CLEVELAND, Ohio — Pediatricians and family doctors are getting a flood of calls from parents about the coronavirus, which began even before Ohio Gov. Mike DeWine announced the state is asking local health departments to partner with schools to vaccinate 16- and 17-year-olds.

“It’s definitely been a pretty dramatic split,” Dr. Amy Edwards, a pediatric infectious disease specialist at University Hospitals, said. “There are some parents who are hounding me on a daily basis … and then there’s the other half that are basically saying ‘No way, it’s scary, I’ll get it myself as a parent, but I just don’t feel comfortable having my kids get it.’”

The vaccine opened to Ohioans 16 and older on March 29, so some parents have already worked with doctors to get the vaccine for their 16- and 17-year-olds. Since the governor announced on Monday that health departments should work with schools to administer the vaccine to students, schools are now interpreting how that guidance applies and discussing future plans. The Educational Service Center of Northeast Ohio, which coordinated vaccination efforts for the majority of Cuyahoga County school staff, is working with the Board of Health this week to determine next steps.

Parents must sign a permission slip for 16- and 17-year-olds to get the vaccine, DeWine said. The vaccine is voluntary.

While seven out of 10 people in an Axios/Ipsos poll said they’ve already gotten or are likely to get the vaccine, about 48 percent said they’re not likely to get their children under 18 vaccinated as soon as shots become available. When cleveland.com posted a story about DeWine’s announcement on Monday, there were more than 100 Facebook comments. Some were excited about the announcement, noting they are eager to get their younger children vaccinated. Some balked at the idea of their child getting the vaccine at all, while others said they’d make an individual decision but were wary of the state interfering.

Only one vaccine — Pfizer — is currently approved for use for 16- and 17-year-olds. Recent trial results for Pfizer are showing that the vaccine could be safe and effective for children as young as 12, and the company is asking for FDA permission to offer the vaccine to ages 12-15.

“I think that probably the concerns that I hear from parents in terms of the COVID vaccine does mirror some of the questions that I hear around other childhood vaccinations,” Dr. Kimberly Giuliano, a Cleveland Clinic pediatrician, said. “I think what is a little bit different in terms of the COVID vaccine, and the questions that parents have is just the the fact that this is so much newer, and the perception that perhaps the process has been more rushed in an attempt to get the vaccine out to folks, and then people being worried or concerned that perhaps it wasn’t studied as robustly as other vaccines have been. And that’s not the case.”

When Svetlana Pundik, a neurology professor, saw that Senders Pediatrics was enrolling patients in Pfizer vaccine trials, she didn’t fit in the age categories. But eventually her son, 14-year-old Daniel Lust, did. Daniel said he was initially hesitant to get the vaccine — it involved getting his blood drawn, something he pointed out doesn’t appeal to people — but he’s glad he participated.

“In hindsight, it really feels like that it was something that’s important and meaningful,” he said.

Children have generally been less likely to show symptoms or experience severe outcomes from the vaccine, but Giuliano said vaccinating children will be key. She added the pandemic had a “significant impact” on childhood socialization, especially when children were learning remotely, which can take a toll on mental health.

“In order to achieve herd immunity, 70 to 90% of the population needs to have either had the disease or had the vaccine,” Giuliano said. “Children under the age of 18 make up greater than 20% of the U.S. population, so vaccinating children is going to be a really important part of ending the pandemic.”

Cleveland.com and the Plain Dealer interviewed pediatricians on the top concerns parents have about the coronavirus vaccine. Here are the answers to the most commonly-asked questions.

Q: It’s a new vaccine — is it safe? Are there going to be long term effects?

A: Pfizer uses messenger RNA instead of actual parts of the virus, which teaches the body how to produce a protein piece from the virus so the body can learn to fight it. Dr. Shelly Senders, of Senders Pediatrics, describes the vaccine using the metaphor of Snapchat, the popular messaging app. On Snapchat, the messages disappear once being opened.

“Just like with Snapchat there’s no reference to (the virus) after 48 to 72 hours,” Senders said. “And that’s what adds a measure of safety that is a little bit different than your standard vaccine, where there is a foreign protein in your body.”

Essentially, the cell forgets the instructions on how to make the virus. Edwards compares the vaccine to taking a single dose of Tylenol. One dose of medicine — or two in the case of Pfizer and Moderna — would be unlikely to show side effects 20 or 30 years down the line when the medicine is out of the system. A vaccine dose would be more likely to show side effects within the first four to eight weeks.

“The vaccine’s only in your arm for a couple of days and then its basically gone — it doesn’t exist any more,” Edwards said.

Because of other vaccines, though not mRNA vaccines, having delayed effects, the FDA required companies developing the vaccine to follow trial participants for a minimum of eight weeks, according to the Children’s Hospital of Philadelphia. In notes from clinical trials for all three vaccines published on the Centers for Disease Control and Prevention website, mild to moderate side effects would show up within seven days.

Q: It seems like this vaccine has been rushed. How can you accept a vaccine that has been rushed?

A: Coronavirus vaccines were developed and approved under emergency authorization from the federal Food and Drug Administration. The approval process has caused some alarm since other vaccines have been developed over longer periods.

For these trials, data is collected and then sent to be scrubbed, where inconsistencies, duplicates and errors are screened and corrected. Then the data is put into a format where it can be analyzed. This is where the process accelerated, Senders said.

“They’re putting the money into collecting data in real time, rather than having delays in the collection of data,” Senders said.

Instead of there being a months-long wait for data, communication about it happened over days.

There were several other factors in how the vaccines were developed so quickly. Experts told Healthline that there were immense resources and widespread public and private support for developing vaccines. The virus’s rapid spread also made it easier to see how vaccines worked versus the placebo.

Daniel doesn’t know whether he got the placebo or the real vaccine, but experienced mild soreness in his arm. He then had to log his symptoms on a phone for several weeks, something he said didn’t get in the way of his life or school.

“There’s a sense of security that comes with it,” he said.

Senders said those who received the placebo in the trial will eventually get the vaccine. Researchers do antibody tests on participants to see how the vaccine works, but these kind of trials can also give clues to whether the vaccine makes people asymptomatic or whether it prevents the virus. This is determined through nasal swabs to test for the virus.

Q: Can this cause infertility?

A: One of the highly-discussed long term effects patients are concerned about is whether the vaccine could cause infertility. Experts trace the spread of this idea back to social media, where there was a claim that a protein in the coronavirus’s surface spike is the same as one necessary for the placenta to grow. This post then said the body would learn to fight that protein because of the vaccine.

Numerous experts have debunked this claim and groups, including the American Society for Reproductive Medicine, now address this as part of educating people on the vaccine.

Q: Why do children need to get the vaccine if they aren’t getting as sick?

A: Children are a part of getting to herd immunity, and there are some severe outcomes for children who contract the coronavirus, though it’s not as common.

Besides children sometimes experiencing symptoms and requiring ventilation or other intensive care, there is a rare condition in children called Multisystem Inflammatory Syndrome which the CDC is investigating in relation to COVID-19. It’s still not known what causes it, but the condition often appears in children who have the virus or have been exposed.

There have been about 166 children in Ohio treated for this condition.



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