Want to convince a patient to get the COVID-19 vaccine? Talk to them about rubella.

Lois Levine

Contemporary Pediatrics recently talked to Dr. Jeffrey Kahn, chief of Infectious Diseases at Children's Health and professor at UT Southwestern about the children's vaccine for COVID-19, the importance of pediatricians, and why the plan to get children vaccinated now should follow the rubella strategy.

Q: So, Dr Kahn, now that Pfizer/BioNTech has emergency use authorization (EUA) for their vaccine in children aged 12 years and older, and we know that Moderna will be applying for a similar EUA, what do you think will happen next?

Dr Kahn: So now we will start looking at much younger children and we will get to the point, after trials, where these vaccines are approved for children younger than 12.

Q: Up to this point, vaccines for the most part had been distributed through megacenters, pharmacies and clinics. Will pediatricians, in their own offices, now start administering directly as we moved forward with children’s vaccines?

Dr. Kahn: It's going to be a hybrid model. The bottom line is, we want to get the vaccines out there. And these massive vaccination centers had some very efficient ways of getting the vaccines into people's arms. As things begin to settle down now, I suspect this is going to transition to the pediatrician's offices. And of course, pediatricians are the masters of vaccinations, right? Public health in the United States really rides on the back of pediatricians because it's the pediatricians who, for decades, have been giving large number of vaccines that have been protecting our population from some truly dreadful diseases. So I think that as we move forward here, yes, 12 to 15-year-olds will see a transition to the pediatricians office for the COVID-19 vaccine.

Q: Any words of advice to the practicing pediatrician for the caregivers of patients that are eligible, to convince them to have their children get vaccinated?

Dr. Kahn: They should mention the safety profile, the extraordinary number of vaccines that have been administered so far, the dozens and dozens of both trials and scientific papers in top medical journals that have come out, describing the safety and efficacy of this vaccine.

One issue I would stress is this argument of, “Well, why should we give children this vaccine if they only get a mild form of the disease?” And the strategy of immunizing children to protect the population is a strategy that we have used for decades. And a perfect example of that is rubella. The rubella virus causes a mild disease in a vast majority of people who get infected. However, the 1 place where rubella is a huge problem is that it causes birth defects. Heart defects, cataracts, brain issues, in the developing fetus. That is the only population where rubella is a problem. So our strategy, in this country, for decades now, was to immunize, not just girls, but boys. And the reason they were immunizing boys was not only to protect them from a mild virus, but to protect the entire population, so that pregnant women would never get exposed to the rubella virus. And that strategy has worked beautifully. And you know, I think any pediatrician out there can ask themselves this one question: When was the last time they saw a case of congenital rubella syndrome?