The FDA authorized Pfizer-BioNTech’s and Moderna’s COVID-19 vaccine for children aged 6 months to 4 years, and experts for the CDC unanimously approved the use of both vaccines – a moment that parents, pediatricians and health leaders are celebrating. 

Connecticut Children’s Physician-in-Chief, Juan Salazar, MD, MPH, and Medical Director of Infection Control, John Schreiber, MD, MPH, answer common questions from families.

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Is the COVID-19 vaccine safe for my infant or toddler? 

Yes, it’s safe. Safety experts from the CDC and FDA have carefully reviewed months of clinical trial data and found that the vaccine is safe and effective for this age group.  

> Related: How to Prepare Younger Kids for the COVID-19 Vaccine

Which COVID-19 vaccine can kids get and is the dosage different for younger ones?

All children ages 6 months to 17 years can receive either the Pfizer-BioNTech vaccine or the Moderna vaccine. While they are the same, exact vaccines made with the same, exact mRNA technology that is used in older children and adults, the dose is different depending on the specific age range.

Pfizer dosing for children

  • Children 6 months-4 years: Just three micrograms per shot, given in two shots, spaced three weeks apart, then: 
    • A third dose of Pfizer is required two months after the second dose for children 6 months to 4 years 
  • Children 5-11 years: Just 10 micrograms per shot, a third of the dosage for adolescents and adults. The vaccine is also given in two shots, spaced three weeks apart. 
  • Children 12-17 years: 30 micrograms per shot, the same dosage for adults. As with adults, the vaccine is given in two shots, spaced three weeks apart. 

Moderna dosing for children

  • Children 6 months-6 years: Just 25 micrograms per shot, given in two shots, spaced one month apart.  
  • Children 6-12 years: 50 micrograms per shot, half of the dosage for adults. The vaccine is also given in two shots, spaced one month apart.  
  • Children 12-17 years: 100 micrograms per shot, the same dosage for adults. As with adults, the vaccine is given in two shots, spaced one month apart.

Please note: right now, there is no required third dose for the Moderna vaccine. 

Are the Pfizer and Moderna vaccines as effective for children 6 months to 4 years as they are for older kids?

Yes. We have seen many more small children hospitalized in this latest COVID-19 surge than in previous surges and unfortunately more than 1,000 children have died of COVID-19 in the United States alone. These vaccines have been shown to be highly effective in reducing severe illness and hospitalizations from COVID-19.

> Related: Is Your Child Scared of Needles? Here’s How to Prepare for Their Vaccine

What was Pfizer and Moderna's testing process for the vaccine in this age group?

Several thousand children were given either the vaccine or a placebo and then closely followed for months.

Two-thirds received the vaccine, and the other third received a placebo for comparison. Over a number of months, Pfizer and Moderna tested different dosages to find the best one for this age group’s immune system.

Does the COVID-19 vaccine cause any new or different side effects for those 6 months to 4 years?

No. In the 24 hours after their shot, younger kids, toddlers and infants may experience the usual short-term side effects: a sore arm, fever, chills or headache. This is similar to what we’ve seen in young children, adolescents and adults.

Keep in mind that many other vaccines, like the flu shot, have similar side effects. Not everyone experiences them, but when they do, it’s just a normal sign of the body’s immune system working. Side effects are usually mild and go away in about a day.

When your child needs care ASAP, we’re here to help

Connecticut Children’s Urgent Care in Farmington is open nights and weekends.

If most kids don't get very sick from COVID-19, why do they need a vaccine?

While serious illness occurs less in kids than adults, it still happens. As mentioned above, thousands of children in the nation have been hospitalized with COVID-19 and over 1,000 have died. Additionally, we’re still studying the long-term effects of this illness since some children are developing longer-term, chronic COVID symptoms.

By now we know the vaccine helps prevent kids from spreading COVID-19 to loved ones, those who are more at-risk for serious complications from COVID-19 and other people in the community. It helps them fully participate in daycare or school, since quarantine requirements are often different for younger children. It’s a safer way for your family to return to their favorite activities.

Does my child really need a second (and third, if Pfizer) dose of the COVID-19 vaccine?

Yes. The clinical studies show that everyone needs both doses to get the strongest protection from the vaccine. That’s not only important against existing variants, but to protect your child from future variants, which may be even more contagious.

Can I give my child acetaminophen (Tylenol) or ibuprofen (Motrin or Advil) for the above side effects?

If your child develops fever or pain after their vaccine, it’s fine to give them an appropriate dosage of children’s pain reliever. Just don’t do it as a precaution before their vaccine. (That could interfere with their immune response, and make the vaccine less effective.)

My child is healthy. How important is it for them to get the COVID-19 vaccine?

It’s very important. While many kids don’t become seriously sick from COVID-19, some do, including with a serious inflammatory syndrome, MIS-C. We’re still working to understand the long-term effects of “long COVID.”

Plus, lots of daycares and schools have different quarantine requirements for students who are fully vaccinated. When a classmate tests positive, a child who’s fully vaccinated may be able to return to the classroom with just a negative COVID-19 test. A child who isn’t may need to quarantine at home for 10 to 14 days. Check with your child’s school or daycare as they may have their own quarantine rules.

A COVID-19 vaccine may be your child’s best way to fully participate in daycare, preschool, and activities they love. It’ll also keep them safe, and everyone else they come in contact with.

If my child already had COVID-19, should they still get the vaccine?

Yes. Even though they’ll have some level of natural immunity, the vaccine provides additional protection. It’s possible to get COVID-19 more than once, so the vaccine helps prevent another infection. Natural immunity from COVID-19 is also believed to be short lived.

Is there any reason my child should NOT get the vaccine – for example, if they have a certain underlying health issue?

Your child’s pediatrician is always the best resource if you have questions about your child and the COVID-19 vaccine, so reach out to them if you have specific concerns.

But in general, almost every eligible child should get the vaccine. One exception is kids who have had a severe allergic reaction to a similar vaccine, but these cases are usually very rare.

If your child is 6 months or older, please make sure they’re fully vaccinated.


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