Covid Vaccination Statement

COVID VACCINATION STATEMENT

February 16,2022

Dear families,

Re: Updated recommendations from the Diabetes and Endocrinology Department at Perth Children’s Hospital and the Children’s Diabetes Centre at Telethon Kids Institute regarding COVID-19 vaccination for children with diabetes

On advice from the Australian Technical Advisory Group on Immunisation (ATAGI), the Department of Health recently announced that children aged between 5 to 11 years old are now eligible to receive the Pfizer COVID-19 vaccine, in addition to the previously announced eligibility for those aged 12-15 years.

Additionally, youth aged 16 and 17 are now eligible for a booster vaccine.

Diabetes is specifically listed as a medical condition where risks of a more severe COVID infection are higher. The Diabetes Service at Perth Children’s Hospital supports ATAGI’s recommendations, and suggests all children with diabetes aged 5 and up be vaccinated against COVID.

There are differences in the doses and schedule for those children under 12 years of age. We also understand there may be many questions from parents and children, so we’ve put together answers to common questions below.

How can we book a COVID-19 vaccine?

You can go to the Vaccinate WA web site at vaccinate.health.wa.gov.au or through rollup.wa.gov.au or contact your GP. 

Current PCH patients aged 5-16 years can get a vaccine on a drop-in basis at the Stan Perron Immunisation Centre on Level 1, Clinic D during business hours.  The clinic can also address any questions that you may have about the COVID-19 vaccine.

Why should children with diabetes get vaccinated?

The evidence from around the world is that, while people with well controlled type 1 diabetes are no more likely to contract COVID-19 than people without diabetes, in the presence of a COVID infection the risks of complications are higher, glucose levels are more difficult to control, and a higher risk of ketones and thus ketoacidosis (DKA) exists.

The chance of a more severe COVID-19 illness may be higher, with studies showing a 3-4 fold higher risk for severe illness in adults with type 1 diabetes than in those without diabetes. It makes sense to reduce these risks in the first place with vaccination.

How is the dose for younger children different?

The dose for this age group is one third of the adult dose of BNT162b2 (Pfizer) - with a recommended interval of 8 weeks between the two doses.

What about children with Type 2 Diabetes?

It has been reported that people with type 2 diabetes have a higher risk of contracting COVID-19, and a higher risk of severe illness.

Is the vaccine effective for children with diabetes?

Yes. There is no evidence that people with diabetes respond any differently to the rest of the population. For example, in the large clinical trial of more than 2200 children aged 5-11, antibody responses were comparable to those seen in adults and the vaccine was more than 90% effective in preventing COVID infection.

Is the vaccine safe for children with diabetes?

Yes. There is no evidence that children with diabetes have a higher risk of side effects from the vaccine. The trials of the vaccines have contained many people with diabetes.

Some people will have heard or read about a rare vaccine side effect called myocarditis, or inflammation of the heart, which has been reported in association with the mRNA vaccines (Pfizer and Moderna). The national vaccine reporting system in the USA, where more than 7 million doses of the Pfizer vaccine have now been given to youth aged 5-11 years, has documented eight confirmed cases of myocarditis (approximately 1 case per 900,000 doses) in youth aged 5-11. Of those eight, most of them appeared to have a mild clinical course that resolved.

The risk of myocarditis has been reported to be higher in older youth and young adults, with the highest rates after the 2^nd dose at around 30 cases per million doses administered and may be higher (though still rare) after the Moderna “Spikevax” vaccine than the Pfizer vaccine.

We don’t know whether risks for these side effects are higher in youth with diabetes, but the data to date do not suggest this is the case.

In summary, myocarditis is rare in children after a COVID vaccine, and when it occurs it appears to be mostly self-limited. Further follow-up is still occurring, but after more than 7 million doses given in young children already it is reasonable to think a higher rate of severe complications is unlikely to appear.

It is most important to remember that the risk of a severe COVID infection in children is, while low overall, high relative to the vaccine risk- latest data suggests up to 1-2% of children may need admission to hospital when infected with COVID. The risk of needing intensive care was about 1 in 1,000 and the risk of a severe inflammatory disease called MIS-C was about 1 in 3,000 in NSW.

Will the vaccine affect blood glucose levels?

A vaccine dose may make blood glucose levels go up transiently but these will settle with time and appropriate management, typically over a few days. Give correction doses as you normally would, check ketones if glucose levels are persistently high and use your sick day plans. Please call us if you need further help – we’ll be happy to assist and to know your child is protected!

Best wishes,

Dr Craig Taplin on behalf of the Diabetes Service

Perth Children’s Hospital