A young boy wearing a mask receives a vaccination.

August 9, 2021

Your kids have been your priority since the first time you held them in your arms. Now the COVID-19 Delta variant is spreading as their in-school classes approach.

If you’re wrestling with whether to vaccinate kids ages 12 years and older against COVID-19, we’ve consulted two top Houston pediatric specialists to help.

Avichal Aggarwal, MD, is an associate professor of pediatric cardiology at McGovern Medical School at UTHealth and a pediatric heart failure specialist affiliated with Children’s Memorial Hermann Hospital. Michael L. Chang, MD, is an assistant professor of pediatrics at McGovern Medical School at UTHealth and a pediatric infectious disease specialist at Children’s Memorial Hermann Hospital.

Here’s the real deal on how risks of the COVID-19 vaccine for children stack up against risks of the disease itself, according to Drs. Chang and Aggarwal.

Ask the right question.

As you consider vaccinating your child, the decision shouldn’t rest on to vaccinate or not to vaccinate—you should consider the risk of your child getting the COVID-19 infection.

“A lot of people forget that not getting vaccinated carries a major risk: getting COVID-19,” Dr. Chang says.

Look at the big picture.

Nearly 98% of Americans adults hospitalized now for COVID-19 are unvaccinated. The same holds true with children, Dr. Chang says. “The overwhelming majority of the pediatric patients being hospitalized so far have been unvaccinated.”

No Child has died from getting the vaccine.

“The same cannot be said about having the COVID-19 virus,” Dr. Chang says.

More than 9.6 million eligible children have received at least one dose of a COVID-19 vaccine and 7.1 million of those are fully vaccinated, reports the U.S. Centers for Disease Control and Prevention (CDC). Those under 12 years old cannot yet be vaccinated.

COVID-19 can hurt your child's heart.

MIS-C, myocarditis and pericarditis are not interchangeable, nor do they have the same causes, yet all three heart conditions have been related to COVID-19 since it arrived.

Let’s start with MIS-C, which is short for multisystem inflammatory syndrome in children. COVID-19 is among its causes. Vaccines are not.

An uncommon and excessive immune response, MIS-C severely inflames the heart as well as the lungs, blood vessels, kidneys, brain and other organs. It overwhelms the body and can be lethal.

More than 4,198,296 kids age 18 and under had caught COVID-19 as of July 28, 2021, reports the American Academy of Pediatrics. So far, health departments nationwide have reported 4,196 cases of MIS-C to the CDC. That’s one in 1,000 children. Of those, 37 died, Dr. Chang says.

Other children with COVID-19 may suffer long-term cardiovascular repercussions, including heart failure and potentially deadly blood clots, he says.

Myocarditis cases have been mild.

Post-vaccination, some children—and adults under 30—have had myocarditis, inflammation of the heart muscle itself, or pericarditis, inflammation of the sac surrounding the heart.

These conditions have been linked to receiving Moderna and Pfizer vaccines. Unlike the Johnson & Johnson shots, they are mRNA, messenger ribonucleic acid vaccines, which deliver genetic codes for a coronavirus protein directly to cells. The body then churns antibodies to identify and destroy the virus.

While many health culprits can cause chest pain, shortness of breath or dizziness, if your child has those symptoms within a week of being vaccinated, alert your pediatrician.

“Heart conditions in children and young adults are far more likely due to COVID-19 itself and they’re much more severe than the very, very rare cases of myocarditis due to vaccinations,” Dr. Aggarwal says.

The good news is that post-vaccination myocarditis has been mild, both doctors say. They’ve admitted very few children locally for observation, and most fully recovered within 2 to 3 days.

“They recover with rest and ibuprofen or other non-steroidal anti-inflammatory drugs (NSAIDS),” Dr. Aggarwal says. “They require no special treatment or breathing assistance and afterward have normal heart function.”

Repercussions of COVID-19 can be longer lasting.

Not just adults are at risk for long haul or Long COVID-19. Approximately 10% to 15% of children who get COVID-19 still have symptoms 5 weeks later.

“Vaccination does not give you long-haul symptoms,” he says.

In-person schools are less than 2 weeks away.

Most children will attend classes among other children and teachers.

“Masks are not mandatory in Texas,” Dr. Chang says. “The best way to protect your children from severe COVID-19 infection is to have them vaccinated as soon as possible.”

Keep up other protective habits beyond vaccination.

Don’t abandon other preventive tactics. “Wearing masks, physical distancing and good hygiene are fundamental practices against infection,” Dr. Chang says. “As surprising as COVID-19 has been, it’s still a virus that spreads and follows basic rules of infection prevention.”

One bonus: The measures adopted to prevent the spread of COVID-19 have led to “historically low” rates of flu and childhood viruses.

Are those measures enough? Drs. Chang and Aggarwal say no.

Only you know your kids, and whether they are likely to shed masks, the way some ditch bike helmets when they’re out of your sight.

When available for children under 12, COVID-19 vaccinations are essential, both say.

Be a good neighbor.

There are people in the population that cannot be vaccinated for various reasons, Dr. Chang says. “Vaccinating as many people as we can not only protects you and your children but also vulnerable people who cannot be vaccinated.”

Learn more about being vaccinated »

The information in this article is accurate as of August 9, 2021.

In Dec. 2021, the CDC issued a preferential recommendation for the use of the mRNA COVID-19 vaccines currently available in the U.S. (Pfizer and Moderna) over the Johnson & Johnson vaccine, citing rare but serious side effects. Throughout the pandemic, Memorial Hermann has closely followed guidance from the CDC as well as the U.S. Food & Drug Administration (FDA) and the State. As such, Memorial Hermann now recommends the Pfizer and Moderna COVID-19 vaccines over the Johnson & Johnson vaccine for those who meet vaccine eligibility.

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