Articles and Updates from Phoenix Children's
This article was last updated on August 30, 2022
We understand that all parents want the best for their children. Many parents have questions about the COVID-19 vaccine. We spoke to the pediatric infectious diseases team at Phoenix Children’s to answer parents’ most common questions.
Q: What COVID-19 vaccine is available for children?
A: The U.S. Food and Drug Administration (FDA) has granted an emergency use authorization (EUA) for both the Pfizer-BioNTech and Moderna COVID-19 vaccines for children ages 6 months and older. Pfizer's vaccine has full FDA approval for those age 12 and older. The Moderna COVID-19 vaccine has full FDA approval for those 18 and older. The Johnson and Johnson/Janssen COVID-19 vaccine is available under EUA for individuals 18 years and older for whom other FDA-authorized COVID-19 vaccines are not accessible or clinically appropriate, and to individuals 18 years and older who elect to receive the Johnson and Johnson/Janssen vaccine because they would otherwise not receive a COVID-19 vaccine.
The FDA recently granted emergency use authorization to the Novavax COVID-19 vaccine for adolescents ages 12 to 17. Instead of an mRNA vaccine (Pfizer, Moderna) or a viral vector vaccine (Johnson and Johnson), Novavax is a subunit protein vaccine. It uses the same technology as other vaccines that are already in use such as the hepatitis B vaccine. In most situations, Pfizer-BioNTech, Moderna or Novavax COVID-19 vaccines are recommended over the Johnson and Johnson/Janssen COVID-19 vaccine.
Q: How many COVID-19 vaccines does my child need?
A: For children ages 6 months up to 5 years, Pfizer-BioNTech's three-dose vaccine and Moderna's two-dose vaccine are available. Pfizer's second dose is given 3-8 weeks after the first, and the third dose is given at least 8 weeks after the second. Moderna's two doses are given 4-8 weeks apart.
For kids ages 5 and up, Pfizer’s COVID-19 vaccine is given in two doses administered at least 21 days apart. Moderna’s COVID-19 vaccine for this age group is given in two doses that are administered at least 28 days apart. The Centers for Disease Control and Prevention (CDC) has recommended that moderately or severely immunocompromised 5-11-year-olds receive a third dose of their Pfizer vaccine at least 28 days after their second dose.
Q: Do children need booster shots for the COVID-19 vaccine?
A: The CDC recommends anyone age 5 years and older should receive a booster dose at least 5 months after their initial vaccination series.
In addition, the CDC recommends those 12 and older who are immunocompromised and those 50 and older should receive a second booster dose at least 4 months after their first.
Q: Is the COVID-19 vaccine safe for kids?
A: Billions of people worldwide have been safely vaccinated against COVID-19, and clinical trials in children have been going on for months. The data shows the vaccine is safe and effective.
Q: Is this the same COVID-19 vaccine as the one given to adults?
A: For both the Pfizer and Moderna vaccines, the dose for young children is smaller than the dose used for older age groups. That’s because children are not little adults - their bodies work differently. Even with a smaller dose, the vaccine still offers younger children protection against COVID-19. Children have physiological differences that affect their susceptibility to disease and immune response to health interventions.
The Pfizer vaccine for children ages 5-11 requires two injections of 10 micrograms given 21 days apart.
The Pfizer-BioNTech COVID-19 vaccine for children ages 6 months to 5 years is given in three rounds of 3 microgram doses each, one-tenth the dosage given to adults.
Moderna's COVID-19 vaccine for children ages 6 months to 5 years is given in two rounds of 25 microgram doses each, a quarter of the dosage given to adults.
Both the Pfizer and Moderna vaccine studies in young children showed that at the end of the vaccine series, the children in the vaccine group were able to make antibody levels that were equal or higher than the antibody levels young adults were able to make in response to the vaccine. Those levels were found to correlate with protection against severe disease.
Q: Has this type of vaccine ever been used before?
A: The same mRNA technique used in Pfizer’s COVID-19 vaccine – where the vaccine teaches our bodies how to make a piece of a protein and trigger an immune response – has been studied for decades. mRNA vaccines do not use the live virus that causes COVID-19, and mRNA never enters the nucleus of the cell, where our DNA is kept. The cell breaks down and gets rid of the mRNA soon after it is finished using the instructions.
Q: Children with COVID-19 generally do not get as sick as adults. Why is it important for children to get vaccinated?
A: While most children experience mild symptoms and make a full recovery, some children become very sick with COVID-19. This is especially true of children with complex and chronic health conditions. The American Academy of Pediatrics reports that hospitalizations for children with COVID-19 are increasing nationwide – including healthy children with no pre-existing conditions.
Q: What complications can children experience from COVID-19?
A: COVID-19 is responsible for a host of potential health complications in school-age children. It can trigger multisystem inflammatory syndrome in children, or MIS-C, a rare, but serious, condition in which different parts of the body become inflamed, including the heart, lungs, kidneys, brain, skin, eyes and gastrointestinal organs. MIS-C develops a few weeks after a child is infected with COVID-19, keeping in mind that the patient may have been asymptomatic during infection. In addition, some children are now developing long-COVID, or post-acute sequelae of COVID-19 (PASC). This condition, which can last weeks or months, is characterized by physical and emotional symptoms including extreme fatigue, shortness of breath, "brain fog," difficulty sleeping, unexplained fevers, gastrointestinal symptoms, anxiety and depression. It can be debilitating for children and teens.
Q: Can children get myocarditis from getting the COVID-19 vaccine?
A: Myocarditis, or inflammation of the heart muscle, is an extremely rare side effect that has been reported after vaccination, and one that pales in comparison to contracting COVID-19. Myocarditis from the COVID-19 infection is more common compared to post-vaccination myocarditis. Reports of myocarditis after receiving the COVID-19 vaccine were mostly seen in older teens and young adults, males, following the second dose versus the first dose, and within 4 days of vaccination. Most recovered on their own or with minimal treatment and rest. Clinical trials have shown COVID-19 vaccines are safe and effective in preventing serious illness and death due to COVID-19. Risks from any potential side effects from the vaccine are lower than COVID-19 infection.
Q: What are the long-term effects of the COVID-19 vaccine?
A: COVID-19 is a relatively new virus, and vaccine trials started in the midst of the pandemic. We know that vaccines rarely cause long-term effects. Billions of people around the world have been safely vaccinated against COVID-19, and thousands of children worldwide participated in vaccine trials.
Q: My child already had COVID-19. Do they still need the vaccine?
A: Even children who have already had COVID-19 should receive the vaccine to shore up their immunity for the future.
Q: What are COVID-19 vaccine side effects in children?
A: Common side effects of the COVID-19 vaccine in young children include fever, chills, body aches and fatigue. Similar to adults, these side effects typically last 1-3 days and can be treated with over-the-counter pain relievers. Risks of COVID-19 infection are much higher than the risk of side effects from the vaccine.
Q: Can my child get COVID-19 from getting the COVID-19 vaccine?
A: The vaccine does not use the live virus that causes COVID-19, so no one will contract COVID-19 as a result of getting the vaccine.
Q: What is the link between vaccines and pandemics?
A: Vaccines have the power to stop pandemics. Children make up a significant part of our population and now account for a sizable number of new COVID-19 cases. Ensuring children are vaccinated against COVID-19 is key to stopping the spread of COVID-19 and putting the pandemic behind us.
Q: Can children spread COVID-19?
A: Yes, children with COVID-19 can transmit the virus to another person.
Q: Is it safe to get my child vaccinated at a pharmacy, as opposed to their pediatrician’s office?
A: Yes. Pharmacists are skilled at administering vaccines to people of all ages, and the vaccine is readily available in the community at many pharmacies.
Vaccines are available to existing Phoenix Children's Pediatrics patients. Please contact your Phoenix Children's Pediatrics office if you have any questions or to make an appointment.
Q: If a child has been exposed to COVID-19, how long after can he/she get the vaccine?
A: Once the child is out of the quarantine period (14 days after exposure), and as long as they are asymptomatic, they can get the vaccine. This means a child could receive the vaccine as early as 14 days after exposure.