Why children can’t get the COVID-19 vaccine yet. Here’s who else may have to wait

The first wave of vaccinations against coronavirus are fully underway now that doses of Moderna’s COVID-19 vaccine are getting dispensed alongside Pfizer’s vaccine. For the sweeping majority of folks, the vaccines from both Pfizer and Moderna have been shown to be safe in large-scale, months-long clinical trials. However, just like with any new drug, doctors encourage caution when taking coronavirus vaccines, especially for people who have had adverse reactions to vaccinations in the past. 

For example, one of the safety measures that’s becoming standard with the coronavirus vaccines involves remaining on-site for a period of time after getting the injection. That’s to give medical professionals time to monitor for any adverse reactions, but it doesn’t mean doctors expect anything bad to happen. Out of over 1.1 million people to get vaccinated so far in the US, only a tiny handful have had allergic or other kinds of reactions.

Read more: Find out your priority to receive the coronavirus vaccine  

What about children, people with known allergies and pregnant or nursing mothers? Here, we compile available data from the FDA and CDC, along with information from leading health experts, to present a guide on who is advised to take the COVID-19 vaccine and who should contact a medical professional first. 

When will there be a coronavirus vaccine for kids?

Right now, Pfizer’s coronavirus vaccine is authorized for use in people aged 16 and older. (Moderna’s is designated for 18 and older.) That’s because, of the several dozen COVID-19 vaccines under development including Pfizer’s and Moderna’s, none has yet been tested in children who are 12 or younger. That’s to be expected. Vaccines are typically tested first in adults before researchers begin tests in children, once the drug has been found to be relatively safe. 

Another factor is that COVID-19 seems to mostly spare children from the worst outcomes. A CDC report from September counted only 121 children among the 190,000 people who had died so far in the US from coronavirus. Other research has found that children catch and spread coronavirus about half as much as adults, though they are still considered vectors in the spread of COVID-19, especially among high-risk populations. For example, a report from the CDC this summer highlighted a Georgia summer camp where coronavirus ran rampant, resulting in over 250 kids and young adults testing positive for COVID-19.

Moderna will begin pediatric clinical trials soon with kids aged 12 through 17, the company announced in early December. That’s a good sign.  

Can people with allergies get the coronavirus vaccine?

In the UK, on the first day of administering the Pfizer vaccine, doctors observed two patients who experienced severe allergic reactions to the drug. Now, British doctors are being told to monitor patients for 15 minutes following administration of a COVID-19 vaccine. In the US, six severe allergic reactions occurred in the roughly 272,000 vaccines given before Dec. 19, according to the CDC. (There are now over 1.1 million people in the US who have been vaccinated.) 

The FDA says that complications are rare and that some people might have an allergic reaction to the COVID-19 vaccines, like anaphylaxis or tissue swelling, from both the Pfizer and Moderna vaccine. Some scientists are investigating if the cause is an ingredient in the vaccine — but not the COVID-19 mRNA itself — that could be triggering some reactions, The Wall Street Journal reported on Dec. 25.

“CDC recommends that people with a history of severe allergic reactions not related to vaccines or injectable medications — such as allergies to food, pet, venom, environmental, or latex — may still get vaccinated,” the agency states one of its COVID-19 Vaccines and Severe Allergic Reactions page.     

The FDA has published a fact sheet on the Pfizer vaccine and a separate fact sheet on the Moderna one. Both publications caution: “A severe allergic reaction would usually occur within a few minutes to one hour after getting a dose…” Both sheets then list several signs and symptoms of such an allergic reaction:

• Difficulty breathing
• Swelling of the face and throat
• A fast heartbeat
• A full-body rash 
• Dizziness and weakness

If you have a history of allergies, you can expect to be monitored for 15 to 30 minutes after receiving the vaccine.

The FDA also recommends you should not take the Pfizer vaccine if you’ve ever had a severe reaction to any of these ingredients:

• Messenger ribonucleic acid (mRNA)
• Lipids ((4-hydroxybutyl)azanediyl)bis(hexane-6,1-diyl)bis(2-hexyldecanoate) 2 [(polyethylene glycol)-2000]-N,N-ditetradecylacetamide 1,2-Distearoyl-sn-glycero-3- phosphocholine, and cholesterol)
• Potassium chloride
• Monobasic potassium phosphate
• Sodium chloride
• Dibasic sodium phosphate dihydrate
• Sucrose

The FDA similarly recommends avoiding Moderna’s vaccine if you’re allergic to any of its ingredients:

• mRNA
• Lipids (SM-102, polyethylene glycol [PEG] 2000 dimyristoyl glycerol [DMG], cholesterol, and 1,2-distearoyl-sn-glycero-3-phosphocholine [DSPC])
• Tromethamine
• Tromethamine hydrochloride
• Acetic acid
• Sodium acetate
• Sucrose

You might still be able to get a vaccine even if you’ve experienced allergic reactions to vaccinations in the past. In its most up-to-date guidance, the CDC echoes the FDA by indicating that just because you’ve had a severe allergic reaction to having been vaccinated in the past shouldn’t automatically stop you from being vaccinated against COVID-19. 

“These persons may still receive vaccination, but they should be counseled about the unknown risks of developing a severe allergic reaction and balance these risks against the benefits of vaccination,” the CDC says on its website. 

What if you’re pregnant or nursing? Is the vaccine safe?

If you’re pregnant or breastfeeding, the FDA leaves the decision over whether to take either of the currently authorized COVID-19 vaccines to you and your doctor. Regulators in the UK have so far recommended against it until the vaccines can be tested on pregnant and nursing women. (There have been no clinical trials for this group so far.) Even though coronavirus vaccines have yet to be studied in nursing and pregnant women, many scientists believe they’re generally safe and that the benefits outweigh potential risks.

How will you be protected against COVID-19 if you can’t take a vaccine?

If you’re a patient with a health condition who is advised against getting a COVID-19 vaccine by your physician, you may have to wait until enough people have been vaccinated in the US to be protected yourself. Even if you yourself don’t take a vaccine, being surrounded by enough vaccinated people — what’s known as “herd immunity” — can provide a measure of protection against the coronavirus. But that will take time. It may require as much as 90% of the population becoming immune to the disease before those who are still susceptible might be considered safe.

To usher that process along, the best thing you can do for now is to follow the CDC’s safety guidelines: wear a mask whenever you’re indoors (except in your own home), wear a mask in public, avoid large crowds and maintain at least six feet of distance from people you don’t live with. 

It’s going to take time before life returns to normal. To get a sense of how long, take a look at this timeline of when different groups will be able to take the COVID-19 vaccine. There will likely be several coronavirus vaccines rolling out over the next several months, and which one you’ll take will also help determine when you get to take it. Finally, here’s our updated list of places where you can get the vaccine.

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.