Earlier this month, the US government recommended that children aged 5 to 11 get the Pfizer COVID-19 vaccine. Many parents had been waiting for this announcement since the beginning of the pandemic, but an authorization comes with its own challenges.
Among those is helping kids in that age group understand the need for a vaccine. While there’s no question that parents must make these kinds of medical decisions for their young ones, a child’s buy-in is important. Getting kids’ approval helps ensure that they develop a long-term, trusting relationship with the health care system, says Rebekah Diamond, a hospital pediatrician in New York City and an assistant professor of pediatrics at Columbia University. That assent can help reduce a child’s stress and fear at the doctor. It also teaches them how to communicate with medical professionals when they eventually take ownership of their own health care.
Before COVID, regular vaccination was simply baked into our children’s office visits, so this is a fairly new conversation to have with kids, particularly those who haven’t turned 12 yet. But with the impact the disease has had on our lives and the regular vaccine coverage across all news media, this shot feels different. As such, discussions around it should be different.
Start the conversation by listening
A good place to start is with what your kids have heard and already think they know about the vaccine, says Holly Schiff, a licensed clinical psychologist in Greenwich, Connecticut. “Give them the opportunity to air their questions and concerns so you can address them head-on and provide answers that reassure your child that you are making this decision solely for their health and safety,” she says.
The conversation may be easier than you expect. Many children are excited and eager to get the vaccine, because they understand that it’s the best way to return to a semi-normal life, says Jeannine Jannot, a developmental psychologist in Georgia. In Massachusetts, for example, schools that reach 80 percent vaccination can apply for a waiver of the state-wide school mask mandate.
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But no matter what your kids say in those early conversations, take their concerns and fears seriously. Your goal is to help your child build trust, and part of that is making sure they feel heard. While you are the one providing the legal consent for their medical procedures, it’s important for your kids to feel like they have given permission—and that goes for just about all areas of pediatric medicine, says Diamond.
Be reassuring, but honest
Schiff says the biggest concerns she has heard from children in her practice focus on side effects, like whether it will hurt, and if they’ll feel sick from side effects afterward. And of course, the answer to both questions is “maybe.” If your goal is to build trust, lying is counterproductive. “The key to preparing children for any medical treatment, visit, or vaccination is being open and honest,” says Diamond. The reality is that the vaccine might hurt. They might feel gross. And they probably already know that. “Usually they know someone who experienced side effects,” Schiff says. “So they might be afraid of having a similar experience.”
Talk with them about the vaccine’s potential side effects, which are far more mild than actually getting COVID, Schiff says. Explain your own experience with the vaccine. If you can, let them talk with grandparents, aunts, uncles, babysitters, and friends who have already received the shot. My kids, for example, know that one family member’s arm hurt for a few days, and that I had a fever and flu-like symptoms after my second shot.
These honest conversations also offer a fantastic teaching opportunity into the importance of research, Jannot says. Whatever their questions are, work together to find the answers. Many of our children have been exposed to the rampant misinformation spreading around the world, and may have developed their own misinterpretations of correct information. Take this time to dig into some of the real scientific information with them, at an age-appropriate level, of course. And consider scheduling a consultation with their pediatrician to let them ask questions directly.
“Give them the respect to have their concerns addressed,” Schiff says.
What if your child doesn’t buy in?
Despite your best efforts, your child still may not want to get the vaccine. For parents with older kids, that may mean letting them make that decision for themselves. Both Jannot and Schiff say that by 14, some kids start to develop the adult critical thinking skills required to be more involved in their medical decisions. By 16 or 17, it may be time to seriously start considering letting them decide what’s best for themselves, even if you don’t agree, and even if your state laws ultimately give you authority over medical consent.
If you do decide to have your child vaccinated without their buy-in, it’s important to talk about why. Jannot recommends framing this conversation around safety. Remind them that you require them to wear a seatbelt in the car, use a helmet while riding a bike, and look both ways or hold hands while crossing the street, even when they don’t want to, in order to keep them safe. Let them know that based on the research you’ve done and the conversations you’ve had with their doctor, you believe getting vaccinated will keep them safe. And that sometimes parents make their kids do things they don’t want to do in the name of safety.
Set clear expectations and make promises you can keep
When it comes time to actually get the vaccine, the conversations aren’t over. Every step of the way, work to reassure your child, just like you would with any other medical procedure. Diamond recommends reminding them several days in advance. If they’re nervous, try some role playing to get them comfortable. Diamond uses this technique with her own daughter. “We’ve done lots of play with her dolls and toys, and pretending to get vaccines and see the doctor for checkups is common for us,” Diamond says.
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You can also try to plan something special for that part of the day—an approach Jannot recommends. If your child has a favorite stuffed animal, let them bring it with them. Have them wear their favorite outfit to help them feel confident. Promise them a trip to their favorite restaurant afterward. There’s absolutely nothing wrong with a little bit of bribery to keep them motivated—the rule in my house is that if a doctor or nurse sticks a needle in you for any reason, you get ice cream. But never make promises you might not be able to keep, Jannot warns. Breaking a promise can undermine the trust you’ve worked so hard to build.
No matter how your discussions go, remember that kids have been through a lot these past two years, often without understanding exactly what is happening with COVID. “Remember that they’re being brave,” says Jannot. “They’re doing something bigger than themselves to protect other people.” That deserves recognition and praise.
And ice cream.
