What to tell your young teen about their shot at the COVID-19 vaccine

By Michael Merschel, American Heart Association News

Jose Luis Pelaez Inc/DigitalVision, Getty Images
(Jose Luis Pelaez Inc/DigitalVision, Getty Images)

Authorization of a COVID-19 vaccine for people as young as 12 offers parents more than the opportunity to protect their kids. It offers them a chance to be a guide.

Adolescents might be wondering whether vaccines are safe or even necessary. They also might be struggling with conflicting information from their peers about those very issues.

That is why the most important thing a parent can do right now is listen, said Francesca Penner, a clinical psychology resident who will do postdoctoral work at Yale University's Child Study Center in New Haven, Connecticut.

"Hearing them out is the biggest thing," Penner said, "because there's just so many influences on what kids might be thinking."

On Monday, the Food and Drug Administration authorized Pfizer's COVID-19 vaccine for emergency use in children ages 12 to 15. The Centers for Disease Control and Prevention followed suit on Wednesday, making the vaccine immediately available to this younger age group.

"This official CDC action opens vaccination to approximately 17 million adolescents in the United States and strengthens our nation's efforts to protect even more people from the effects of COVID-19," the CDC's director, Dr. Rochelle Walensky, said in a statement. "Getting adolescents vaccinated means their faster return to social activities and can provide parents and caregivers peace of mind knowing their family is protected."

Vaccines from Moderna and Johnson & Johnson are still being evaluated for people under 18.

Dr. Kristin Moffitt, an infectious diseases physician at Boston Children's Hospital, expects safety to top the list of concerns for young teens.

"I think it would be important for them to know that there was a clinical trial that included several thousand 12- to 15-year-olds," and the side effects were very similar to what was seen in the 16- to 25-year-olds, she said.

For most, that meant pain or swelling at the injection site. Some also experienced low-grade fever, chills, fatigue or headaches in the 24 to 48 hours after getting the vaccine, particularly after the second dose. That tends to go away within 24 hours and can be treated with acetaminophen or ibuprofen.

But sending a clear message about safety might be complicated by peer pressure and social media.

"I was talking to one of my teenage patients a few weeks ago who's actually old enough to get the vaccine now, but she's hesitant about it because she's getting misinformation," Penner said.

Parents can turn such problems into a learning opportunity, Moffitt said. She's been talking to her own children, who are 11 and 14, about the importance of getting medical information from trusted sources. She recommends the Centers for Disease Control and Prevention, the World Health Organization or the American Academy of Pediatrics. Information also is available through the COVID-19 Vaccine Education Initiative.

"And then beyond that, if they feel that their questions haven't been answered, their pediatricians should be very well educated in these topics and able to further answer questions," she said.

Developmentally, adolescents often are primed to listen more to peers and peer-like figures on social media than they do to authority figures, Penner said. Parents can help counterbalance that by setting good examples.

If a parent had any hesitancy about getting vaccinated, a child will pick up on that, she said. So a parent can walk through their decision-making, saying, "You know, I was hesitant, but here's what convinced me to actually get it."

And while older kids now have a spot in line for vaccination, younger kids might be anxious about having to continue to wait for emergency use authorization in their age group. If a child of any age is showing signs of anxiety that interfere with their daily life, therapy is an option, Penner said.

"If they can't sleep at night, or if they're having trouble sleeping on a regular basis, if you're noticing changes in their appetite, or their ability to complete school or just get through the day without expressing a lot of worries, then that might be a signal."

Overall, Penner said, a parent's main job while listening is to hear out the child's thoughts and emotions in a validating way and affirming what's true – while correcting what's not in a way that's developmentally appropriate for that child. After all, there are "individual factors about the child that the parent knows better than anyone else."

Moffitt said it's good to remind a child that vaccines are meant to help save lives and keep people out of the hospital. Concerns about side effects need to be balanced with the threat of contracting COVID-19 and what that might mean not just to the person getting vaccinated, but to their entire household, she said.

They should be reminded that getting vaccinated puts the whole community one step closer to being able to resume all the fun, good parts of being a kid that have been put on hold for safety's sake.

"My kids, like so many kids, are desperate to get back to some sense of normalcy, to get back to being able to be in school, be with their friends, participate again in all the activities that have always made them so happy," Moffitt said. "And they very much have come to understand that safe and effective vaccination is a critical part of that path forward."

Editor's note: This story was corrected Aug. 10, 2021. The COVID-19 vaccines have been "authorized," not "approved." To date, no COVID-19 vaccine has received full FDA approval. The vaccines are currently available under an emergency use authorization. Because of the rapidly evolving events surrounding the coronavirus, the facts and advice presented in this story may have changed since publication. Visit Heart.org for the latest coverage, and check with the Centers for Disease Control and Prevention and local health officials for the most recent guidance.

If you have questions or comments about this story, please email editor@heart.org.


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