cycle changes as a result of vaccines, and touch on the vaccines and fertility discussion.

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Listener Questions

I am wondering if there is any information around boosters with pregnant or breastfeeding Moms? – Sahiba

Hi Dr. Sarah and Stacy! I love your show. I’ve been listening for about 2 years now and have listened to so many of your shows multiple times, plus many of your archives. And I love Patreon and the inside scoop over here. I’m sure you’re really hoping not to do anymore COVID shows, and I totally appreciate that. However I trust your analysis of the science so much that I was really hoping to hear about the vaccine for kids: What is the science saying so far? I’d like to hear the science, as well as your opinion as a mom regarding the benefits and safety please. I look forward to learning more and appreciate your show for the factual, scientific evidence it bring on on things health and nutrition related. Thanks for all the work you both do to bring this show to us each week, I’m a dedicated and avid fan and always look forward to each new release. -Jaclyn

Hi to you both. I love the show and am so grateful for the resources you share. I have a question that I’m not sure where to go for answers and thought it might be up your alley- so here goes: I have heard of many women experiencing issues with their period post COVID vaccine. I am vaccinated and now that my 7 year old can be I am looking for research on why the vaccine impacted some women’s periods and if it could impact fertility or menstruation for young kids as they hit puberty? Due to quarantines and wanting to protect my kids I do want to get them vaccinated but also am hoping there is some science on this point? Thank you!! -Katie

Key Takeaways

Dr. Sarah and Stacy share their personal experience with the booster shot, both of whom had side effects comparable to their second shots of the Moderna vaccine.
Pregnant people are at higher risk of severe covid-19 or death from covid-19 as well as pregnancy complications as a result of covid-19 infection. The vaccines have been shown to be safe and effective for pregnant and lactating people, and in fact, some of those protective antibodies are passed on to the fetus or to the baby through breastmilk. Pregnant people can receive any of the currently FDA-approved or FDA-authorized COVID-19 vaccines as a booster dose.
There is a benefit to mixing and matching which vaccine you get as a booster compared to your initial course. If you received a Johnson & Johnson/Janssen vaccine for your initial course, studies show you’ll get a much better boost of neutralizing antibody production if you get either the Pfizer/BioNTech or the Moderna mRNA vaccine booster, with Moderna being the best boost by a slim margin. If you received either the Pfizer/BioNTech or the Moderna mRNA vaccine for your initial course, studies show that the boost of neutralizing antibody production is comparable regardless of which vaccine you get as a booster, with Moderna being the best boost by a slim margin (followed by Pfizer, followed by J&J).
The side effects from the booster shot are comparable to the second vaccine dose. On average, Pfizer had the lowest frequency of Grade 2 side effects and very very few Grade 3 side effects. If you had really bad side effects from the first series, consider Pfizer. It’s no guarantee, of course. Moderna has the highest frequency of Grade 3 side effects on average, followed by J&J, then Pfizer.
The Pfizer/BioNTech mRNA vaccine has been approved at a lower dose (10μg compared to 30μg for people over 12 years and older) for children aged 5 to 11. The clinical trials showed that the vaccines are safe and effective in this age group. The most common side effects are pain at the injection site, fatigue, headache, muscle pain and chills. No serious adverse events were reported, including no cases of myocarditis or pericarditis. The vaccine prevented 90.7% of symptomatic infections at a time when the more contagious Delta variant was dominant, which is great news!
Getting any vaccine can cause transient menstrual irregularities because cortisol is increased when the immune system is activated and there’s crosstalk between the HPA axis and sex hormones that regulate the menstrual cycle. While there are studies underway to study this effect further, the most important thing to know is that it’s a normal side effect of the covid-19 vaccines and that periods will return to normal. If you are a person who could get pregnant but who would prefer not to, it’s important to take precautions against pregnancy since the timing of ovulation may be impacted. There is no reason to expect that this would impact puberty onset.

Citations

Atmar RL, Lyke KE, Deming ME, Jackson LA, Branche AR, El Sahly HM, Rostad CA, Martin JM, Johnston C, Rupp RE, Mulligan MJ, Brady RC, Frenck Jr. RW, Bäcker M, Kottkamp AC, Babu TM, Rajakumar K, Edupuganti S, Falsey AR, Posavad CM, Archer JI, Crandon S, Nayak SU, Szydlo D, Zemanek J, Dominguez Islas CP, Brown ER, Suthar MS, McElrath MJ, McDermott AB, O’Connell SE, Montefiori DC, Eaton A, Neuzil KM, Stephens DS, Roberts PC, Beigel JH, the DMID 21-0012 Study Group. Heterologous SARS-CoV-2 Booster Vaccinations – Preliminary Report. medRxiv 2021.10.10.21264827; doi: 10.1101/2021.10.10.21264827

Li K, Chen G, Hou H, Liao Q, Chen J, Bai H, Lee S, Wang C, Li H, Cheng L, Ai J. Analysis of sex hormones and menstruation in COVID-19 women of child-bearing age. Reprod Biomed Online. 2021 Jan;42(1):260-267. doi: 10.1016/j.rbmo.2020.09.020.

Schmidt T, Klemis V, Schub D, Mihm J, Hielscher F, Marx S, Abu-Omar A, Schneitler S, Becker SL, Gärtner BC, Sester U, Sester M. Immunogenicity and reactogenicity of a heterologous COVID-19 prime-boost vaccination compared with homologous vaccine regimens. medRxiv 2021.06.13.21258859. doi: 10.1101/2021.06.13.21258859

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Zambrano LD, Ellington S, Strid P, Galang RR, Oduyebo T, Tong VT, Woodworth KR, Nahabedian JF 3rd, Azziz-Baumgartner E, Gilboa SM, Meaney-Delman D; CDC COVID-19 Response Pregnancy and Infant Linked Outcomes Team. Update: Characteristics of Symptomatic Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status – United States, January 22-October 3, 2020. MMWR Morb Mortal Wkly Rep. 2020 Nov 6;69(44):1641-1647. doi: 10.15585/mmwr.mm6944e3. PMID: 33151921; PMCID: PMC7643892.

Call for more research on vaccination and menstruation