Got questions about the Covid vaccine for kids? Here’s a helpful FAQ for parents

The Centers for Disease Control and Prevention (CDC) has just approved vaccines for kids 5 to 11 this week, making shots now finally available for this age range—and we know that parents have questions about what that means for their kiddos.

To help you navigate this new landscape, we asked top pediatric experts to share their insight on what you need to know. Of course, if you have more questions, your child’s pediatrician is your best resource.

Q. Is the Covid vaccine safe for kids? 

Yes. Officials from both the FDA and the CDC have rigorously reviewed the data from Pfizer’s clinical trials, and determined the vaccine to be safe and effective for the 5 to 11 age group. 

It’s also worth noting that the dosage of the pediatric vaccine is one-third of the dose of the vaccine for adults. Researchers identified this smaller dose as one that will still confer a powerful immune response while minimizing potential side effects. Even with this smaller dose, the shot is 90.7% effective at preventing Covid symptoms in kids. 

“The data we have thus far indicates that the Pfizer-BioNTech vaccine at the lower dose [10 micrograms] is safe for children ages 5 to 11 and that the benefits of protection from the vaccine outweigh the risk of serious COVID-19 disease and complications [hospitalization, death, long term complications],” says Suellen Hopfer, PhD, CGC, an assistant professor in the department of health, society and behavior, and the department of pediatrics at University of California, Irvine.

Advisory panels for the FDA and the CDC also reviewed the risk of heart inflammation (from a condition called myocarditis) seen in some young male adults after vaccination with the adult dose of mRNA vaccines like Pfizer and Moderna. The condition is extremely rare, and no cases of myocarditis were seen in Pfizer’s pediatric trials. 

“COVID-19 vaccines have undergone—and will continue to undergo—the most intensive safety monitoring in U.S. history,” the CDC said in a media statement announcing the vaccines were approved. 

If you have further questions about vaccine safety, talk to your child’s pediatrician.

Q. I’m feeling hesitant about getting my child vaccinated. Should I wait until more information is available?

“The sooner you can get your child vaccinated the better,” says Preeti Parikh, MD, a pediatrician and medical director at GoodRx. Getting your child vaccinated now is the best way to protect them from Covid. Even though the risk of getting the virus is still relatively low in kids, with vaccination, the chances of your child contracting the virus—and transmitting it to others—drops significantly. 

Early in the pandemic, experts observed that the original strain of the SARS-CoV-2 virus seemed to have little impact on kids. But the more contagious Delta variant that surged this summer changed everything: Cases in kids 5 to 11 skyrocketed, nearing the highest of any age group, and Covid moved into the top 10 causes of mortality for kids in this bracket. 

“[Vaccination] will allow safe return to social activities for children and prevent rare yet serious disease in children,” Dr. Hopfer adds.

Now that kids ages 5 and up are eligible for vaccination, getting more shots in arms as soon as possible is the most effective way to prevent the disease from spreading in all age groups—and to prevent the virus from mutating again.

Q. My kid already had Covid. Should I still get them vaccinated?

Yes. In a study published by the CDC in October 2021, researchers found that Covid vaccines are five times more effective at preventing Covid-related hospitalization than prior infection alone. 

While previous Covid infection can provide some immunity to future infections, the more we learn about antibody protection from a prior Covid infection, the more the research points to the importance of vaccination, even if you’ve already had the virus.

Both the American Academy of Pediatrics (AAP) and the CDC recommend vaccination for kids who have previously been infected.

Adding to that, a study released in November 2021 by Johns Hopkins found that those who received two doses of the vaccine after being infected by the virus had higher and longer-lasting antibody levels than those who were vaccinated but not infected. Getting the shot after having Covid seems to be even more protective against future infections.

Q. What are the side effects from the vaccine for kids ages 5 to 11?

Some parents are worried about potential side effects from the vaccine. The most common ones seen in the 2,268 children observed in the Pfizer trials were mild, such as fatigue, arm pain and headaches. 

As for the several myths that keep making the rounds regarding long-term effects on fertility? Experts have dispelled all of them. The risks for unvaccinated children who get the virus, however, are very real and much more grim.

For one, a serious complication called MIS-C (an inflammatory syndrome that affects multiple organs) has been observed in more than 5,200 kids who got Covid since the start of the pandemic. 

And while kids typically don’t get as severe disease as adults, they are most definitely not immune. At this point, 172 children have died of Covid-related causes in the 5 to 11 age group.

“We also don’t know the long term effects of COVID-19 in children, since some have experienced long haul effects. There has also been a tremendous mental health toll on children during the pandemic and the quicker we get them vaccinated, the faster they can get back to a more normal life,” adds Dr. Parikh. Last month, the AAP declared a national emergency in children’s mental health due to the effects of the pandemic. 

While no vaccine is 100% effective nor completely without side effects, both the Food and Drug Administration (FDA) and CDC advisory panels overwhelmingly ruled that vaccine benefits outweigh the possible risk of vaccine side effects for this age group. 

Q. What do we know about the risks of getting myocarditis from the vaccine?

We know from clinical trial data that there were no signs of heart inflammation observed. There is still a very low risk of myocarditis from mRNA vaccines, which does give pause, says Dr. Hopfer. But it’s worth highlighting the fact that myocarditis may resolve on its own even without treatment. 

“Among the young adult males who experienced myocarditis [in the older age groups], though scary, the heart inflammation resolved within one week,” Dr. Hopfer notes. It does not seem to cause lasting harm.

In actuality, the risk of getting myocarditis from Covid is much greater than from a side effect of the vaccine, adds Dr. Parikh. The virus can infect the cardiac muscle and weaken the heart and surrounding blood vessels.

One study estimated that for every 100,000 vaccinated adolescent males, there are roughly 11 cases of myocarditis. Because the risk is so low, we’d need vaccine trial participants in the hundred-thousands to determine the real prevalence of myocarditis after vaccination. 

In contrast, the risk of myocarditis after Covid infection is 37 times higher for children under 16 compared to uninfected children of the same age. If you’re worried about heart inflammation, Covid is the much bigger risk.

“The signs and possibility of myocarditis should be discussed with families, [and] parents can be on the lookout for symptoms should any arise and promptly take children to a medical visit,” says Dr. Hopfer. “Again, however, no serious side effects were observed in the 2,268 children in the [Pfizer] clinical trial.” 

Potential signs and symptoms of myocarditis (inflammation of the heart muscle) or pericarditis (inflammation of the lining outside the heart):

• Chest pain
• Shortness of breath
• Heart palpitations

If your child experiences any of the above after receiving an mRNA vaccination, call your child’s doctor.

Q. How was a safe and effective vaccine made available so quickly?

Because the vaccines were released relatively soon after the pandemic hit, some were skeptical that safety was sacrificed for speed. But the technology used in the mRNA vaccines has been in development for nearly two decades, which allowed vaccine makers to apply that same knowledge to the Covid vaccine at the outset. 

“The mRNA vaccines were made following routine protocols, and they did not skip any steps,” assures Dr. Hopfer. “This background research on mRNA vaccines, together with collaboration among scientists and financing across the world, allowed for the rapid entry into the vaccine development process and subsequent steps to have a vaccine available to the public when it did.”

Q. Are the vaccines linked to infertility in boys or girls?

No. “This is a false rumor that has been circulated across communities,” says Dr. Hopfer. There never has been any link between any vaccine, including the mRNA vaccine, and infertility. 

“Both the Pfizer-BioNtech and Moderna vaccines are not live virus vaccines. They do not enter the nucleus and cannot cause any genetic changes,” ACOG’s Vice President Dr. Christopher Zahn, MD, told Motherly.

The mRNA vaccines use messenger RNA to help your body’s immune system defend against the virus. The vaccines instruct your cells to create a protein that’s part of the SARS-CoV-2 coronavirus, which helps your body recognize and ward off the virus if you come into contact with it, but they don’t have access to your DNA, which resides in the nucleus of the cell. The mRNA breaks down after it tells the cells to make the proteins to stimulate an immune response. 

Your DNA remains unaffected—which means there’s no way that the vaccines could have an effect on fertility later in life.

 Q. I have an 11-year-old who will turn 12 soon. Should I sign them up for the pediatric dose or the adult dose?

The AAP has shared guidance on this situation, stating that 11-year olds should get the lower dose Pfizer vaccine recommended for 11-year-olds, and it’s OK if their second dose happens after they turn 12. Because the vaccine dosages are based on age rather than size or weight, getting your child the dose that matches their age group is the best course of action. 

And because the lower dose vaccine was found to be nearly 91% effective at preventing symptomatic disease, you can rest assured it will elicit a strong immune response. 

Q. Should my child get both a flu shot and a Covid shot? How should these be timed?

Yes. Both The AAP and CDC recommend kids get both the flu and Covid vaccine as soon as possible this year in order to prevent a potential twindemic of flu and Covid. “​​We cannot forget how important it is to protect our kids not just from COVID-19, but all diseases,” notes Dr. Parikh. 

As the weather gets colder and people spend more time indoors, respiratory viruses like flu and Covid can spread more easily. It’s not necessary to space out flu and Covid vaccinations, but you may choose to separate them by a week if you wish, says Dr. Hopfer. The AAP recommends that the Covid vaccine should simply be given in a different injection site if given at the same time as other routine vaccines.

Q. How can I help my child who’s afraid of getting the vaccine?

Quell any fears by being honest about what they can expect from the experience, including a slight pain when the needle goes in and possibly some arm soreness after. But also be sure to celebrate the occasion as a milestone, says Stuart Lustig, MD, National Medical Director for Behavioral Health for Cigna. 

“Just like it was for adults, making the COVID-19 vaccine available for children is a big deal. While the celebration doesn’t need to be elaborate, one way to help them overcome any fears is to plan to do something special after receiving the shot. Maybe it’s a favorite meal, family activity or even planning a vacation that you’ve been unable to take because of the pandemic,” notes Dr. Lustig.

The Covid vaccine will be administered in the upper arm, the same way many other routine childhood vaccinations are given, including flu shots. If your child gets extra anxious about needles, a small device such as the Shotblocker or Buzzy Bee can help ease pain.

St. Jude’s Children’s Hospital also released a free printable coloring book in which kids can color in pictures of the virus, vaccine and healthcare workers to get them more comfortable with the concept. 

Q. Where can I get a Covid vaccine for my kid? 

Now that the Pfizer vaccine is authorized for children, you can book a vaccine appointment online at a local pharmacy starting Nov. 3, or call your child’s pediatrician to see when shots may be available at their office or other health clinic. Look to your state’s health department for more guidelines on how to access a vaccine for your child, or try the GoodRx Vaccine Guide, which aggregates data from the CDC and other partners to help locate appointments across the country.

Q. Will my child eventually need a Covid booster?

It’s likely that, yes, your child will eventually need a Covid booster, but this depends on many different factors, including long-term vaccine effectiveness, community transmission rates and vaccine uptake numbers. We don’t have data or a timeline on boosters for kids yet, but more information is sure to come to light in the following months (and years). 

Q. When will shots be available for kids under 5?

While we don’t have a specific timeline, Dr. Anthony Fauci told Motherly that he thinks shots will be available for kids between the ages of 2 and 5 before the end of the year. Hopefully, kids ages 6 months to 2 years should be eligible for vaccination in the first quarter of 2022. 

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