Parenting·7 min read

The CDC Endorsed COVID-19 Vaccines for Kids Under Five: What You Need to Know

Doctor gives child under five vaccination.
Camille Rapay
Jun 15, 2022

COVID-19 vaccines for kids under 5 were endorsed by the CDC on June 18. But data gathered a month later showed only 2.8% of kids 6 months to 5 years old had received at least one dose of the vaccine. A recent Kaiser Family Foundation survey found that 43% of parents with kids under 5 said they would “definitely not” have them vaccinated. Still — health experts hope vaccination rates for the roughly 20 million babies, toddlers, and preschoolers will pick up, especially as many of them head back to daycare or school. 

Also potentially happening in the fall — new boosters for adults. Pfizer and Moderna are working on updated vaccines that would be more effective against the Omicron subvariant BA.5. (FYI: It wins the award for most contagious version of the virus we’ve seen). The FDA and CDC will have to sign off on the new shots before they can be distributed. But in the meantime, parents may be wondering…

Should I wait to get my kid under 5 vaccinated until the shots are updated to fight the latest variant?

No. 

“The most important thing is to get vaccinated as soon as possible if you’re 6 months of age and older,” said Patsy Stinchfield, a pediatric nurse practitioner in infectious disease at Children’s Minnesota and president of the National Foundation for Infectious Disease. “This could change, but what we’re hearing is that [the updated vaccines] coming in the fall will be considered boosters by the FDA, which means you won't be able to get it unless you've already had your primary series, which is what's out right now.”

How long will it take for the updated vaccines created for adults to be available for kids under 5? 

No one knows for sure. Pfizer and Moderna promised to have the new boosters ready in September. Stinchfield said if the process goes smoothly, they could be available to kids later in the fall (maybe in October). But she said several things have to happen before then. 

“First, we have to have the data. Is it safe? Does it work? Does it build immune antibodies? Does it protect against disease, or severe disease, or hospitalization? Number two, you need to have the approval process [from the FDA and CDC]. And the third thing is — the manufacturers for children have to have that age-specific formulation.”

How do the current COVID-19 vaccines for young kids compare to the COVID-19 vaccines given to adults?

Both the Pfizer and Moderna vaccines are the same versions as the adult vaccines. Just in smaller doses. Experts said they were effective against severe illness and death.

What do I need to know about the Pfizer COVID-19 vaccine for kids?

It's for kids 6 months through 5 years old. It includes three doses, and each dose is 3 micrograms (about one-tenth of what adults get). The first two shots are three weeks apart. And the third shot is at least eight weeks after the second.

In its trial, the Pfizer vaccine was 80% effective in preventing symptomatic COVID-19 after the third dose. But the FDA said they don’t have enough data to reach “definitive conclusions” on the vaccine’s effectiveness after three doses. Thing to know: It's only 28% effective after two doses.

What do I need to know about the Moderna COVID-19 vaccine for kids?

It’s for kids 6 months through 6 years old. It includes two shots four weeks apart. Each shot is one-fourth of what adults get. 

Moderna’s two-dose series was 51% effective in preventing symptomatic infection in kids 6 months to 2 years old. And 37% effective for kids 2 through 5.

What's the difference between the Pfizer and Moderna shots?

Dr. Tina Tan is a professor of pediatrics at Northwestern’s Feinberg School of Medicine and a pediatric infectious disease physician at Ann & Robert H. Lurie Children's Hospital of Chicago. 

She said it’s hard to compare the vaccines and their effectiveness because the shots were tested at different times when different variants were circulating. And the results were reported in different ways.

“The major thing to look at is that you want these vaccines to be able to prevent serious disease so that kids are not hospitalized and they don’t die from it. Both of these vaccines are able to do that. They're not apples to apples, oranges to oranges. They’re completely different. So you can’t compare the numbers that way."

Dr. Tan said you can’t go wrong with either shot. But in order to get complete protection, you have to get the complete series. That means three shots for Pfizer and two for Moderna.

“For the Pfizer vaccine, you're going to have to get all three doses because we know that after two doses they really don’t have adequate protection. Parents need to think about whether they are going to be able to stick to that three-dose regimen,” she said. 

“The bottom line is you can’t make the wrong decision. I think that either choice is fantastic. I would be happy with either choice as a parent of two little ones," said Katelyn Jetelina, an epidemiologist and adjunct professor at the University of Texas. 

What are the side effects of the COVID-19 vaccines for kids?

Side effects for both were minimal. Some include irritability, drowsiness, and pain at the injection site. Some kids in the trial got fevers. But they weren’t severe. 

“We know that the side effects that we’re seeing in the under-5 population were less than what was seen in older children, adolescents, and adults,” said Dr. Tan. “Probably the most common side effect — which is true with a lot of vaccines — is fever.”

What if I'm hesitant to get my kid vaccinated?

Some parents are weighing the newness of the shot against the risk from the virus. But experts recommend all kids get vaccinated.

“I understand the concern. But there are just so many systems in place and our knowledge has evolved so much since we started working on mRNA vaccines, that personally I’m not concerned,” said Jetelina.

“It is worse to get the coronavirus disease naturally and risk the complications that are associated with the disease, compared to getting the vaccine,” said Dr. Tan. 

The CDC estimates three in four kids have had coronavirus infections. But experts said those kids should still get vaccinated because immunity from the virus wanes over time. 

“If kids were only infected by Omicron, we’re seeing in the evidence that it doesn’t protect against other variants of concern,” said Jetelina.

Thing to know: While only about 3% of COVID-19 cases in the US to date were in kids 6 months to 4 years old, hospitalization and death rates in that group are higher than those for older children. And CDC experts say COVID-19 is the fifth leading cause of death for children ages 1 to 4.

Where can my kid get a COVID-19 vaccine?

The CDC recommends you reach out to your pediatrician or local pharmacy. And vaccines.gov is another place you can check for vaccine availability. The White House has already taken advance orders from states for 10 million doses and is prioritizing getting shots to pediatricians and PCP providers, given the age group. But they’ll also send orders to health clinics, hospitals, and pharmacies.

If my child is about to turn 5, should I get them vaccinated right away with the lower dose Pfizer vaccine or wait until they’re 5 so they can get the more potent version?

The dosage that’s recommended for kids is based on their age on the day they get the shot. So it’s OK if they’re given different doses if they have a birthday between shots. 

For example, Dr. Tan explained: “Say your child was 11 when they got the first dose of the Pfizer vaccine, and they turn 12 before they get the second dose. Well, the second dose should be the 12-year-old dose, which is the adult dose.” 

“The way that a dose of a vaccine is chosen is based upon how much of an immune response you can generate with the smallest amount of antigen, [a substance that stokes an immune response], while causing the fewest side effects. And all of that is based on age,” she said

Can my child get the COVID-19 vaccine and other vaccines on the same day?

Yes. “A child can receive COVID-19 vaccine and other vaccines on the same day with no interference in the development of immunity to any of the vaccines,” said Dr. Tan.

theSkimm

Vaccine experts, the FDA, and the CDC have said vaccines for kids under 5 are effective and safe. But data shows parents have been hesitant to get their kids the shots. Experts say even with plans of an updated booster for adults, parents should get their kids vaccinated ASAP. If you have questions, reach out to your pediatrician. And reminder: vaccines.gov is the place where you can check for vaccine availability and appointments.

Updated on Aug. 3 to include the latest on new booster shots for adults.

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