Session 263: Children & The COVID-19 Vaccine

Session 263: Children & The COVID-19 Vaccine
Dr. Joy: Hey, y'all! Thanks so much for joining me for Session 263 of the Therapy for Black Girls podcast. We'll get right into our conversation after a word from our sponsors.

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Dr. Joy: Although restrictions related to COVID-19 may have lessened around the country, the risk has not gone away. Vaccines have been an important part of protecting our health throughout the pandemic, but so far, they haven't been available to children under the age of five, which has left parents and caregivers in a very difficult position. Last week, the FDA authorized use of the vaccine in this age group so we can expect administration in this group to start soon.

If you're a parent or a caregiver, you probably have lots of questions. Joining me this week to help answer some of these questions is Dr. Nina Ford Johnson. Dr. Johnson is a board-certified pediatrician who has been serving the families of the Mobile Alabama area for 10 years. With her expertise in serving children of all ages, Dr. Johnson has been a go to voice for black children's health during the pandemic. Her recent national campaign “I'm a Mom First” is by moms and for moms who have concerns about vaccinating their children.

Our conversation explores what's in the COVID vaccine and how it works, breaking down common concerns and debunking myths around the vaccine, how to identify COVID symptoms at home, and she shares advice to caregivers who might be struggling with the decision to have their children vaccinated. If something resonates with you while enjoying our conversation, please share it with us on social media using the hashtag #TBGinSession or join us over in the Sister Circle to talk more in depth about the episode. You can join us at Community.TherapyForBlackGirls.com. Here's our conversation.

Dr. Joy: Thank you so much for joining us today, Dr. Johnson.

Dr. Johnson: Thank you. I'm so glad to be here. Thank you for just having me.

Dr. Joy: This is such an important topic and it feels like there's new information almost every day. I would love for you to get started. I know that when we talk about children, there's lots of anxiety, lots of concerns about perhaps getting your child vaccinated with the COVID-19 vaccination. Can you talk to us a little bit about what the vaccine is and what it does for children?

Dr. Johnson: This is such an important conversation because we are seeing cases starting to uptick a little bit in our children and so it's so important that we still tell our parents and their family members how important it is for these children to get vaccinated. This COVID vaccine is very safe. It does not have any eggs, it does not have latex, it does not have any preservatives whatsoever. The vaccine, as we call it, is very clean and it is made with excellent technology by our medical scientists so we're so proud of this vaccine.

This vaccine contains a couple of salts like magnesium and others. It contains lipids which allows the vaccine to deliver it very effectively to where it's supposed to, and it contains mRNA. It does not change the child's DNA; it basically tells the immune cells to protect against the virus and it allows them to protect against the spike protein. And the spike protein of COVID-19 is what causes this virus to be so virulent and very scary, and it does wreak havoc in our immune systems of our children and adults. And then once the mRNA does what it's supposed to do into the cells, it degrades very rapidly and does not cause any problems. It does not change the person's DNA at all; it just allows it to be very effective for what it's supposed to do.

Dr. Joy: Dr. Johnson, can you break that down into maybe simpler terms? Because some of the words, I understand what you’re saying, but I definitely want to make sure people understand exactly what the vaccine does for the kids.

Dr. Johnson: mRNA is basically a cousin, we can say, to DNA. Which basically, genetic code that makes us all so different and very special. The vaccine basically is encoded into the mRNA (it’s basically put in mRNA) which allows it to go into our different cells, which helps us fight different viruses and bacteria and the like. COVID-19, it produces a protein and basically this protein is called spike and it allows the spike protein that COVID-19 produces to attack different cells of the body. Which is where we see why COVID-19 has caused a lot of problems with the lungs—it attacks the lungs, it can attack the heart, it can attack blood vessels.

You'll see a lot of people, especially when COVID-19 first came out, it caused a lot of clots and stuff like that, so it'll attack that system as well. And so what the vaccine does, it causes an antibody which basically fights that spike protein if someone was to become in contact with COVID-19. So they've already produced an immune response to the virus even before they've been introduced to the virus, meaning before they've even got infected with it. This vaccine is very good, and I hope that helps.

Dr. Joy: It does, it does. So it's basically helping you, like should you become infected. If you get the vaccine, it helps your body to fight against that infection so that maybe you don't become as sick as you might if you didn't have the vaccine.

Dr. Johnson: That is correct. That is very correct. Thank you.

Dr. Joy: Got it, okay. You mentioned that there's no eggs, no latex, so those are some of the common concerns with other vaccinations. I know that for some of the very early childhood vaccinations, you often hear parents talk about like trying to space them out, or do we give them all at once? Is there any concern with having to space this out, say, from your regular flu shot or from other vaccinations that a child might have?

Dr. Johnson: Good question, but no. Again, this vaccine is very good. I've actually given it in conjunction with the flu shot—same day, same time. I've actually given it in conjunction with a child who came in for their yearly checkup and they needed shots. And so for like my 11-year-olds who come in ready to go to middle school and needing those shots to get in, they've actually received that vaccine as well (right along with the other ones) and have done completely fine. There's no need to space out any of your other vaccines to get that COVID vaccine. Or also, if you were to get the flu shot when it is flu season, it's okay to get the COVID vaccine right along with it.

Dr. Joy: Got it. Are there any side effects or risks that you have found or heard about related to the COVID vaccine for kids?

Dr. Johnson: Good question. The main thing that I've seen are fevers, so a fever for like a day or so. Of course, you may get some arm tenderness, it may hurt where the shot was given and that may happen for a couple of days. Other side effects are just chills or feeling more fatigued or tired than usual. Again, those symptoms just usually last 24–48 hours, just a couple of days. I say take some Motrin, get plenty of liquids, get plenty of rest like you would with any vaccine—like you would with a flu shot or anything like that—and those usually go away.

Dr. Joy: You know, Dr. Johnson, I feel like I've heard lots of different information about how COVID actually impacts kids. It feels like maybe sometimes that the severity of how sick kids get is different between the different strains. I know that there's like a new strain, I think, on the horizon. Can you say a little bit about how COVID-19 does show up in kids? Like is it typically less severe than we see in adults? Or should we be just as concerned about kids being infected with COVID-19 as adults?

Dr. Joy: You know what, from what I've seen in my office, the symptoms are less severe. A kid I saw two weeks ago just had like a little cold stuffy nose, barely even had a fever, so that was his symptoms. COVID-19 is a virus so it affects you from head to toe. Headaches, you may get some red eyes, a runny nose, sore throat. You may cough, a little vomiting, diarrhea. Again, affects you from head to toe. Usually, the symptoms that I've seen in my office mainly look like the flu or may come in looking like a stomach virus because they’ve got a lot of vomiting and diarrhea. Very rarely have I had to admit one of my children who had COVID-19. One did get admitted, but this child had several other chronic ailments and conditions.

A couple of long-term effects, though, I have seen with kids with COVID, and those have been more so my teenagers. Where they've had headaches for long periods of time, or one had issues with her taste and so couldn't taste or couldn't smell things for like a couple of months and so lost weight because of that. Fatigue or they had what we call that brain fog, when they couldn't really think through like their schoolwork, so they had to go to homeschool and not do in-person school. That's been a couple of effects. But I will say this: it is still very, very important for children to get the COVID vaccine because, I believe it was last year, 2020 or 2021... I can't remember the year, but it was the 11th cause of death of children in the United States so it's still very serious and it's still very important for children of African American descent to get the COVID vaccine. Because I hate to say it like this, but this is true. When white people get a cold, black people get flu or pneumonia, so it does affect us more serious. Our rates are higher for hospitalization and serious illness because of this than other nationalities.

Dr. Joy: More from my conversation with Dr. Johnson after the break.

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Dr. Joy: Can you speak a little bit about why that is?

Dr. Johnson: That's a good question and we really don't know why. I'll say this: black women, we've seen COVID affect us pretty hard, and we are more prone to get conditions like lupus and other things like that, other autoimmune problems. And so we're wondering if it's because maybe the clotting system is different. Because when it first came out, we thought we were gonna be safe from COVID-19 because majority of us have O+ blood, but that's not true at all. We really don't know why. We don't know if it's because it's late presentation, are we coming to our doctors too late to be treated?

Is it because the medical system still does not...? I'm trying to say this where I won't offend anyone, but still tell the truth. When we come and when we go to the emergency room and when we go to the doctor, it's usually at a last resort. We try to do our best at home. Take all the medicine and everything we can before we go to a doctor. So is it because we're showing up sicker than usual, than we would have if not? And so when this illness first came out, I told the medical society and the community here locally (in Mobile County in Alabama) that when your patients arrive to the ER or to your office, believe them when they say that they're sick because they wouldn't come otherwise. They're not just gonna show up just to show up. They're having to take off work, they're having to get to the ER or to their doctor's office the best way they can. They're not just showing up just because it's something for them to do; they're showing up because they're ill and you have to take them serious for it.

Dr. Joy: Yeah, and I think that speaks to the long-standing institutional racism we see, the misinformation that has existed related to lots of different illnesses and medical experiments. I mean, there's a long history and so I know that a lot of that has fed into some of these concerns as well.

Dr. Johnson: Definitely, and so that's why it's so important that what you're doing and what others are doing is putting out correct and right information for our communities to receive.

Dr. Joy: You mentioned a lot of symptoms, Dr. Johnson. I'm in Georgia and so all this stuff with like runny nose and scratchy throat and all of that also sounds like allergies. And so I'm wondering, for our kids, should we be using the COVID-19 at-home tests to test them if they have any of these symptoms? Or should we bring them straight to the doctor's office? Like how should you proceed with any of these concerns or these symptoms you've mentioned?

Dr. Johnson: You know what, that's a good question and allergy season is big, especially around this time of the year and sometimes all year round. You have to know your children. If you see them like runny nose and cough and congestion, but now they're sleeping more than usual or they're not eating as much, then that will be the time to either do an at-home test or take them to their doctor to find out what's going on. But especially if they have other past medical problems like asthma or something like that or even high blood pressure or diabetes—those are the kids who you don't want to play around with, who it will not hurt for them to be seen by their doctor, just in case. Because we know that if a child or an adult has other comorbidities like diabetes, high blood pressure, having to use a CPAP because they have sleep apnea, then those are concerns that they need to see their physician quicker than someone who does not have any medical problems at all.

Dr. Joy: Dr. Johnson, what is the latest update about vaccinations for children under five? I hear these parents, and my heart goes out to them because it does feel like there's a large segment of our population who just have not had any options. Like they're too young for the vaccine and a lot of them are too young even for masks. What is the latest update about when we might expect any information about vaccines for kids younger than five?

Dr. Johnson: Good question because my three are all younger than five and so I'm ready. They’ve got to go to school, right? Without delay. What I've been hearing is that by the end of June there’s a good possibility that the vaccine will be ready for them. And it's at 80% effective, which is still really good. The COVID vaccine for us adults is around 90–95% but I will still take 80% for those five-and-under children. And so as soon as that is available, I do recommend. I was looking at the news and I saw this update while I was in the bed, and I turned over, I said my kids are gonna be first in line because they need that vaccine. Because they're sick so often, they're exposed to so much. Of course, they see me with my mask, but my kids are three and they're not even trying to wear a mask. I put it on their face and it's all here or here, it's everywhere. So as soon as it comes out for them, I totally recommend it for those six months and older.

Dr. Joy: Got it. And will it also be two doses or is the dosage changed for children younger than five?

Dr. Johnson: I think it will be two doses and it may even be three. I think it's like the child gets one and they come back in about a month and get that second dose and then we'll see what they say about when the third one should be given. I think it's at least two but it may be three.

Dr. Joy: Got it. We've already talked about some of the concerns around why our community is sometimes hesitant to believe that we should trust vaccines and all of those things. What kinds of information or wisdom would you like to share for parents who might still feel a little hesitant about vaccinating their children?

Dr. Johnson: It's a difficult conversation to have, but a necessary one. We don't want to just give our children shots willy-nilly, but these vaccines have been tried and proven. We don't see people with smallpox walking around or yellow fever or polio anymore in our modern-day society. That's because the vaccines work and so I encourage parents. And there are still parents, even patients I take care of, who are against it and they've seen my commercial. They see me on TV, they've heard me on the radio, and they're still hesitant. But the main thing is I don't try to browbeat them about it, I just encourage the conversation. If they say no today, they may say no the next time, they may say no a year later. We talk about it more often, what kind of concerns they have. So talk to your pediatrician about it and get the right information.

Dr. Joy: The other thing, Dr. Johnson, is that we are seeing now in the news about monkeypox. Is this something that we should be concerned about? I don't remember—is there a monkeypox vaccination we get as children?

Dr. Johnson: No, not at all. I told the Lord, I said, Lord, I can only take one thing at a time. Luckily, I don't know what's going on with this monkeypox thing. I'm sure we'll get more and more information about it. It's nothing that I've seen in my office or anything yet, nothing that they're warning us against that we need to be on the lookout for. There's nothing that the state public health department has put out and says “hey, you need to watch out for this and this” yet. When it comes time, we'll be ready. But right now, I just have parents just concentrate on this and then we'll move on to the next thing, because there's always a next thing.

Dr. Joy: Yeah, understandable. What other vaccines do we get, though, as kids? I have two young ones and so I don't remember all of what they've gotten, or all I got as a kid. What other vaccines are kids typically getting, like their shots for school, so to speak?

Dr. Johnson: Whooping cough, polio vaccine. Again, I was telling somebody like the last time I saw somebody with polio was my great aunt Flossie who was a beautiful woman, but she had one leg that was shorter than the other because she had polio. But that's something that we protect against. Chickenpox. I had chickenpox as a child but they didn't have the vaccine available. My sister who is eight years younger than me, she's never had chickenpox because she's had the vaccine. We like to vaccinate against different strands of hepatitis, which is an infection of the liver that is caused by a virus, and that can be given to people or children by something as simple as eating something that is not cooked properly. And so that's something we like to protect against as well.

There are numerous other bacteria we protect against that can cause pneumonia and meningitis. Pneumonia is an infection of the lungs and meningitis is an infection of the brain, so we protect against that for children and in our teenagers, especially the ones who are going off to high school and college. As they start living in those closed communities and quarters, where it's more easy to catch something than another child who may not be living with their classmates. There are a number of vaccines and stuff that we protect our children against, but it's very necessary.

Dr. Joy: Thank you for that, Dr. Johnson. More from my conversation with Dr. Johnson after the break.

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Dr. Joy: The other conversation that I think has been happening in parallel to the conversation around vaccines is also the mental health toll that this has taken on our kids. There's lots of new research coming out, talking about anxiety getting higher in kids. We do see, sadly, an increase in youth suicide rates. Can you talk a little bit about some of the mental health impact we've seen from the pandemic on children?

Dr. Johnson: Yeah, and it's been really challenging, especially the anxiety portion of it that we're seeing. I’m having kids who are in elementary school having issues dealing with going out in public now, to the point where they don't like to go to the store, they just want to stay at home and parents are having to homeschool them. They are actually saying like their stomach hurts. Their mental health problems are now becoming more somatic, meaning they're blaming it on a headache or they're having issues with their stomach, and they’re having to see different specialists and the specialists telling them, hey, your stomach is totally fine. But it's all up here.

The main thing I tell parents is to have real conversations with your children and be upfront. Even if you have anxieties or something that makes you concerned or nervous yourself, say, hey, I understand what you're feeling because Mommy is also feeling a little concerned about this as well. But as your mother, as your parent, that is my job to take care of you 100% so you don't have to worry about that. And so seeing the anxiety portion has been very concerning and there has been some uptick in depression.

Some of the depression I think has to do with loss of family members. I have several kids who are now orphans because of COVID and so you have to talk about these mental health issues in our children, but also in some of these surviving parents. Because I've had children who've lost grandparents due to COVID and that was their primary caregiver. So it's been very challenging these past couple of years, having to navigate the system where, as you know, Dr. Joy, it’s not funded as well, especially in our communities. Giving them the resources that they need to be successful in terms of that. Because the mental health portion plays such a key part in their academics and also their physical wellbeing.

Dr. Joy: You talked about the loss of family members, but I think a lot of kids also like the loss of social interaction. There was a time they weren't back in school or they were doing virtual school and so I think the loss of just like hanging out with their friends and all of that has led to maybe some increase in depression and anxiety.

Dr. Johnson: Definitely, definitely. And how they just miss a hug. I took my kids to Disney World at the end of last year and they couldn't give Mickey Mouse a hug. It's really just the small things.

Dr. Joy: I know that you are a pediatrician by training and so mostly you see the little people. But you also come into contact with their parents when parents are bringing (them in.) What kinds of conversations have you been having with parents about their own mental health? Because that has been a huge toll as well.

Dr. Johnson: It's so important, especially my moms who have just had babies. You have postpartum depression and we're talking about that. And so then you're wondering, like in the height of COVID, could my child get COVID because they're at daycare? I also make sure that my parents and my grandparents are staying on top of their physical health in terms of making sure they're getting their annual checkups. Don't forget your mammograms, don't forget your colonoscopies, all those other things that sometimes get put off. Because of COVID, they don't want to go to the doctor because they're scared they're gonna get COVID.

Dr. Joy: Yeah, all that has been very real. It has felt very hard, I think, to make some of those decisions and I think that's where some of the frustration has come. Is that it doesn't feel like there was a largely, like solid messaging in place to help people figure out how to determine their risk around certain things.

Dr. Johnson: Exactly, and that's why it's still so important that they hear. Because people are still dying from heart attacks, they're still dying from strokes. Kids now more than ever, especially at home, we're seeing the COVID 15, the COVID 20 pounds more, because they're eating so much. We're still seeing diabetes and high blood pressure in our children, so it's still something that you hate. Even though we may be in a pandemic or hopefully starting to inch our way out of it, you can exercise. You can go outside, get some of that vitamin D.

Dr. Joy: You bring up another good point around people have different opinions around vaccinations for kids. And I think that this has caused some tension I think even in families. Let's say you have a sister who has kids that she doesn't plan to vaccinate—is it still okay for them to have playdates with other people who are not vaccinated? Can you give us some guidelines around how we should move forward with kids in terms of maybe interacting with other kids who may not be vaccinated? Or how do we make some decisions around that?

Dr. Johnson: That can be tough because you don't want to shelter your own children. You can ask the parent, are they having any symptoms, any coughs, runny nose? Do your activities outside instead of in a confined space, so at a park where everybody's running around and doing everything like that. Like I said, just plant the seed. And if they don't accept it, then that's okay because at least you did what you know you thought was right. If they know we're coming from a good place, then I think people will be more apt to receive it.

Dr. Joy: That’s helpful, thank you for that. Are there considerations or things we should be thinking about in preparation for...? I know one school year just ended, maybe not even for some people, but in thinking about going back to school in August—are there things we should be thinking about in terms of talking with teachers around like mitigating risks? Are there any things that you suggest for that?

Dr. Johnson: We still keep up that good hand hygiene, we’ve still got to wash our hands, we still have to make sure we keep our hands out of our face and out of our mouths. Even as adults, we still have to do that. The child’s shot records and all that stuff is up to date. You want to encourage your kids to make sure they're seen by their physician for their annual checkup so we can talk about even school readiness. Every time I see a kid come in for an office visit, whether they're sick or well, I always ask them how they're doing in school. Because to me, that shows such an important part of how their physical and their mental health is doing, is how are they doing in school? And so we can talk about things like are they having issues with attention? Or how do you feel their reading comprehension is doing or their math or their handwriting skills and stuff like that? That's something to be addressed. Their speech. That way, like during the summer, we can send them to speech therapy or occupational therapy or even behavioral therapy, so we can work on some of those attention and focusing things. We can get the ball rolling during the summer so they can make progress, so by the time school year starts, they'll be ready or on a better foot than they were before they ended the school year.

Dr. Joy: Thank you. Dr. Johnson, can you tell us a little bit about your educational background and your pathway to the work that you do now?

Dr. Johnson: Yeah, thank you. My family's in Atlanta, I'm a graduate of Stone Mountain High School. And then I went to Tennessee State in Nashville, where I did my bachelor's degree in biological sciences. And then I graduated from Meharry Medical College, which is right down the street in Nashville, where I got my medical doctorate. So two outstanding, historically black college and universities that I really hold dear to my heart. And then I did my pediatric training at Baylor College of Medicine in Houston, Texas, and now I've been practicing in Mobile, Alabama. They also call it LA—Lower Alabama—and I’m glad to be here.

Dr. Joy: I'm curious to just hear how being a pediatrician has changed for you. Five years ago versus what your practice looks like now, like what has that change looked like?

Dr. Johnson: I'm definitely more busy but I'm grateful for it. I've gotten more gray, so I have more wisdom—my patients and my parents take me a little bit more serious. And then it also helps that over the past three years now going on four, I became a mom. I think parents appreciate that perspective because now I can give them some tips on what I've done. And some things that I was dead set on... You know, stop the bottle at one year of age, stop that pacifier at about one year of age, now I can tell them what happened for me and my kids and how it was a little bit different. And so definitely more understanding to the plight of parents

Dr. Joy: What is it that you do? Do you have a private practice in Mobile or are you doing something else?

Dr. Johnson: Yeah, I've worked with three other great pediatricians in a group practice in Mobile, Alabama. We don't see any hospitalized kids. We used to before a certain period of time, about four or five years ago we did, but we cut that out of our practice. Now we just see our patients totally in the office.

Dr. Joy: Thank you, Dr. Johnson. Where can people find you? Do you have a website you'd like to share, and are you on any social media?

Dr. Johnson: I am not really on Instagram. I am somewhat on Twitter. Definitely more on Facebook, but slacked off in the past couple of months, just because kids and life has just gotten so busy. But @DrNinaFJ on Twitter and Nina Ford Johnson on Facebook.

Dr. Joy: And your practice website.

Dr. Johnson: Oh, yes, yes. Actually, we're just on Facebook. We’re @InfirmaryPediatrics and that's where our practice is.

Dr. Joy: Thank you so much, Dr. Johnson. It has been such a pleasure to chat with you.

Dr. Johnson: Thank you for dealing with me and my voice. My kids gave me something called RSV, which causes a lot of coughing and wheezing. And so thank you for the good work that you do.

Dr. Joy: Thank you. I'm so glad Dr. Johnson was able to share her expertise with us today. To learn more about her and her work, be sure to visit the show notes at TherapyForBlackGirls.com/session263. And be sure to text two of your girls and tell them to check out this episode right now.

If you're looking for a therapist in your area, be sure to check out our therapist directory at TherapyForBlackGirls.com/directory. And if you want to continue digging into this topic or just be in community with other sisters, come on over and join us in the Sister Circle. It's our cozy corner of the internet designed just for black women. You can join us at Community.TherapyForBlackGirls.com. This episode was produced by Fredia Lucas and Ellice Ellis, and editing was done by Dennison Bradford. Thank y’all so much for joining me again this week. I look forward to continuing this conversation with you all real soon. Take good care.