Prep for jab

Parents of younger children will soon be able to make bookings for them to get their Covid-19 vaccine, now that the Pfizer-BioNTech/ Comirnaty vaccine has been approved for children aged five to 11.

From the end of this month, children from Primary 3 to 5 will be able to get their first jabs, with younger ones following suit early next year. The vaccination exercise will involve more than 300,000 children.

Paediatricians offer suggestions on how to prepare children for the vaccine.

Give ample time for the discussion

Q. Should I talk to my child about the vaccination?

A. Dr Elizabeth Tham, consultant and head of the division of paediatric allergy, immunology and rheumatology at National University Hospital's Khoo Teck Puat - National University Children's Medical Institute, says: "Children aged five and above are old enough to understand what is happening to their body and around them.

"It is thus very important to help them prepare for vaccination at least a few days in advance, if their parents choose to proceed with it."

Giving kids time to prepare and ask questions will help them feel less confused, anxious and upset during the unfamiliar process, so that it will be a smoother and less distressing experience for them and the family, says Dr Tham.

"As there are two vaccine doses, a highly unpleasant or unexpected experience at the first dose may make it more difficult for the child to complete his or her second dose."

Dr Darryl Lim, a consultant paediatrician at Kinder Clinic in Mount Alvernia Hospital, says: "Find out what their fears and thoughts are on the whole process... and whether they might have had prior negative experiences in the hospital.

"Most primary-school kids will understand why they're getting the vaccine, which is to protect them... to help their body fight off the virus and to keep them safe, so they don't fall very sick."

He adds: "Give some time to the discussion, and it shouldn't be when you're in a flustered state or when you're on the way to an event."

Parents can also walk their child through the entire procedure, from the vaccination to the observation period so they know what to expect.

It might be helpful to also watch videos or read a book on getting injections, or role-play using doctor's kits, he says.

Use child-friendly language, like "you're going to feel a pinch or a poke", he says, and avoid words with negative connotations.

"For instance, you might not want to use phrases like 'you're going to get a shot', because to some kids, 'shot' is like gunshot."

Reward with a small treat after jab

Q. What about children who are afraid of needles?

A. Dr Cheng Tai Kin, who runs Kinder Clinic at Parkway East Hospital, says most children are reluctant to get injections and are scared of the pain.

"Some children will cry and may need an adult to be with them and comfort them," he adds.

Dr Lim suggests taking along some ice packs or a cool water bottle to numb the injection site.

"You can tell them that it's going to be a smaller needle, and if they're very fearful, maybe they don't want to look at the needle and they can close their eyes."

Parents can also let their children watch a video during the jab to distract them or take along books to read during the waiting time after.

Dr Tham suggests telling children that they had already gone through a similar process during their childhood immunisations, even if they do not remember it.

Parents can share their own vaccination experience with the child - how their own body responded and how they managed the symptoms, to show them it is something that many people have gone through and that it is safe, she says.

She adds that children should continue their daily routine on the vaccination day, have a good meal and be well-hydrated before the jab, to avoid dizziness or fainting.

"They may also choose to take along a small comfort object along to the vaccination centre and to reward the child with a small treat after the vaccination to help them feel more comforted," she says.

Watch for side effects

Q What are the side effects?

A Dr Cheng says parents should treat the vaccine as "any other childhood immunisation". "There's nothing extraordinary about the injection itself. It probably will be less painful than other vaccinations, if the volume given is similar to the adult Covid-19 vaccine," he adds.

Dr Tham says parents may choose to have their child vaccinated earlier in the day, and schedule it so that they can look out for symptoms over the next two to three days.

Immediate allergic reactions like anaphylaxis can usually be detected during the 30-minute observation period at the centre, she adds.

This presents as a combination of rashes, swelling of eyes or face, breathing difficulties, low blood pressure or severe abdominal pain.

Parents should monitor the child for the next 24 to 48 hours for delayed symptoms, like fever, muscle aches or lymph node swelling - similar to what adults experience.

These side effects are similar to those for kids' vaccines like the three-in-one vaccination against diphtheria, tetanus and pertussis that Primary 5 pupils undergo.

Dr Tham says: "Normal daily activities can be continued, but children should avoid vigorous activities like physical fitness lessons, sports enrichment classes for at least two weeks after each vaccine dose."

Worrisome symptoms which warrant a doctor's consultation, she adds, include persistent chest pain, breathlessness or persistent fever that lasts beyond three days.

"Myopericarditis is very rare - around three per 100,000 doses in individuals aged 30 years and below - and its symptoms include persistent chest pain, palpitations or an irregular heartbeat," she says.