Pediatric COVID-19 vaccine FAQs

We honestly cannot be more excited. Our youngest children now have access to vaccines to protect them and their loved ones from the multiple negative effects of COVID-19 infections. Again and again, vaccination has proven to be the safest way to protect children from COVID-19.

While children have a lower risk of hospitalization for severe COVID-19 than adults, it’s not benign for all children either. Since the emergence of Omicron, we have seen the most hospitalizations due to COVID-19 in children who have not yet been vaccine eligible. COVID-19 is currently the 5th leading cause of death in children. COVID-19 occasionally causes critical illness, multisystem inflammatory syndrome in children (MIS-C) and Long COVID; these direct health effects of COVID-19 can cause death and disability in affected children. Other indirect effects of missing school and being disconnected from friends and loved ones continue to dramatically impact the wellbeing of children. Children make up 25% of our population in the U.S., and vaccinating our children is incredibly important for our communities to move through this pandemic.

The vaccine doses are different depending on the age of the child and the vaccine product used. Both Pfizer and Moderna are authorized for children 6 months of age and older. Generally speaking, the dose is smaller for the youngest age groups, and Pfizer’s regimen uses a lower vaccine dose than Moderna. Another different to note is that the Pfizer vaccine used in children aged 6 months to 4 years is given as a 3-dose series, whereas Moderna’s vaccine for children aged 6 months to 5 years is a 2-dose series.

The data from Pfizer and Moderna as well as real-world experience show very rare serious adverse effects other than occasional high fever. The overall side effect profile is very reassuring for this vaccine in children. We continue to diligently monitor for safety signals as the vaccine is provided to more children.

The most common side effects are pain at the site of the injection, fatigue, sore muscles and occasional mild fever. These side effects are expected with ANY vaccine. Other mild side effects that can be experienced after COVID-19 vaccination include sleepiness, loss of appetite, irritability, and nausea.

Myocarditis (inflammation of the heart muscle) and pericarditis (swelling and irritation of the think saclike membrane that surrounds the heart) following COVID-19 vaccination is a rare condition that can affect adolescents and young adults. Myopericarditis is a treatable condition from which affected individuals recover. At least one vaccine dose has been given to millions of children aged 5 years and older in the US, and as of January 2022 there have been only 11 verified cases of myocarditis in 5-11 year olds, and all patients have recovered or are recovering. Myopericarditis is extremely rare after COVID-19 vaccination and occurs in 1-2 of 100,000 vaccine recipients. The risk of an adverse health outcome from having a COVID-19 infection is 5,000-10,000 times higher than myopericarditis after COVID-19 vaccination. Therefore, vaccination is by far and away safer than being naturally infected with the virus.

The number of vaccine doses for our youngest children depends on the vaccine product given. Children in this age group need 3 doses of the Pfizer vaccine, or 2 doses of the Moderna vaccine. For children of all ages with select immune deficiencies, additional doses may be required as part of the primary series to achieve adequate immunity from the vaccines.

Children who have already had COVID-19 will have some immunity for a period of time, but we are not sure for how long. We also know that the newest variant of concern, Omicron, can easily cause infection in a child or adult who previously had COVID-19, and vaccination has been shown to be the most effective way to prevent severe disease from Omicron infection. Once your child is out of isolation and has recovered from COVID-19, it is safe for them to be vaccinated. Being vaccinated after having COVID-19 provides optimal immunity against future infections.

The annual flu shot is currently recommended for everyone – children and adults. It is important to get both your COVID-19 vaccine and flu vaccine every year, and it is safe to receive both at the same time. The COVID-19 vaccine can also be given at the same time as other routine pediatric vaccines that your children receive at their well child visits.

Vaccinating children is an essential step that we need to take as a community and as a population. This will help reduce the likelihood that novel variants will continue to emerge and will also reduce overall spread of COVID-19 in the community.

Yes, your child should be vaccinated even if they are completely healthy. Negative impacts from an acute COVID-19 infection as well as suffering from long COVID-19 infection can be worse than side effects of the vaccine.

These children may have additional risk of becoming ill from COVID-19 and should certainly be vaccinated.

Myopericarditis after COVID-19 vaccination is treatable and patients with this condition fully recover. The risk of cardiac injury and MIS-C are much higher with natural COVID-19 infection than from the vaccine. Because of these facts, expert recommendation is for those who have had vaccine-associated myopericarditis to complete their COVID-19 vaccine series and receive their boosters as soon as they are eligible. Our pediatric cardiologists and infectious diseases specialists are available to have a discussion on the risks and benefits of further COVID-19 vaccination in those who have been diagnosed with post-vaccine myopericarditis.

The definite cause of MIS-C is still unknown. Vaccination against COVID-19 is very effective at preventing MIS-C from occurring in a child or teenager. The risk of developing MIS-C is astronomically much higher after having a natural COVID-19 infection. Therefore, we recommend that approximately 3 months after a child has recovered from MIS-C (and they are no longer receiving steroid therapy) they should be vaccinated or receive their boosters against COVID-19.

Yes! Children in this age group can now receive their booster if it has been at least 5 months since they completed their primary series of the COVID-19 vaccine.

Boosters have now been authorized for this age group and are strongly recommended. If it has been 5 months or more since your child completed their initial COVID-19 vaccine series, we strongly encourage them to receive their booster.

For more information, visit: Vaccine Information Center | COVID-19 | Spectrum Health