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COVID-19 vaccines for kids between the ages of 6 months and 5 years have been recommended by the Centers for Disease Control and Prevention.
Vaccinating our kids under 5 years old will protect some 18 million children.
A Swedish pediatric infectious disease expert has answers to your questions.
Update: On Dec. 8, 2022, the U.S. Food and Drug Administration authorized the updated or bivalent Moderna and Pfizer-BioNTech COVID-19 vaccines for children as young as 6 months of age. For more information check with your pediatrician or primary care provider.
On June 18, the Centers for Disease Control and Prevention (CDC) unanimously recommended the Pfizer-BioNTech vaccine for children ages 6 months through 4 years, as well as the Moderna vaccine for children ages 6 months through 5 years. The approval followed the U.S. Food and Drug Administration’s (FDA) amendment of both vaccine makers' emergency use authorizations to include the youngest age group. On June 19, the Western States Scientific Safety Review Workgroup announced completion of its review and unanimously concluded that the Pfizer-BioNTech and Moderna vaccines are safe for children as young as 6 months old. And on October 12, the FDA and CDC authorized updated bivalent COVID-19 boosters for children as young as 5 years old.
These changes give some 18 million children protection against coronavirus and ensure that everyone in the United States over the age of 6 months old is eligible for a vaccination against COVID-19.
We understand that additional questions come with this new information. To help you make the most educated decision possible for your family, we spoke with Frank Bell, M.D., a pediatric infectious disease specialist here at Swedish and board member of the Washington chapter of the American Academy of Pediatrics to answer some important questions about the CDC’s new guidance for kids and the COVID-19 vaccine.
Should I vaccinate my young child?
Yes, most pediatricians strongly support COVID immunization for children aged 6 months to 5 years. Younger children have been significantly affected by the COVID pandemic and there is no question for me that the benefits of vaccination far outweigh the risks of getting COVID for children in this age group.
How sick can my baby or toddler get from COVID?
We saw a large number of younger children admitted to the hospital with COVID-19 across the country during the Omicron surge last winter. Many required admission to the intensive care unit, and some young children have died from COVID infection.
If younger kids don’t get as sick as adults, why should I get my child vaccinated?
Vaccination protects your child and helps to protect our community. Being vaccinated against COVID-19 prevents illness and hospitalization, and protects against the complications of COVID-19, including the multisystem inflammatory syndrome MIS-C and protracted recovery, or "long COVID." Although it's true that younger children don't typically get as sick as adults with COVID-19, young children still benefit directly from the protection that vaccines provide.
Will my 5-year-old or toddler receive the same dose as an adult or older child?
No, the vaccine dosing is different for each age group. For the Pfizer-BioNTech vaccine, the dose for children up to 4 years is 3 micrograms (mcg) compared with 10 mcg for 5- to 11-year-olds and 30 mcg for those aged 12 years and older. For the Moderna vaccine, children aged 5 years and under get 25 mcg per dose compared with 50 mcg for 6- to 17-year-olds and 100 mcg for those 18 and older.
What are some potential side effects for babies and young children? Are they more serious for younger kids?
Side effects following immunization appear to be similar in infants and preschool-age children when compared with older children. Most side effects were noted in the day or two after immunization and lasted 1-2 days, the most commonly noted side effects were fussiness in infants and tiredness or fatigue in older children. Fever was noted infrequently, and no serious side effects were seen in the clinical trials for either vaccine.
Is there a difference between the Pfizer-BioNTech vaccine and the Moderna vaccine for kids?
The main difference is that the Pfizer vaccine requires three doses for younger children, whereas, at present, the recommendation for the Moderna vaccine is just two doses. It's important to be sure that your young child receives the full primary series. Both vaccines provide important protection against COVID-19, with a similar side effect profile.
Will my little kids need boosters after receiving these vaccinations?
It's probably too early to know for sure but given our experience so far with COVID-19, it seems likely that the virus will continue to evolve and that younger children, just like their older counterparts will need a later booster dose for continued protection against COVID-19. We will learn more as we get into the fall and winter about the need for and the type of booster for infants and preschool-age children. For now, our focus should be on getting these younger children their first doses of much-needed protection.
My child is also due for regularly scheduled vaccinations, such as their MMR; can they be given together?
Talk with your child’s provider about what other vaccines are needed and explore your preferences together. Many preschoolers have gotten behind with vaccines over the COVID pandemic, and it makes sense to try to catch up where vaccines are overdue. There is no reason why other vaccines that are also due should not be given together with the COVID-19 vaccine at any age, but for families who have been able to keep mostly up to date, it is also reasonable to schedule a visit to return to the clinic for other needed vaccines.
My child already had COVID. Should they get vaccinated?
Yes, children who have already had COVID-19 should also be immunized. There is a degree of short-term protection from having already had COVID-19, but this protection is not reliable in preventing reinfection, and it appears that individuals of all ages are better protected by "hybrid immunity," i.e., a mix of protection following infection and the completion of a COVID-19 vaccine series.
Where can I find the vaccine for my child?
Swedish Medical Group patients may schedule an appointment at one of our vaccine clinics through their primary care provider. If you're unable to schedule an appointment with us, we encourage you to visit our partnership with the City of Seattle at www.seattle.gov/vaccine. You can also find vaccine appointments at the Washington State Department of Health's vaccine locator. School districts should also be sharing vaccine clinic information with students and parents. Visit your local school district website for more information.
Call your child’s regular health care provider to see if they are offering COVID-19 vaccines for younger children as there are advantages in coordinating all-round care, particularly for younger preschool-age children who benefit from other assessments including screening for health-related conditions. In these first few weeks after FDA authorization COVID-19 vaccine shipments from the federal government for children 6 months through 5 years may be somewhat delayed.
If your own pediatric provider does not have vaccines available, you may search on the King County website, or alternatively, check with your local pharmacy, as they may be offering the vaccine to younger children. In the weeks to come, the state's vaccine locator will allow you to search specifically for sites administering vaccines to children under 5 years of age.
Vaccine availability for younger children is likely to become easier in the coming weeks as vaccine distribution is finalized. You will likely need to make an appointment for your child ahead of time. It may be advisable to check with the clinic to make sure that they are able to administer vaccines for preschool-age children. You can call the state COVID hotline at 1(800) 525-0127 for help with scheduling an appointment for your child.
You should also consider signing your child up for "v-safe" at https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/vsafe.html, a free app from the CDC that provides a personalized and convenient health check-in after immunization. That way, you can then be an important part of the monitoring of vaccine safety for all age groups.
Find a doctor
If you have questions about COVID-19 vaccination for your child, contact Pediatric services at Swedish. We can accommodate both in-person and virtual visits.
Whether you require an in-person visit or want to consult a doctor virtually, you have options. Swedish Virtual Care connects you face-to-face with a nurse practitioner who can review your symptoms, provide instruction and follow up as needed. If you need to find a doctor, you can use our provider directory.
Join our Patient and Family Advisory Council.
Questions about the COVID vaccine for kids? Swedish has some answers for you.
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This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.