Table 1.

Themes, example topics, and example comments for the “What” domain (arguments against the COVID-19 vaccine for children) emerging from thematic and discursive analysis of public comments on the EUA of COVID-19 vaccines for pediatric use.

Theme (number of topics mapped to this theme)	Example topics mapped to theme	Example comments from mapped topics
Unsafe (n = 19)	(T4) long, term, body, develop, still, new, affect, future, grow, could, impact, technology, generation, development, idea, consequence, brain, stage, growth, negative (T56) heart, blood, clot, myocarditis, cause, issue, problem, attack, stroke, damage, neurological, increase, inflammation, disorder, etc, pericarditis, cancer, bell, palsy, infertility (T81) effect, term, long, side, unknown, short, possible, possibly, worth, immediate, detrimental, known, excellent, longterm, gamble, underutilized, devoid, disqualify, certainty, undone	(T4) Do not approve the Covid vaccine for 5-12 year olds. Their bodies and brains are still developing and who knows what this vaccywill do to them. (T56) I do not support the Vaccine for children of any age. These vaccines cause blood clots, strokes, and heart attacks. (T81) Absolutely NO! The long term effects are UNKNOWN. There are so many side effects already for adults. NO ONE knows the long term effects down the road.
Rushed development process (n = 17)	(T31) experimental, drug, jab, inject, subject, inoculation, untested, unproven, stage, circumstance, unapproved, inoculate, jabbed, inhumane, innoculations, innoculation, serum, concoction, horrendous, cocktail (T58) long, term, safety, study, data, efficacy, lack, short, complete, effectiveness, determine, review, ensure, adequate, conduct, sufficient, collect, reckless, peer, longitudinal (T86) time, enough, research, rush, wait, feel, information, testing, understand, determine, period, sure, amount, comfortable, anti, sufficient, soon, conduct, diligence, collect	(T31) There is no way you should even consider giving an experimental drug to children. Look at what happened with chantex and that was an approved drug. What is wrong with you people? (T58) Are there publised peer-reviewed clinical data on safety and efficacy of vaccine in children age 11 and below? If there are, can we have access to clinical data. (T86) This vaccine has not been out long enough- nor has it been researched enough yet for children. Until it has been out longer I will take a wait and see attitude!
Ineffective (n = 7)	(T18) prevent, transmission, spread, infection, disease, symptom, contract, reduce, therefore, others, mild, neither, catch, hospitalization, transmit, spreader, severity, lessen, contraction, argument (T74) variant, vaccinated, spread, infection, prevent, unvaccinated, delta, current, likely, viral, become, infect, strain, booster, load, israel, protection, omicron, transmit, breakthrough (T79) get, vaccinate, still, spread, sick, vaccinated, fully, transmit, others, unvaccinated, catch, pass, someone, hospitalize, besides, easily, vaxxed, pas, argument, powell	(T18) It's absolutely asinine to mandate an experimental drug for anyone. The FDA has the burden of proof that the vaccine would prevent infection. The vaccine does not prevent infection nor does it prevent the spread of Covid. (T74) With vaccinated infecting unvaccinated and the children are 99.9% unaffected by Covid-19 or the Delta Variant what motive other than making money is there for vaccinating children? (T79) I strongly disagree, that kids supposed to be vaccinated. First of all they have thair own immunity system, they dont need a vaccine. You dont have to be that smart to understand, that vaccine dose not help. It is official information—that any vaccinated person can ged covid. So, i dont see any reason to vaccinate the kids.
Unnecessary (n = 17)	(T12) risk, low, high, serious, illness, extremely, complication, severe, minimal, category, reward, worth, associate, incredibly, carry, ratio, factor, burden, incidence, sever (T27) flu, like, cold, polio, common, deadly, measles, childhood, different, seasonal, pox, booster, chicken, eradicate, season, corona, influenza, mmr, similar, cure (T85) die, chance, likely, ill, less, seriously, zero, almost, become, sick, least, car, survive, accident, percent, hospitalize, severely, statistically, catch, drown	(T12) I am not in support of children being vaccinated as children are not at as severe a risk as pethaps the elderly.are or those who.underlyng conditions. (T27) It is 99.7% Recovery! Not Polio. No TB. Not Whooping Cough. No mandates for CHILDREN. Use your common sense. Not about money or politics. (T85) The 5-11 age group has no risk of mortality from COVID! They are more likely to die from a car crash or being struck by lightning. Do not move forward with unnecessary recommendations at the hands of for profit pharmaceutical companies.
There are better alternatives (n = 4)	(T37) immunity, natural, antibody, recover, herd, strong, build, protection, naturally, superior, provide, fight, robust, acquire, expose, lasting, gain, recognize, achieve, quickly (T38) treatment, effective, ivermectin, early, treat, therapeutic, doctor, protocol, proven, medication, medicine, patient, alternative, cure, vitamin, hospital, option, hydroxychloroquine, instead, zinc (T92) healthy, food, exercise, instead, care, vitamin, focus, eat, help, promote, chemical, lifestyle, etc, diet, nutrition, medicine, proper, teach, obesity, educate	(T37) What happened to bodily autonomy? What happened to natural immunity? Where is the evidence that vaccinated immunity is superior? What are the standards for herd immunity? (T38) Stop the vaccine mandates and open up medications such as Ivermectin, Hydrochloroquin and Buedesonide so the country can move on to normalcy. (T92) In your health guidance, including influenza and Covid19, please put much more focus on healthy lifestyle approaches to health—like healthy diet, proper nutrition, clean air and water, and restful sleep. Thank you.

Source: Authors’ own analysis of 149 897 public comments submitted to Docket FDA-2021-N-1088 from October 13 to 25, 2021, and Docket FDA-2022-N-0082 from February 4 to 14, 2022. The dockets pertained to amendment of the EUA for the Pfizer-BioNTech COVID-19 mRNA vaccines for administration to children aged 5-11 years and 6 months to 4 years, respectively.

Notes: Example topics and comments are keyed to the full annotated 100-topic database posted on Open Science Framework (20). “T” designates the topic number.

EUA, emergency use authorization; FDA, Food and Drug Administration.