Emily Oster

8 min Read Emily Oster

Emily Oster

Pediatric COVID Vaccines

Emily Oster

8 min Read
Today’s post is about new data on COVID-19 vaccines for the 5-to-11 age group. Two studies in the past few weeks have generated updated information on efficacy. I’ve held off writing about this, since I wanted to reflect on the data all together and also to think more broadly about how it might change the landscape. This post will go through two new studies, and discuss decisions.

But first, a note. Recently, the leadership in Florida suggested that they may actively recommend against vaccination for healthy children. I think this is a mistake. The vaccines have been shown to be very safe, and (more below) they show good evidence of protection against serious illness. While it is true that children are at low risk for serious illness, that is also the case for many other diseases for which we vaccinate. In the end, vaccines for children are going to be the choice of individual parents. But the idea of actively pushing against vaccination is counter to public health.

Some of the data below has been used to argue for this move in Florida. Given that, I feel some trepidation in writing about it. However, ultimately making good decisions requires understanding the data, even if it’s sometimes complicated.

With that…

New York study

Study number 1 comes out of New York, where researchers were able to access all the COVID data from children in the state in the 5-to-11 and 12-to-17 age groups. They combine information on vaccination status, COVID-19 test results, and inpatient hospital data. Together, this allows them to estimate the case rates and hospitalization rate among both age groups, and among vaccinated and unvaccinated individuals.

The authors calculate the relative infection rate and, more useful probably, the vaccine efficacy rate, which measures the share of infections or hospitalizations prevented by vaccination.

The paper has both a glass-half-full and glass-half-empty message.

On the glass-half-empty side, vaccine efficacy against any infection declined significantly over time as Omicron took over. This was especially true in the 5-to-11 age group. The graph below shows the estimates of vaccine efficacy over the December 2021 to January 2022 period.

By the end of this period, it looks like very little protection is being provided for the 5 to 11 age group.

The glass-half-full message is that the point estimates still suggest that vaccines are protective against hospitalization. The headline table points to about 50% protection in the 5-to-11 age group by the end of January, versus 75% in the 12-to-17 group. The data looks better overall if you focus on hospitalizations that are for COVID rather than with COVID (which is in the supplementary materials).

People have noted that there is limited statistical precision in the estimates of impacts on hospitalizations. This is true, and in some ways it represents good news. Hospitalizations are really low in these age groups. In the 365,000 children ages 5 to 11 who were vaccinated, there were just six hospitalizations for COVID between January 17 and 30. Among the unvaccinated group (about 1 million children), there were 28 hospitalizations for COVID in that two-week period. The vaccinated rate is lower, but both are small.

However: the combination of what we see here, plus everything else we know about COVID vaccines in other age groups, suggests that the vaccines remain effective against serious illness. Such an outcome is rare, but it’s also not unheard-of.

CDC data

The second study comes out of the CDC. The method here is different — it’s a case-control, test-negative design. Specifically, the agency uses data from about 40,000 ER or urgent-care visits in 10 states. It evaluates people who came in with possible illness and tested for COVID, comparing vaccination status in the people who tested negative with those who tested positive.

Using this approach, the authors find that protection against illness was similar across the whole age range, from 5 to 17. During the Omicron period, recently vaccinated children ages 5 to 11 had about 50% protection against any COVID infection, versus 45% for recently vaccinated 12-to-15-year olds. This represents a considerable drop for the older group from the Delta period (although the authors find that protection was restored in 16- and 17-year-olds by a booster).

For hospitalization, all groups showed high protection (between 73% and 94%) regardless of age or the timing of vaccination. It is worth noting, once again, that the 5-to-11 age group has small hospitalization numbers, so the estimates are statistically imprecise.

Big-picture message, similar to the study from New York: vaccination protection against any infection waned during Omicron, but the vaccines also remained effective against any infection. The main difference with the New York data is that the 5-to-11-year-old group retained similar protection to the older group, and it was generally higher. This difference could be due to variations in methods, or in geographic reach, or something else.

An important bottom line in both of these papers is that serious illness in this group is extremely rare. This is both reassuring and also makes it somewhat difficult to study. It’s easy to see the tremendous value provided by vaccines for older adults in the data; it is simply harder for this group with lower risks.

What does this mean? 

The facts here are simple and, I think, not that surprising. It was hard to miss, during the Omicron wave, that vaccination wasn’t as protective against infection, even if it retained a huge value against serious illness, hospitalization, and death. That this would also be true for children seems reasonable.

The question is, then, how to process these facts as a parent. So let me run through a few scenarios in the space of “How should I think about this?”

My 5-to-11-year-old is vaccinated and also had COVID recently. First, I’m sorry to hear it, and I hope they are feeling well now. Second, your child is now quite well-protected, both due to the recency of infection (I wrote more about that here) and the strength of the vaccine/Omicron infection.

My 5-to-11-year-old is not vaccinated, or is partially vaccinated, and had COVID recently. There is increasingly good evidence suggesting that infection-acquired immunity is very strong overall, and also that infection plus one dose of an mRNA vaccine is even better. This means that if your child hasn’t had any vaccine, they may benefit in terms of protection from a shot. If they have had one shot, the marginal value of another may be small after infection.

My 5-to-11-year-old is vaccinated and hasn’t had COVID. For this group, I think the new information here probably presents the biggest change. The degree to which your child is protected against getting COVID at all is less than we thought. They are, however, still well-protected against serious illness, both by the vaccines and by the fact that children are largely low-risk. This calculus may be different if your child is higher-risk or if you’re worried about higher-risk people they are exposed to.

On the plus side for this group: the case rates have come down enormously in recent weeks, so the risks are much lower than they were a few months ago. And there is an expectation that a third dose of the vaccine will be approved for 5-to-11-year-olds, which could provide some additional protection.

I have a child under 5. Will this affect me? Not directly, of course. I do think this news is in broad strokes related to the reason for the delay in the under-5 vaccines; when that was more fully explained, it seemed that the issue was the more limited efficacy of a two-dose series during Omicron. I still expect, though, if the third dose in this group produces a good antibody response, the FDA will approve it. Moderna is also expected to submit filings for this group, perhaps even this week.

Final thoughts

There has been discussion about the fact that these new findings may discourage parents from vaccinating children, either in the 5-to-11 age group or, down the line, the under-5 group. Already, vaccination rates in this group are low and geographically variable.

This seems likely to me, although I am not sure there is much to do about it, or that it necessarily constitutes a mistake. When initially discussing vaccines for kids, I wrote about a number of the reasons that I vaccinated my own children. They included protecting them from the small risk of serious disease (still an excellent reason to do it), making it possible for them to do things that required vaccines, like go to school (still a good reason), and lowering their infection risk to protect their older relatives and anyone at risk who they interact with.

This last piece has less bite now. The decision moves, as many COVID decisions seem to of late, to be more individualistic. There are still good reasons to vaccinate your children — I would do it again in a heartbeat — but it’s also foolish to think that this doesn’t change the calculus to some extent.

On the flip side, a small change in this individual calculus should not be a reason to change the policy of making vaccines widely available and making clear the benefits to families. Ahem, Florida.

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Milestones. We celebrate them in pregnancy, in parenting, and they’re a fun thing to celebrate at work too. Just a couple years ago I couldn’t have foreseen what this community would grow into. Today, there are over 400,000 of you here—asking questions, making others feel seen wherever they may be in their journey, and sharing information that supports data > panic. 

It has been a busy summer for the team at ParentData. I’d love to take a moment here to celebrate the 400k milestone. As I’ve said before, it’s more important than ever to put good data in the hands of parents. 

Share this post with a friend who could use a little more data, and a little less parenting overwhelm. 

📷 Me and my oldest, collaborating on “Expecting Better”

Milestones. We celebrate them in pregnancy, in parenting, and they’re a fun thing to celebrate at work too. Just a couple years ago I couldn’t have foreseen what this community would grow into. Today, there are over 400,000 of you here—asking questions, making others feel seen wherever they may be in their journey, and sharing information that supports data > panic.

It has been a busy summer for the team at ParentData. I’d love to take a moment here to celebrate the 400k milestone. As I’ve said before, it’s more important than ever to put good data in the hands of parents.

Share this post with a friend who could use a little more data, and a little less parenting overwhelm.

📷 Me and my oldest, collaborating on “Expecting Better”
...

I spend a lot of time talking people down after they read the latest panic headline. In most cases, these articles create an unnecessary amount of stress around pregnancy and parenting. This is my pro tip for understanding whether the risk presented is something you should really be worrying about.

Comment “link” for an article with other tools to help you navigate risk and uncertainty.

#emilyoster #parentdata #riskmanagement #parentstruggles #parentingstruggles

I spend a lot of time talking people down after they read the latest panic headline. In most cases, these articles create an unnecessary amount of stress around pregnancy and parenting. This is my pro tip for understanding whether the risk presented is something you should really be worrying about.

Comment “link” for an article with other tools to help you navigate risk and uncertainty.

#emilyoster #parentdata #riskmanagement #parentstruggles #parentingstruggles
...

Here’s why I think you don’t have to throw away your baby bottles.

Here’s why I think you don’t have to throw away your baby bottles. ...

Drop your toddlers favorite thing right now in the comments—then grab some popcorn.

Original thread source: Reddit @croc_docs

Drop your toddlers favorite thing right now in the comments—then grab some popcorn.

Original thread source: Reddit @croc_docs
...

Just keep wiping.

Just keep wiping. ...

Dr. Gillian Goddard sums up what she learned from the Hot Flash  S e x  Survey! Here are some key data takeaways:

🌶️ Among respondents, the most common s e x u a l frequency was 1 to 2 times per month, followed closely by 1 to 2 times per week
🌶️ 37% have found their sweet spot and are happy with the frequency of s e x they are having
🌶️ About 64% of respondents were very or somewhat satisfied with the quality of the s e x they are having

Do any of these findings surprise you? Let us know in the comments!

#hotflash #intimacy #midlifepleasure #parentdata #relationships

Dr. Gillian Goddard sums up what she learned from the Hot Flash S e x Survey! Here are some key data takeaways:

🌶️ Among respondents, the most common s e x u a l frequency was 1 to 2 times per month, followed closely by 1 to 2 times per week
🌶️ 37% have found their sweet spot and are happy with the frequency of s e x they are having
🌶️ About 64% of respondents were very or somewhat satisfied with the quality of the s e x they are having

Do any of these findings surprise you? Let us know in the comments!

#hotflash #intimacy #midlifepleasure #parentdata #relationships
...

Should your kid be in a car seat on the plane? The AAP recommends that you put kids under 40 pounds into a car seat on airplanes. However, airlines don’t require car seats.

Here’s what we know from a data standpoint:
✈️ The risk of injury to a child on a plane without a carseat is very small (about 1 in 250,000)
✈️ A JAMA Pediatrics paper estimates about 0.4 child air crash deaths per year might be prevented in the U.S. with car seats 
✈️ Cars are far more dangerous than airplanes! The same JAMA paper suggests that if 5% to 10% of families switched to driving, then we would expect more total deaths as a result of this policy. 

If you want to buy a seat for your lap infant, or bring a car seat for an older child, by all means do so! But the additional protection based on the numbers is extremely small.

#parentdata #emilyoster #flyingwithkids #flyingwithbaby #carseats #carseatsafety

Should your kid be in a car seat on the plane? The AAP recommends that you put kids under 40 pounds into a car seat on airplanes. However, airlines don’t require car seats.

Here’s what we know from a data standpoint:
✈️ The risk of injury to a child on a plane without a carseat is very small (about 1 in 250,000)
✈️ A JAMA Pediatrics paper estimates about 0.4 child air crash deaths per year might be prevented in the U.S. with car seats
✈️ Cars are far more dangerous than airplanes! The same JAMA paper suggests that if 5% to 10% of families switched to driving, then we would expect more total deaths as a result of this policy.

If you want to buy a seat for your lap infant, or bring a car seat for an older child, by all means do so! But the additional protection based on the numbers is extremely small.

#parentdata #emilyoster #flyingwithkids #flyingwithbaby #carseats #carseatsafety
...

SLEEP DATA 💤 PART 2: Let’s talk about naps. Comment “Link” for an article on what we learned about daytime sleep!

The first three months of life are a chaotic combination of irregular napping, many naps, and a few brave or lucky souls who appear to have already arrived at a two-to-three nap schedule. Over the next few months, the naps consolidate to three and then to two. By the 10-to-12-month period, a very large share of kids are napping a consistent two naps per day. Over the period between 12 and 18 months, this shifts toward one nap. And then sometime in the range of 3 to 5 years, naps are dropped. What I think is perhaps most useful about this graph is it gives a lot of color to the average napping ages that we often hear. 

Note: Survey data came from the ParentData audience and users of the Nanit sleep monitor system. Both audiences skew higher-education and higher-income than the average, and mostly have younger children. The final sample is 14,919 children. For more insights on our respondents, read the full article.

SLEEP DATA 💤 PART 2: Let’s talk about naps. Comment “Link” for an article on what we learned about daytime sleep!

The first three months of life are a chaotic combination of irregular napping, many naps, and a few brave or lucky souls who appear to have already arrived at a two-to-three nap schedule. Over the next few months, the naps consolidate to three and then to two. By the 10-to-12-month period, a very large share of kids are napping a consistent two naps per day. Over the period between 12 and 18 months, this shifts toward one nap. And then sometime in the range of 3 to 5 years, naps are dropped. What I think is perhaps most useful about this graph is it gives a lot of color to the average napping ages that we often hear.

Note: Survey data came from the ParentData audience and users of the Nanit sleep monitor system. Both audiences skew higher-education and higher-income than the average, and mostly have younger children. The final sample is 14,919 children. For more insights on our respondents, read the full article.
...

Happy Father’s Day to the Fathers and Father figures in our ParentData community! 

Tag a Dad who this holiday may be tricky for. We’re sending you love. 💛

Happy Father’s Day to the Fathers and Father figures in our ParentData community!

Tag a Dad who this holiday may be tricky for. We’re sending you love. 💛
...

“Whilst googling things like ‘new dad sad’ and ‘why am I crying new dad,’ I came across an article written by a doctor who had trouble connecting with his second child. I read the symptoms and felt an odd sense of relief.” Today we’re bringing back an essay by Kevin Maguire of @newfatherhood about his experience with paternal postpartum depression. We need to demystify these issues in order to change things for the better. Comment “Link” for a DM to read his full essay.

#parentdata #postpartum #postpartumdepression #paternalmentalhealth #newparents #emilyoster

“Whilst googling things like ‘new dad sad’ and ‘why am I crying new dad,’ I came across an article written by a doctor who had trouble connecting with his second child. I read the symptoms and felt an odd sense of relief.” Today we’re bringing back an essay by Kevin Maguire of @newfatherhood about his experience with paternal postpartum depression. We need to demystify these issues in order to change things for the better. Comment “Link” for a DM to read his full essay.

#parentdata #postpartum #postpartumdepression #paternalmentalhealth #newparents #emilyoster
...

What does the data say about children who look more like one parent? Do they also inherit more character traits and mannerisms from that parent? Let’s talk about it 🔎

#emilyoster #parentdata #parentingcommunity #lookslikedaddy #lookslikemommy

What does the data say about children who look more like one parent? Do they also inherit more character traits and mannerisms from that parent? Let’s talk about it 🔎

#emilyoster #parentdata #parentingcommunity #lookslikedaddy #lookslikemommy
...

SLEEP DATA 💤 We asked you all about your kids’ sleep—and got nearly 15,000 survey responses to better understand kids’ sleep patterns. Comment “Link” for an article that breaks down our findings!

This graph shows sleeping location by age. You’ll notice that for the first three months, most kids are in their own sleeping location in a parent’s room. Then, over the first year, this switches toward their own room. As kids age, sharing a room with a sibling becomes more common. 

Head to the newsletter for more and stay tuned for part two next week on naps! 🌙

#parentdata #emilyoster #childsleep #babysleep #parentingcommunity

SLEEP DATA 💤 We asked you all about your kids’ sleep—and got nearly 15,000 survey responses to better understand kids’ sleep patterns. Comment “Link” for an article that breaks down our findings!

This graph shows sleeping location by age. You’ll notice that for the first three months, most kids are in their own sleeping location in a parent’s room. Then, over the first year, this switches toward their own room. As kids age, sharing a room with a sibling becomes more common.

Head to the newsletter for more and stay tuned for part two next week on naps! 🌙

#parentdata #emilyoster #childsleep #babysleep #parentingcommunity
...

Weekends are good for extra cups of ☕️ and listening to podcasts. I asked our team how they pod—most people said on walks or during chores. What about you?

Comment “Link” to subscribe to ParentData with Emily Oster, joined by some excellent guests.

#parentdata #parentdatapodcast #parentingpodcast #parentingtips #emilyoster

Weekends are good for extra cups of ☕️ and listening to podcasts. I asked our team how they pod—most people said on walks or during chores. What about you?

Comment “Link” to subscribe to ParentData with Emily Oster, joined by some excellent guests.

#parentdata #parentdatapodcast #parentingpodcast #parentingtips #emilyoster
...

Humility. That’s why. That’s the whole reason.

#emilyoster #secondbaby #parentingjokes #parentinghumor

Humility. That’s why. That’s the whole reason.

#emilyoster #secondbaby #parentingjokes #parentinghumor
...

Bug season is upon us. Besides annoyance, this can bring up safety concerns, particularly with ticks. They are carriers of diseases, most notably Lyme disease. So what’s the best course of action?

Prevention is key! I suggest:
⭐ Regular tick checks
⭐ Using bug sprays with DEET 
⭐ Wearing long sleeves and pants in the woods

Some parents worry about DEET, but repellants with up to 30% DEET are recommended by both the CDC and AAP. The data says you’re in the clear, so go for it. Enjoy your summer!

#parentdata #emilyoster #tickseason #bugbites #bugspray

Bug season is upon us. Besides annoyance, this can bring up safety concerns, particularly with ticks. They are carriers of diseases, most notably Lyme disease. So what’s the best course of action?

Prevention is key! I suggest:
⭐ Regular tick checks
⭐ Using bug sprays with DEET
⭐ Wearing long sleeves and pants in the woods

Some parents worry about DEET, but repellants with up to 30% DEET are recommended by both the CDC and AAP. The data says you’re in the clear, so go for it. Enjoy your summer!

#parentdata #emilyoster #tickseason #bugbites #bugspray
...