Understanding the COVID-19 vaccination in teens

By Amichai Perlman, PhD, PharmD
Medically reviewed
June 24, 2021

In the past six months, the approved COVID-19 vaccines have been found to be extraordinarily effective at reducing coronavirus related infection, disease, hospitalization, and death. These vaccines have been used in hundreds of millions of people in the US and around the world and have been found to have a very good safety profile. Expected vaccine-related side effects, such as local soreness, fatigue, and headache, are common and transient, while very few significant side effects have been identified.

K’s vaccination expert, Dr. Amichai Perlman, shares insight on what this means as vaccines roll out among adolescent populations nationwide.

The research & clinical trials

In recent weeks results of studies testing the mRNA vaccines in teenage children (over the age of 12) have been announced and published. The studies show that these vaccines, made by Pfizer and Moderna, are very effective and have a good safety profile in teenagers as well. Each of the studies enrolled a few thousand participants. Half of them received a vaccine and half received a placebo injection. Those receiving the vaccine developed high levels of antibodies capable of neutralizing the coronavirus, and had much lower rates of COVID-19 than those receiving placebo. In fact, not one of the teenagers, in either trial, got COVID-19 following full vaccination. Moreover, vaccine efficacy could be seen already 10-14 days after the first dose. Of note, no significant safety concerns were found in these trials.

What the experts are saying

These results have led to the approval and endorsement of the Pfizer vaccine by the FDA and CDC (as well as many other regulatory bodies) in teenagers aged 12 and older. The American Academy of Pediatrics, and many other medical organizations, have issued recommendations encouraging vaccination of this age group, as well, and in the US over 6.5 million teenagers aged 12-17 have received this vaccine to-date. The results of the Moderna vaccine trial in teens were announced more recently, and have been submitted for evaluation and approval. Overall, both of these vaccines are based on very similar mRNA-based technology, they are both given as two doses. The data from clinical trials, and the experience in the “real world”, show very high efficacy and good safety for both vaccines.

The benefits of vaccination do differ in adolescents

The expected benefits of vaccinating teenagers is different compared to adults, as the rate of severe COVID-19 is much lower at younger ages. The most universal and direct benefit will be the ability to return to normalcy and engage in activities with far less concern about the potential impact of being exposed to someone with coronavirus. In addition, preventing COVID-19 in teenagers is important as well. Though teenagers usually do not suffer from severe COVID-19, they often do suffer from significant symptoms, and a study from Britain estimated that 1 in 7 children go on to suffer from prolonged symptoms (“long-covid”) for months later. According to the CDC’s report in early May, over 13,000 teenagers aged 12-17 have been hospitalized in the US due to COVID-19, and 127 have died. The CDC has also been following serious complications following recovery as well, including over 800 documented cases of Multisystem Inflammatory Syndrome (MIS-C) in this age group.

How it relates to herd immunity

Studies since vaccine rollout have proven the vaccines not only reduce disease and complications, but also the rates of infection and transmission to those around us. Extending vaccination will help protect the community, and is expected to help achieve population immunity (“herd immunity”). Population immunity benefits both those vaccinated (as no vaccine is 100% effective) as well as our families and communities.

Risks and side-effects

When considering medical interventions one should of course also take potential risk into accounts. No significant safety concerns were found in the vaccine clinical trials. These trials are large enough to rule out risks of a fraction of a percent, however smaller risks are still possible.

Following rollout, very rare cases of severe allergic reactions have been reported with the mRNA vaccines. Guidance has therefore been issued to minimize this extremely small risk, including remaining for 15-30 minutes of observation following vaccination, and a contraindication to giving the vaccines to people with a known allergy to the vaccines or their components.

Recently there have also been reports of cases of heart inflammation, called myocarditis, among primarily male young adults and adolescents after receiving the mRNA vaccines. Almost all cases were not severe and resolved within days. The CDC is currently assessing whether these cases were caused by the vaccine, however continues to recommend vaccination based on the extensive data and experience with the vaccines supporting the conclusion that the benefit of getting these vaccines outweighs known and potential risks. The American Academy of Pediatrics, and the American Heart Association have likewise reiterated that the benefit of the vaccine outweighs this potential risk as well.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Amichai Perlman, PhD, PharmD

Dr. Perlman is a clinical pharmacist and pharmacoepidemiologist, with over 10 years of experience advising patients and clinicians on medication use, personalization, and safety. He has extensively published peer-reviewed research addressing medication safety.