A common source of confusion, sewn largely by COVID-19 minimizers, is around whether we should be vaccinating kids because children are less likely to get sick than adults. This is true—but also not the point. The real question is how the risk of COVID in kids compares to other risks children face. Here, the data for protecting kids is compelling: COVID-19 was the sixth-leading cause of death among children ages five to eleven in 2020 and overall, has led to nearly 700 deaths among children. In a typical flu season, approximately 200 children die, an unacceptably high number for which we recommend universal vaccination. COVID remains far more deadly for children than the flu…

Myocarditis in the pre-COVID era was a rare condition more commonly associated with infections from viruses such as influenza or coxsackie. These cases could occasionally be serious leading to long-term complications due to direct infection of the heart muscle by the virus itself or the intense immunologic response triggered by the infection. We see this myocarditis in unvaccinated children who have been infected by COVID, where some cases can be serious.

Vaccine-induced myocarditis is quite different. First, it is very rare. In fact, we know that the risk of getting myocarditis from COVID among 12- to 17-year-olds, for whom we have the best data, is about 1 per ten thousand children vaccinated. The side-effect occurs more often in boys, as often as 17 per 100,000 boys vaccinated. We don’t know why this difference exists, though there may be a role for the hormone testosterone. But these rare instances of vaccine-related myocarditis cases in teenagers were mild and the teens recovered in a week or two.