Pediatric COVID-19 vaccine FAQs

Questions and answers with Dr. Rosemary Olivero

Pediatric infectious disease physician at Helen DeVos Children’s Hospital

Rosemary Olivero, M.D., pediatric infectious disease specialist at Helen DeVos Children’s Hospital, answers frequently asked questions about the COVID-19 Vaccine and children.

COVID-19 vaccine for children questions and answers

Updated January 13, 2022

What is your reaction to the evolving authorizations and recommendations for Pfizer vaccines for children?
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The updated guidance and authorizations for vaccines and boosters in children are very timely. Omicron has caused astronomical caseloads of COVID-19. COVID-19 remains a significant health issue for school-aged children. Again and again, vaccination has proven to be the safest way to protect children from COVID-19.

Many say COVID-19 has had minimal impact on children. Is it important for children to be vaccinated?
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While children have a lower risk of hospitalization for severe COVID-19 than adults, it’s not benign for all children either. Nationally, children have had a 1.7-4.1% hospitalization rate in children, and locally 2% of children who contract COVID-19 get hospitalized. 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 moving past this pandemic.
What is the difference in the vaccine dose for children?
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The only vaccine currently authorized for children is the Pfizer vaccine. This vaccine is available for children aged 5 years and older. The dose authorized is different between children aged 5-11 years and those 12 years of age and older. Children aged 5-11 years receive one-third of the dose given to those 12 years of age of older.

Are there any concerns about the safety of this vaccine for children?
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The data from Pfizer 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, especially those aged 5-11 years. We continue to diligently monitor for safety signals as the vaccine is provided to more children.

What side effects have we seen in children who receive the vaccine?
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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.

Is myopericarditis a concern after COVID-19 vaccination?
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Myopericarditis is a very rare condition that can affect children and young adults after vaccination. It is a treatable condition from which children recover. At least one vaccine dose has given to almost 8 million children aged 5-11 years in the US, and as of January 2022 there have been only 11 verified cases of myocarditis in this age group, 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.
Do kids aged 5-11 years need two vaccine doses as well?
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Children 5-11 years of age require 2 doses of the Pfizer vaccine to complete their initial series, similar to children 12 years of age and older. For children 5-11 years of age with select immune deficiencies, a 3rd dose is required to achieve adequate immunity from the vaccines.

If my child has had COVID-19, do they still need the vaccine?
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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.

Can children get the flu shot and COVID-19 vaccine at the same time?
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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 this year, and it is safe to receive both at the same time.

How does flu and COVID-19 appear similarly or differently?
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It is very difficult to differentiate between cold, flu or COVID-19. All can have mild symptoms or present like cold or flu. If you have any concerns about a respiratory illness in your child, we strongly recommending having your child tested for COVID-19.

How important is it that children receive this vaccine?
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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.

My child is completely healthy, should I give them the vaccine?
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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.

My child has a chronic medical condition like asthma or diabetes – should they get the vaccine?
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These children may have additional risk of becoming ill from COVID-19 and should certainly be vaccinated.

If my child had myopericarditis following COVID-19 vaccination, should they get a booster?
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Myopericarditis following 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.
What if my child has a history of MIS-C?
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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.

Are boosters available for children 5-11 years of age?
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At this point in time, boosters for this age group are not yet approved. This may occur in the future as further research is done and the pandemic continues to evolve.

Are boosters available for children 12 years of age and older?
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Boosters have now been approved 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

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