Kids over five can now get a Covid vaccine in the U.S. Some people have been waiting for this day to line up their kids the door to get the shots, and others still may have some questions about how the vaccine works for kids, how scientists know it's safe, and exactly how to get one. Immunologist Azza Gadir joins Jill Riley to help explain.

Jill Riley: So, kids over five now getting that COVID vaccine. How is it going so far?

Azza Gadir: The most recent data we have shows that about 4.3 million children in the U.S. ages five to 11 have received at least one dose of the Covid-19 vaccine. A few of those have actually now received their second shots as well. But in general, yeah, the numbers are looking really good. We're getting there slowly. I think the main thing to note at this point is that in regards to Covid-19 itself, what we're seeing in children in particular is that the group that's contracting Covid-19, at the highest rate is that five-to-11 age group, which is why there is an importance here to make sure that like we can get as many of those children vaccinated as possible. And hopefully we'll start to see those numbers come down.

How does the vaccine work for kids? What kind of immunity do kids have, even after their first shot?

To be considered fully vaccinated, it's really important to actually have both shots. The data that we have at the moment shows that fully vaccinated children are about six times less likely to become infected if they are exposed to Covid-19. But I think at this point, it's really important to remember how vaccines generally work.

The key thing to keep in mind here is that the parts of your immune system that makes memory responses to infectious organisms - so to viruses, or things like SARS-CoV-2 are only going to remember things that they've seen before. So what that means is that the vaccine itself is essentially introducing one part of the virus - the spike protein, not all the other bits - at a very specific dose so that your child can make those spike-protein-specific T cells and those spike-protein-specific B cells. If they're ever out and about and may encounter that virus with spike protein on itself, they have those specific responses ready to go.

So essentially, a vaccine is important for giving your immune system that head start so that it kind of has had a heads-up that this threat is on its way; it's mounted some of those responses that are ready to protect you. The key thing here is that the vaccine only has that one protein in it; whereas by comparison, getting exposed to the virus itself without that prior protection, the virus itself has about 29 proteins in it. So in terms of getting those specific responses, it's the vaccine versus natural exposure to the virus, which of course comes with a lot of risk. And all of the data we have so far shows that the vaccine is a way safer way to mount those memory responses.

I would think that there are some parents out there who are concerned over safety. What would you say to people that Covid isn't a big deal for kids, or they're worried about the safety of the vaccine?

So, given that the pandemic is still raging, it is possible or likely, depending on where you live, that your child will be actually exposed to Covid-19 at some point, if they haven't already been. And so Covid-19 vaccines do get your immune system that help, that head start, and help prevent kids from getting the worst outcomes: getting severely sick or the long-term complications, or even death in some rare cases. Although there is evidence that vaccinated children can infect others, or vaccinated people can, it's still rare, and people are way more likely to be infected by unvaccinated individuals. That's the main thing to keep in mind.

The other additional key point as we're moving into the holidays, is that children that are exposed or may be exposed to Covid in schools can accidentally then expose teachers or grandparents or other high-risk people that are in their lives. So the reason why there are so many people having to get booster shots right now is because the levels of transmission of Covid are still very high. And so it's important to kind of keep your immune system pumping, and to realize that that threat is still imminent.

And so as you're considering whether it's safe for your child, or whether to take your child to get the vaccine or if you're thinking that it's not a big deal: just getting vaccinated has short term benefits, but also long-term benefits in terms of protecting the people around you. And the last thing to mention here is that children are actually being given a smaller dose of the vaccine compared to adults, and to kind of minimize those side effects that adults did see. And so that's another kind of comforting point to know is that those side effects have been lower in children after the injection.

That brings up another point that I'd like to ask you about: if if a child or even an adult has already been infected with Covid-19, is it still important to be vaccinated?

Yes, absolutely. Because we know at this point that there is a possibility to be reinfected, especially with the emergence of newer variants. Delta was a concern before now, we've got the Omicron variant that that's floating around. But the nice thing, actually, that we have seen in studies where immunologists are taking blood from people over time, both from people who’ve had Covid-19 [and] people who are vaccinated, comparing the two, is that it's very clear right now that if you've had both, if you've had Covid-19 previously, and then you get a Covid-19 vaccination, you kind of mount this what we call hybrid immunity, which is the super powerful immunity and you're seeing activation of immune responses across multiple different cells. That just looks really nice. And it's actually resulting in in lower cases of reinfection within that group.

So even if you've had Covid-19 before, it is absolutely necessary to consider getting a vaccine in order to prop up those immune responses.

Yeah, I mean, I'm not going to say no to having superpowers. Once kids are fully vaccinated, you know, can they still spread the virus? Is masking a good idea still after the immunization?

Yeah, so there's still a large cohort of society that can’t get vaccinated, which is the kids under the age of five. So that means that masks in general are an important way to protect them. But in general, yes, even if you're fully vaccinated, given that the pandemic is still continuing to rage, it's important to wear a mask, particularly in public indoor settings, when you're surrounded by people you don't know - or in areas where there’s substantial or really high transmission.

Regardless of the level of transmission there are obviously other more vulnerable people in society: the immunocompromised people with severe disease, and people with comorbidities should consider wearing a mask regardless of the situation they're in. So in general, yes, we do know that the vaccines are effective at giving your immune system a head start. However, it's important to add another layer here by masking and the more layers that we can all implement. So things like masking, increased ventilation, testing when we can, vaccinating…the more of those layers that we can all implement the the better it is for us in terms of reducing the risk of catching Covid-19.

Do you have any tips for how kids can distract themselves if they're feeling nervous about getting any type of vaccine? I mean, I know my six-year-old son gets pretty worked up about it. And then once it happens and it's over, he's like, oh, that wasn't as big of a deal as I thought it was going to be. But he definitely has nerves about any kind of jab or poke. Do you have any tips for parents or for kids about how to prepare?

Yeah, so I think shots in general make most people…you know, I know lots of adults as well that still struggle with it. And, you know, needles can be scary. But a few things that are recommended is trying to distract yourself while you're waiting for the shot to happen. So bringing a game or a book or some music, taking some slow, deep breaths to try to relax, focusing on something in the room to kind of distract your brain a little bit. There is some research that shows that coughing once before and coughing right after you get the injection can help with that distraction and help people feel a little less pain.

Thinking about exactly what's going on with that injection, I find to be quite relaxing. So it's getting excited about the fact that when you get that jab, you're basically showing your immune system this thing and it can start the process of ringing the alarm and saying, “Oh, I'm encountering the thing that I have to remember.” And so what you're then seeing a series of events that are happening that can mount those memory responses and so thinking about exactly what's going on to me, gathering that information can help as well. And I know some people have said that that's quite helpful.

Every Wednesday morning at 8:30 CST, Jill Riley connects with experts and local personalities for some real talk about keeping our minds and bodies healthy — from staying safe in the music scene, to exercising during a pandemic, to voting and civic engagement. Looking for more resources and support? Visit our friends at Call to Mind, MPR's initiative to foster new conversations about mental health. Subscribe to Wellness Wednesday as a podcast on Spotify, Apple, RSS, Radio Public, Stitcher, or Amazon Music.

Wellness Wednesday is hosted by Jill Riley, and produced by Christy Taylor and Jay Gabler. Our theme music is a portion of the song "F.B. One Number 2" by Christian Bjoerklund under the Non Commercial Share Alike 3.0 International License.