Children ages 5-11 years old are now eligible to receive the Pfizer BioNTech COVID-19 vaccine following the approval of emergency use of the vaccine in this age group, granted by the Centers for Disease Control and Prevention (CDC) and the Food and Drug administration (FDA).

The providers at Eugene Pediatric Associates strongly encourage parents to get their children vaccinated. In the vaccine trial, the shot was determined to be nearly 91% effective. It greatly lowers the chance of becoming severely ill from COVID and reduces the likelihood of getting infected in the first place, then passing the virus to others.

About the vaccine
Pfizer’s kid shots contain a third of the vaccine dose that’s already been used to vaccinate millions of people 12 and older. Children ages 5-11 receive two shots, three weeks apart—the same schedule as everyone else—but they get a smaller amount of the vaccine with each shot, dispensed with a smaller needle.

Safety data from clinical trials, which included more than 3,000 children who received the vaccine, found that the most common reactions were pain at the injection site, fatigue and headache; those reactions were mostly mild or moderate.

Why should my child get the COVID-19 vaccine?
Nearly 6.3 million children have been infected with COVID-19 since the pandemic began. Of those, 605 children have died and more than 22,400 have been hospitalized, including numerous children in our practice, from newborns to young adults.

While the virus tends to be less severe in kids and teens overall, they can become extremely ill from multisystem inflammatory syndrome, which causes inflammation of various organs, including the heart, lungs, kidneys and brain. The CDC reports that more than 5,200 children have developed multi-system inflammatory syndrome due to COVID-19 and 46 have died. In addition:

  • Many children with mild COVID-19 symptoms have chest X-rays showing extensive inflammation, and we don’t know what that will mean for their future lung and heart health.
  • Children with moderate or worse COVID-19 illness require cardiac evaluation and may have long-term cardiac consequences that we don’t understand fully because the disease is still relatively new.
  • It’s clear that some children, like adults, are experiencing post-acute sequelae, or “Long COVID,” following an infection. While no one is certain how many people become long-haulers, the United Kingdom estimates that between 13% and 15% of children younger than 16 infected with coronavirus still experienced symptoms five weeks after infection. One study showed that as many as 52% of older teens (and adults up to age 30) experience symptoms for six months after having COVID.
  • Children with underlying medical conditions, such as chronic lung diseases, diabetes or heart conditions are more at risk for severe illness from COVID-19 compared with children without underlying medical conditions.
  • According to the American Academy of Pediatrics, more than 140,000 children in the United States have experienced the death of a parent or grandparent caregiver due to COVID, causing tremendous stress on children and families.
  • Kids who are unvaccinated present a risk to their elderly or immunocompromised family and community members because kids can carry COVID-19 even when they have few or no symptoms.
  • There has been a significant rise in mental health issues in children of all ages due to isolation and changes to their daily lives, stemming from the COVID-19 pandemic.

What about booster shots for children?
Most children ages 5 and older can receive a single booster dose of the Pfizer-BioNTech vaccine if it’s been at least five months since receiving their second of two primary shots.

For moderately or severely immunocompromised children and teens, the booster shot can be given at least 3 months after the last primary shot. Immunocompromised children may also receive a second booster at least 4 months after the first booster shot.

Data suggests the vaccine’s effectiveness wanes over time for all age groups, so a booster can help provide continued protection against COVID-19.

The FDA made its recommendation for booster shots following a study of the shots’ safety and effectiveness in 400 children. The most reported side effects were pain, redness and swelling at the injection site, as well as fatigue, headache, muscle or joint pain and chills and fever.

What about possible cardiac issues related to the COVID-19 vaccine?
Concerns about myocarditis, or inflammation of the heart muscle, after receiving the COVID-19 vaccine first surfaced in spring 2021, and the condition has been a focus of significant ongoing research. While it appears that the COVID vaccine carries with it a slightly increased risk of myocarditis, affected patients recovered fully in about a week with rest and ibuprofen. Multiple analyses have shown that the risk of developing myocarditis after contracting coronavirus is significantly higher than the chances of getting it after receiving the COVID-19 vaccine.

How should I prepare my child for getting the vaccine?
Talk to your child about what to expect. Some additional things to keep in mind:

  • After your child’s COVID-19 vaccination, you will be asked to stay for 15–30 minutes so your child can be observed in case they have a severe allergic reaction and need immediate treatment.
  • To prevent fainting and injuries related to fainting, your child should be seated or lying down during vaccination and for 15 minutes after the vaccine is given.
  • Be sure to tell the doctor or nurse about any allergies your child may have.
  • It is not recommended that you give pain relievers before vaccination to try to prevent any side effects.

How much does the vaccine cost?
The federal government is covering the cost for COVID vaccinations for anyone in the United States, regardless of immigration or health insurance status. If you have health insurance, your plan can be charged the cost of administering the vaccine, but you will not have to pay a co-pay or remaining balance.

Can my child get the flu vaccine at the same time as the COVID-19 vaccine?
Yes. It is safe to get a COVID-19 vaccine along with any other routine vaccine, including the flu vaccine, but any additional vaccines should be given at a different injection site.

Should I wait to vaccinate my 11-year-old so they can get a bigger dose of the vaccine?
Kids in the 5-11 age group will receive 10 micrograms of vaccine per dose, or one-third the amount that a 12-year-old would receive, which has created some confusion for parents of 11-year-olds. Experts in the field of immunology and infectious diseases say the appropriate dosage is best determined by a child’s age, not their size.

The virus is not going to disappear anytime soon, and variants could make the virus more infectious or dangerous. The bottom line is that the sooner your child is vaccinated, the better. If your child is 11 years old, our recommendation is to get the shot right away and not wait. They will be better protected than if you postpone vaccination until your child turns 12.

Some children may be 11 years old when they get their first dose and 12 at the time of their second dose. According to the CDC, they should receive a dose based on their age on the day of vaccination.

Would a heavier child be better protected with a larger dose of vaccine?
While weight is an important factor when you give a young child specific medications, such as acetaminophen, the optimal COVID-19 vaccine dose is based on age and immunity and is tailored to minimize potential side effects. Medical data shows that children ages 5-11 have functionally similar immune systems, regardless of their weight. Because their immune systems are strong, they produce the same number of antibodies as those ages 12-17 even when given a lower vaccine dose.

Should a child who’s already had COVID-19 still get vaccinated?
The CDC recommends that individuals who previously were diagnosed with COVID-19 still get vaccinated. The vaccine provides additional, longer-lasting protection than recovery from illness.

Is there a certain amount of time after having a COVID-19 infection and getting the vaccine that is acceptable, or should vaccination wait until symptoms end?
Children or adults with COVID-19 who have symptoms should wait to be vaccinated until they have recovered from their illness and have met the criteria for discontinuing isolation; those without symptoms should also wait until they meet the criteria before getting vaccinated. This guidance also applies to people who get COVID-19 before getting their second dose of vaccine.

After a child is fully vaccinated, should they follow the same quarantine guidelines as adults if they are exposed to COVID-19?
Most fully vaccinated children and adults without symptoms do not need to quarantine or be restricted from activities outside the home following an exposure to someone with suspected or confirmed COVID-19, if they adhere to the following testing and masking recommendations:

  • They should be tested within 5-7 days and wear a mask in public indoor settings for 14 days or until they receive a negative test result. They should also be monitored for symptoms for two weeks and isolate if they test positive.
  • If they experience symptoms, they should be isolated from others, be clinically evaluated for COVID-19, and tested for SARS-CoV-2 if indicated.
  • Fully vaccinated people who live in a household with someone who is immunosuppressed, at increased risk of severe disease, or with unvaccinated adults or children should also consider masking at home for 14 days following a known exposure or until they receive a negative test result.

Can children who are considered high risk and who were advised to stay out of in-person learning this year return after they are fully vaccinated?
People who have a condition or are taking medications that weaken their immune system may not be protected even if they are fully vaccinated. They should continue to take all precautions recommended for unvaccinated people, including wearing a well-fitted mask, until advised otherwise by their healthcare provider.

Studies so far show that vaccinated people are 8 times less likely to be infected and 25 times less likely to experience hospitalization or death than unvaccinated people. Immunocompromised patients remain at high risk despite the vaccine because their body doesn’t always mount an appropriate immune response.

If a parent has specific questions about risk vs. benefit of a child with a specific condition returning to school or other social situations with higher exposure risks than confining at home, they should schedule a visit with their child’s doctor to discuss further.

Should a child who’s had previous allergic reactions get the Pfizer-BioNTech vaccine?
A small number of vaccine recipients have experienced anaphylaxis after receiving the Pfizer vaccine, so all patients should be monitored for at least 15 minutes following COVID-19 vaccine administration. Patients with a history of severe allergic reaction should be monitored for at least 30 minutes.

Patients who experience anaphylaxis following the first dose of vaccine should be counseled not to receive additional doses and referred to an allergist-immunologist for appropriate follow up.

In people who report a history of anaphylaxis to another vaccine or injectable therapy, a risk assessment should be conducted with their doctor.

Should children get COVID-19 vaccinations 21 days apart? Are there alternate timelines for vaccinations?
For those receiving first and second doses, the Pfizer vaccine should be administered at a 21-day interval. The CDC recognizes a 4-day grace period if a second dose can’t be administered precisely on the 21st day.

Why we’re recommending vaccination for kids
Eugene Pediatrics has been preparing for months to perform the crucial task of immunizing our 5- to 11-year-old patients.

Millions of lives have been lost or forever changed by this pandemic. Vaccination is the fastest way to get kids back to their normal life. It will protect children and loved ones and allow them to fully engage in all the activities that are so important to their health and development.

This vaccine will also provide parents greater peace of mind when gathering with family members this winter, in addition to sending kids to school, sports and other events that were paused during the height of the pandemic. It will also decrease the chances that kids will have to isolate or quarantine if exposed to someone who tests positive for COVID-19.

If you have questions about vaccinating your child against COVID-19, talk with your pediatrician. They can help guide and direct you with information specific to your child’s health.