COVID-19 Vaccine For Children: What Parents Need to Know

We will update this post as news comes out about COVID-19 vaccines and children. This post was last updated on June 22, 2022.

The Pfizer/BioNTech and Moderna COVID-19 vaccines are now available for children ages 6 months and older.

The U.S. Centers for Disease Control and Prevention (CDC) recommends children 6 months of age and older get the COVID-19 vaccine. The CDC recommendation follows the U.S. Food and Drug Administration (FDA) granting the vaccine an Emergency Use Authorization (EUA) for both vaccines in children ages 6 months and older.

Parents can get their child the COVID-19 vaccine at any place authorized to administer the Pfizer/BioNTech and/or Moderna vaccines. Visit Vaccines.gov to find a vaccine location near you or call your local or county health department.

As of June 2022, more than 13.6 million children ages 0-18 have been diagnosed with COVID-19 since the start of the pandemic, according to the American Academy of Pediatrics (AAP). This represents 18.8% of all cases. Per CDC, there have been 8,206 hospitalizations and 1,257 deaths among children.

Widespread vaccination is a critical tool in stopping the pandemic.

“Children are very much part of the herd immunity picture,” says board-certified allergist Purvi Parikh, MD. “We can’t get out of this pandemic until our children are vaccinated, especially with schools reopening. I know there is a lot of hesitancy because parents are more protective of their children than themselves. What I say to them is that if your child gets this virus, it’s far scarier.”

Vaccine researchers continue to examine whether changes to the vaccines are needed to counter new variants as they emerge.

Is the COVID-19 vaccine for children under 5 years old available?

Yes. Children 6+ months of age, toddlers and preschool-age children are eligible to get either the Pfizer/BioNTech COVID-19 vaccine or the Moderna COVID-19 vaccine.

What are the Pfizer/BioNTech and Moderna COVID-19 vaccines?

The Pfizer/BioNTech and Moderna vaccines are both Messenger RNA (mRNA) vaccines. They are designed to trigger an immune response that produces antibodies. They can protect people from getting infected when exposed to the virus. They can also reduce the risk of severe illness.

What are the dosages for the Pfizer/BioNTech and Moderna vaccines for children?

Doses are different for each age group.

Pfizer/BioNTech

6 months to 4 years old age group: the dosage 3 mcg, which is about one-third of what’s given to children ages 5-11. This vaccination series is given in three doses. The first two doses are given three weeks apart, and the third dose is given at least 2 months later.

5-11 age group: the dosage is 10 mcg, or one-third of what’s given to older adolescents and adults. This vaccine is given in two doses, three weeks apart.

12-17 age group: the dosage is 30 mcg, the same as for adults. The vaccine is given in two doses, three weeks apart.

Moderna

6 months to 5 years old age group: the dosage is 25 mcg. This is one-fourth of the adult dose. The vaccine is given in two doses, four weeks apart.

6-11 age group: the dosage is 50 mcg, which is half of the adult dose. The vaccine is given in two doses, four weeks apart.

12-17 age group: the dosage is 100 mcg, the same as the adult dose. The vaccine is given in two doses, four weeks apart.

The needle used to administer the vaccine to children from 6 months of age to 11 years old is expected to be smaller than needles for older age groups.

Children will be deemed fully vaccinated two weeks after receiving their last dose. Parents who want their child vaccinated as soon as possible may want to choose the Moderna vaccine. That vaccine offers protection in 4 weeks.

Pfizer/BioNTech and Moderna vaccines are administered as an injection in a muscle, usually the arm. The doses are available in pediatricians’ offices and primary care sites, as well as hospitals, pharmacies, community health clinics and possibly schools.

When your child receives the first dose, make sure to schedule an appointment for the next dose(s). Until children are fully vaccinated, they may be advised to continue wearing masks, keeping their distance from others especially when indoors, and washing their hands.

Can my child get a COVID-19 Booster Shot?

Children ages 5 and older who received the Pfizer/BioNTech vaccine are eligible to get a COVID-19 booster shot. They can get the booster dose 5 months after their second dose.

Is the Pfizer/BioNTech COVID-19 vaccine effective in children?

FDA published results of clinical trials for each of the vaccines administered to children in different age groups.

Pfizer/BioNTech

6 months to 4 years old age group: in children ages 6 months to 2 years old, the vaccine was 75.6% effective against symptomatic COVID-19 (including the Omicron variant) after all three doses. In children ages 2-4 years of age, the vaccine was 82.4% effective against symptomatic COVID-19 (including the Omicron variant) after all three doses.

Children ages 5-17 years old have been eligible to receive the Pfizer/BioNTech vaccine since 2021. The vaccine is reported to be 95% effective against symptomatic COVID-19 in children in this age group. Children who received the Pfizer/BioNTech vaccine booster increased their protection even more.

Moderna

6 months to 5 years old age group: in children ages 6 months to 2 years old, the vaccine was 50.6% effective in preventing COVID-19 after the second dose. In children ages 2-5 years of age, the vaccine was 36.8% effective in preventing COVID-19 after the second dose.

Despite these lower percentages, the vaccine is expected to provide strong protection against severe illness because children have higher antibody levels than adults.

6-11 age group: the vaccine was 76.8% effective in preventing COVID-19 after the second dose.

12-17 age group: the vaccine was 93.3% effective in preventing COVID-19 after the second dose. This data was obtained before Omicron became the dominant variant in the United States. The vaccine’s effectiveness applies to the original COVID-19 virus, the Delta variant and other previously circulating variants.

What are the COVID-19 vaccine side effects?

Side effects are reported to be mild in young children. They are more common in the 12-15 age group than in those 16 and older. Tiredness was the most common side effect reported, with 78% of the 12-15 age group reporting it as part of the clinical trial. According to FDA, side effects may include:

• pain, redness or swelling at the injection site
• fever
• chills
• headache
• muscle pain
• joint pain
• nonallergic reactions such as rash, itching, hives or swelling of the face
• nausea
• swollen lymph nodes
• diarrhea
• vomiting
• arm pain

What is the risk for allergic reactions to the COVID-19 vaccine?

Cases of severe allergic reactions, or anaphylaxis, to the Pfizer/BioNTech vaccine are very rare. As of Jan. 29, 2021, the anaphylaxis rate was five cases per 1 million Pfizer/BioNTech vaccine doses administered. In the Pfizer/BioNTech clinical trial of the 12-15 age group, there were no reports of serious allergic reactions.

Cases of severe allergic reactions to all vaccines are also very rare. It’s estimated at 1.31 cases per 1 million vaccine doses given.

Signs of a severe allergic reaction to a vaccine may include:

• difficulty breathing,
• hives or skin rash
• swelling of the face and/or throat
• rapid heartbeat
• dizziness

What is the allergic reaction protocol for the COVID-19 vaccine?

Children with an allergy to food, insect venom medications, latex or environmental allergens are eligible to receive the Pfizer/BioNTech or Moderna vaccines. Your child should NOT get the vaccine if there is:

• a history of anaphylaxis to any ingredient of the Pfizer/BioNTech or Moderna vaccines
• a history of non-severe immediate allergic reactions to any ingredient of the vaccines
• an allergy to polyethylene glycol (PEG). PEG is a component in the vaccine.
• had a severe allergic reaction to a first dose of the vaccine

If you have any questions or concerns about the COVID-19 vaccines and allergic reactions, consult with your doctor or allergist.

What is the benefit vs. risk for children getting the COVID-19 vaccine?

Now that children ages 6 months and older are eligible to get the vaccine, parents may have questions about it. Some may be concerned about the risk of long-term side effects or allergic reactions.

Medical experts continue to emphasize the benefits of the COVID-19 vaccine outweigh any potential risks. Benefits of the COVID-19 vaccine include:

• Preventing your child from getting COVID-19 or from becoming seriously ill or dying due to COVID-19
• Preventing your child from spreading the virus to others
• Increasing community-wide protection from COVID-19, making it harder for the virus to spread
• Preventing the COVID-19 virus from replicating and possibly become more resistant to vaccines

What are the risks of not getting vaccinated and then getting COVID-19?

While most children who get COVID-19 tend to experience mild symptoms or no symptoms at all, some do get severely ill. Adolescents and older children are more at risk for serious COVID-19 cases than younger children.

Hospitalizations and deaths in children due to COVID-19 have been uncommon, according to AAP. Hospitalizations were from 0.1% to 2.0% of all cases among states reporting. Deaths were between 0.01% to 0.03% of all cases among states reporting. Three out of four of children who died from COVID-19 had an underlying medical condition such as asthma, obesity or a heart condition.

In addition, children who have died of COVID-19 are disproportionately children of color: about 75% of all pediatric deaths have been children of color.

Medical researchers are also investigating cases of a rare but serious condition affecting some children with COVID-19. It’s called Multi-system Inflammatory Syndrome in Children (MIS-C) and symptoms involve inflammation of body organs including the heart, lungs, kidneys, skin, brain. It’s unknown at this time what the risk factors are for developing MIS-C.

Will there be a vaccine mandate to attend school in person?

This will depend on the state you live in – and possibly the school district your child attends.

Can my child get other routine vaccinations at the same time as the COVID-19 vaccine?

CDC says your child can receive routine vaccinations, such as for measles and HPV, at the same time as the COVID-19 shot. The American Academy of Pediatrics supports this as well.

Routine vaccinations reportedly fell off during the pandemic. Doctors say it’s important that children resume routine vaccinations.

Is there a risk for heart problems such as myocarditis from COVID-19 vaccines?

FDA and CDC say children (particularly male adolescents and teens) who receive the Pfizer/BioNTech or Moderna vaccines may be at risk for the following heart-related conditions:

• myocarditis: inflammation of the heart muscle, making it hard to pump blood. It can lead to heart failure.
• pericarditis: inflammation of tissue and the sac around the heart.

Cases of myocarditis and pericarditis following COVID-19 vaccination are rare. Males 12-17 years of age on the Pfizer/BioNTech vaccine were at higher risk than other age groups. Males 18-24 years of age on the Moderna vaccine were also at higher risk. Symptoms tended to emerge several days after vaccination.

A study published in the Journal of the American Medical Association in January 2022 found 1,626 cases of myocarditis post-vaccination in children 12-17 years of age. In addition, CDC has cited 20 cases of myocarditis in children 5-11 years of age.

The rates of myocarditis cases from the vaccine are:

• 5-11 age group: 2.7 cases per 1 million vaccines given
• 12-15 age group: 70.7 cases per 1 million vaccines given
• 16-17 age group: 105.9 cases per 1 million vaccines given

CDC says people who are 12 to 64 years old – especially males ages 12 to 39 – may benefit from longer spacing between the first and second doses of the Pfizer/BioNTech and Moderna vaccines. This could help reduce the risk of myocarditis. Talk with your doctor to see if waiting up to 8 weeks between the first and second doses, instead of the previously recommended three or four weeks, can help.

Myocarditis can occur as a result of getting any type of virus, including COVID-19, the flu and the common cold. Doctors say there is a greater risk of getting myocarditis from COVID-19 infection than from vaccination. In that regard, the benefits of COVID-19 vaccination outweigh the risks.

If your child reports any of the following symptoms, either as a result of COVID-19 infection or after getting a COVID-19 vaccine, seek medical care immediately:

• chest pain
• shortness of breath
• feelings of a fast-beating, fluttering or pounding heart

CDC reports that, with treatment and rest, most myocarditis patients improve quickly.