Many of our patient families have questions about the COVID-19 vaccine for their children with autoimmune or autoinflammatory conditions. Board-certified pediatric rheumatologist, Dr. Ruy Carrasco and Shelby Brooks, MSN, APRN, CPNP-PC, have compiled the most frequently asked questions from families and addressed them here.
These are unusual times and there is little we can say with 100% certainty. But, what we can say with certainty, is that we are invested in the wellbeing of our patients and will continue to stay abreast of the most current recommendations regarding the vaccine to provide you with the latest scientific information.
COVID-19 Vaccination FAQ
1. Who should receive the COVID-19 vaccine?
All children 5 years of age and older, especially those with rheumatic diseases, who are eligible are encouraged to receive the COVID-19 vaccine. Those who may not be eligible include patients with allergies to the vaccine, severe reaction to past vaccines, those who are currently experiencing severe flare of their rheumatic disease, or other special circumstances. Please discuss with your primary care provider if you are concerned regarding your child’s eligibility.
2. Is it safe for my child to receive the COVID-19 vaccine if they have an autoimmune or autoinflammatory condition?
Yes, it is both safe and encouraged for children with autoimmune or autoinflammatory conditions, especially those that take immuno-modulating medications, to get the COVID-19 vaccine. In fact, children with autoimmune conditions are more at risk of developing severe cases of COVID-19 resulting in hospitalization than the general population. The benefits of the vaccine include prevention of the COVID-19 virus, decreasing hospitalization risk, and many others. These benefits highly outweigh the risks of the COVID-19 vaccine which are outlined below.
3. What side effects and risks are there to the COVID-19 vaccine?
The side effects of the COVID-19 vaccine may include redness, pain, and swelling at the injection site, fever, nausea, headache, chills, muscle pain, and tiredness. Most children experience mild or no side effects. If a child does develop side effects, they are signs that your child’s body is working hard to build antibodies against the virus and does not mean that your child has COVID-19. The COVID-19 vaccine cannot give your child the COVID-19 virus.
4. Where can I go to find more information regarding the recommendations and guidelines for children who have autoimmune conditions?
You can find more information for vaccination of kids at the Centers for Disease Control (CDC) website and for vaccination of people with suppressed immune systems here. You can also find guidelines for COVID-19 vaccine at the American College of Rheumatology website.
5. Why should I receive the COVID-19 vaccine?
The COVID-19 vaccine creates antibodies against the COVID-19 virus. The risk of infection from the COVID-19 virus heavily outweigh the risk of the vaccine. Risks of the COVID-19 virus include, but are not limited to, severe respiratory illness, myocarditis, multi-system inflammatory syndrome in children (MIS-C), and sequelae such as long-term respiratory dysfunction and fatigue. Risks of the COVID-19 vaccine are rarer in children but can be found below. Patients with autoimmune conditions are at higher risk of developing severe symptoms of COVID-19 than the general population. Therefore, it is highly encouraged for these children to become vaccinated to protect themselves against the COVID-19 virus.
6. When should my child receive the COVID-19 vaccine?
– If your child takes abatacept (Orencia), belimumab (Benlysta), cyclophosphamide, hydroxychloroquine, or rituximab (Rituxan), please contact our office as there are specific timing recommendations when taking the COVID-19 vaccine for these medications.
– If your child takes any other immuno-modulating medication for their rheumatic disease, such as methotrexate, adalimumab (Humira), tofacitinib (Xeljanz), etc. to name a few, they should follow the following vaccine timeline based on how often the medication is taken:
PRESCRIBED MEDICATION TIMING
VACCINE TIMING RECOMMENDATIONS
|Obtain the COVID-19 vaccine 1-2 days after the last immuno-modulating medication dose, and skip the medication for 1-2 weeks depending on the child’s history of control. If the child has been well controlled without symptoms of rheumatic disease for 3 months, skip the medication for 2 weeks. If the child has not been well controlled and has had symptoms of their rheumatic disease within the last 3 months, skip the medication for 1 week.
For example, if the medication is last taken on January 1st, the vaccine should be taken on January 2nd or 3rd. The medication should be held on January 1st until January 7th or 14th, depending on the child’s history of control as described above.
|Obtain the COVID-19 vaccine 1-2 days after the last dose of immuno-modulating medication, and skip the medication for 1 week.
For example, if the medication is last taken on January 1st, the vaccine should be taken on January 2nd or 3rd. The scheduled dose for January 7th should be skipped, and the next given dose would be on January 14th.
|Obtain the COVID-19 vaccine 1-2 days after the last dose of immuno-modulating medication, and do not skip any doses of the prescribed medication.
For example, if the medication is last taken on January 1st, the vaccine should be taken on January 2nd or 3rd. The scheduled dose for January 14th would be taken as scheduled.
|Obtain the COVID-19 vaccine within one week after the last dose of immuno-modulating medication, and do not skip any doses of the prescribed medication.
For example, if the medication is last taken on January 1st, the vaccine should be taken between January 2nd through January 7th. The scheduled dose for January 31st would be taken as scheduled.
|Obtain the COVID-19 vaccine within one week after the last given dose of immuno-modulating medication, and do not skip any doses of the prescribed medication.
For example, if the medication is last taken on January 1st, the vaccine should be taken between January 2nd through January 7th. The next scheduled dose would be taken as scheduled.
7. What brand of vaccine should my child receive?
At this time, only the Pfizer brand of the COVID-19 vaccine is approved for 5-17 years of age. We recommend your child get the Pfizer brand of the COVID-19 vaccine. If your child is 18 or older, they can receive either the Moderna, Pfizer, or Johnson & Johnson vaccine. The PRC team has no preference for which vaccine your child receives.
8. My child is under the age of 5 years or is not eligible for the vaccine. What are ways I can protect my child until they become eligible for the vaccine?
There are ways to protect your child if they are not eligible for the vaccine. Please encourage all family members, especially those in the immediate family who spend time with your child, to become vaccinated. This creates “herd immunity” which will assist in reducing exposure of the COVID-19 virus to your child. Your child and family should continue to follow all CDC guidelines to prevent infection, including handwashing, social distancing at least 5 feet apart from others, and wearing masks while indoors or around large crowds of people. Other guidelines for infection prevention can be found here.
9. Where can I find a location to receive the COVID-19 vaccine?
You can find eligible COVID-19 vaccine locations at vaccines.gov or call your local pharmacies to make an appointment for your child to get the COVID-19 vaccine. If your child is under the age of 18, please ensure the pharmacy has the Pfizer version of the COVID-19 vaccine prior to making the appointment.
10. Do the COVID-19 vaccines cost money?
No, the COVID-19 vaccines do not cost money. All vaccines are free and paid for by taxpayer dollars.
Centers for Disease Control and Prevention (CDC). (2021, November 4). COVID-19 vaccines for children and teens. Retrieved November 8, 2021, from https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/children-teens.html.
Centers for Disease Control and Prevention (CDC). (2021, October 18). COVID-19 vaccines for moderately to severely immunocompromised people. Retrieved November 8, 2021, from https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/immuno.html.
Center for Disease Control and Prevention (CDC). (2021, November 3). Families with vaccinated and unvaccinated members. Retrieved December 1, 2021, from https://www.cdc.gov/coronavirus/2019-ncov/your-health/about-covid-19/caring-for-children/families.html.
Curtis, J. R., Johnson, S. R., Anthony, D. D., Arasaratnam, R. J., Baden, L. R., Bass, A. R., et al. (2021, October 27). COVID-19 vaccine clinical guidance summary for patients with rheumatic and musculoskeletal diseases- Version 4. American College of Rheumatology. Retrieved November 8, 2021, from https://www.rheumatology.org/Portals/0/Files/ACR-COVID-19-Clinical-Guidance-Summary-Patients-with-Rheumatic-Diseases.pdf.