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Pediatric Expert Answers 10 Top Questions about COVID-19 Vaccines

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young child waiting to receive the COVID-19 vaccine

The Federal Food and Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC) have approved the COVID-19 vaccine for most children. Any child 6 months or older can now get vaccinated. Stephen Rinderknecht, pediatrician and chair of the UnityPoint Clinic vaccine committee, answers common questions, so you feel confident getting your child vaccinated.

What is the Dose Difference for Kids?

As of June 2022, both Moderna and Pfizer have mRNA products approved for Emergency Use Authorization (EUA) by the FDA and CDC. The dosing and number of shots are different.

Pfizer

  • 6 months through 4 years old is 1/10 the adult dose (3 shots for initial series)
  • 5-11 years old is 1/3 the adult dose (2 shots for initial series)

Moderna

  • 6 months to 5 years old is 1/4 the adult dose (2 shots for initial series)
  • 6-11 years old is 1/2 the adult dose (2 shots for initial series)

“The dose amounts were chosen due to studies that showed it was most effective and safe. We already know there's a booster shot for the Pfizer product for ages 5-11, which isn't surprising. We have a lot of childhood vaccines that require a booster – hepatitis A, hepatitis B, MMR (measles, mumps, rubella) and varicella (chickenpox),” Dr. Rinderknecht says.

Which Kids Should Get the COVID-19 Vaccine?

Both Pfizer and Moderna have vaccines that are now recommended for all kids 6 months and older. Some high-risk children would benefit more, such as those with obesity or asthma. 

"Anyone who's eligible should get vaccinated. The COVID-19 vaccine means your child will be much less likely to get the virus, but it’ll also mean they’ll be less likely to spread it to others who might be high risk. That’s an important thing to remember,” Dr. Rinderknecht says.

Talk to your child's doctor to understand vaccine scheduling options near you.

What are COVID-19 Vaccine Side Effects in Children?

In clinical trials, young kids had the same local side effects as older children and adults, including arm soreness, redness and swelling at the injection site. However, kids experienced fewer systemic side effects of fever, headache and muscle aches. Dr. Rinderknecht says if side effects do happen, they’re predictable. They’ll happen within a day or two and then they’re gone within a day or two.

The COVID-19 Vaccine Does Not Impact Fertility in Children

While it’s understandable for parents and caregivers to ask about how the COVID-19 vaccine will impact a child’s future – the truth is it only protects their future.

“There is no evidence any vaccine, including COVID-19 vaccines, cause fertility side effects. It’s misinformation someone spread to make people feel uneasy. Furthermore, plenty of adults who’ve received the vaccine have gone on to become pregnant,” Dr. Rinderknecht says.

Will Younger Kids Experience Heart Side Effects after the COVID-19 Vaccine?

The CDC is actively monitoring cases of myocarditis from the mRNA COVID-19 vaccines (Pfizer and Moderna). Myocarditis is the inflammation of the heart muscle. So far, cases are more common in male adolescents and young adults. Usually, people respond well to treatment, medication and rest.

“So far, there haven't been any cases of pericarditis or myocarditis during both Moderna and Pfizer vaccine trials. Researchers will continue to watch for that as the vaccine becomes more broadly used in younger age groups. We do know, the virus itself causes myocarditis much more frequently than is anticipated with the vaccine,” Dr. Rinderknecht says.

What about the Chance of Long-Term Effects from the COVID-19 Vaccine?

“There has never been a vaccine that has caused a side effect attributed to the vaccine after about four to six weeks post-vaccination. It’s never happened, which makes sense. When you get a vaccine, that vaccine doesn’t stay in your system. It does its thing and is gone. You’re not going to have problems months later. That’s different than a medication you’re taking long-term. That can have long-term side effects because you’re still on it,” Dr. Rinderknecht says.

Why Vaccinate Kids When They Usually Do OK with the COVID-19 Virus?

While the disease isn’t often very severe in kids, they can and do get very sick. For example, multi-system inflammatory disease was first identified in children following a COVID-19 diagnosis. There are also about 300 kids a day in the U.S. who get admitted to the hospital with COVID.

Remember, as the COVID-19 pandemic continues, your best shot at keeping your child healthy is getting eligible children the COVID-19 vaccine, encouraging masking as recommended by the CDC and keeping kids home when they’re feeling sick.

How Should I Talk to My Young Child about the COVID-19 Vaccine?

Be honest with your kids and tell them how this vaccine can keep them healthy and prevent disease. 

“Talk to them realistically about what side effects to expect. We know what to expect with the vaccine now. What’s harder to know is what to expect after the disease because responses can be much more varied. I’d be realistic by explaining they might feel a little under the weather and might be a little sore, but it’ll pass quickly, and they’ll be better protected for it,” Dr. Rinderknecht says.

Is the COVID-19 Vaccine Safe for Kids?

“We’ve given hundreds of millions of doses in this country. The systems in place for monitoring safety are working. We know some of the very rare things that can happen from this vaccine. And, with what we know, this is one of the safest vaccines we have available,” Dr. Rinderknecht says.

What Happened to Kids in COVID-19 Vaccine Studies?

“The original Pfizer clinical study gave the vaccine to greater than 4,000 kids in this age group. While that doesn’t seem like a huge number, knowing how many vaccines have been given to older kids, who are just a bit older, it’s reassuring to know the side effects weren’t any different and efficacy is high,” Dr. Rinderknecht says.

You can see all the FDA data from the studies. You can also look at the CDC summary of that data to save you some time.

Should I Get My Child Vaccinated if They’ve Already Had COVID-19?

It’s still everyone’s best bet to get vaccinated, even if you’ve already had the COVID-19 virus.

“The immunity that develops after being diagnosed with COVID-19 is very unpredictable. Some people with severe disease could have protection for months, maybe years. If you get mild disease (recovering at home) or asymptomatic disease (without symptoms) immunity isn’t very robust. Vaccination offers better immunity, broader spectrum and more consistency.”

In fact, studies show about two and a half times more breakthrough infections after disease than what’s being seen after getting the vaccine.