Jun 15, 2022, 3:08:46 PM CDT Sep 22, 2023, 1:51:12 PM CDT

COVID-19 vaccine for under 5: FAQs for parents

An infectious disease expert shares information about the COVID-19 vaccine for young kids

Mom holding son while doctor is providing a shot Mom holding son while doctor is providing a shot

On June 17, 2022, the U.S. Food and Drug Administration (FDA) authorized the use of the COVID‑19 vaccine in children as young as 6 months old. The authorization of the COVID‑19 vaccine for children under 5 brings a long-anticipated sigh of relief for many parents. COVID‑19 vaccines were first approved for adults in December 2020 and have been available for children ages 5-11 since October 2021. During this time, the vaccines have shown to be a safe and effective way to prevent COVID‑19 illness and hospitalization. They've helped many families return to regular activities without worry of serious illness.

But as communities have opened up, parents of children under 5 may have felt left behind. The authorization of the COVID‑19 vaccine for children ages 6 months and older means that nearly all people in the U.S. are now eligible for vaccination.

Despite feelings of excitement, it's likely that nearly all parents have questions about the COVID‑19 vaccine for their young child. Is it safe? Will it work? Is it worth it to vaccinate young children? Jeffrey Kahn, M.D., Director of Infectious Disease at Children's Health℠ and Professor at UT Southwestern, answers these questions to help parents feel confident in their decision.

Is the COVID‑19 vaccine safe for children under 5?

Hundreds of millions of adults and children age 5 and older have safely received COVID‑19 vaccines. Experts have closely studied and monitored the vaccine, and data has proven that the COVID‑19 is safe and effective.

In order for the COVID‑19 vaccine to be authorized for use in children under 5, it had to meet high standards for effectiveness and safety. In clinical trials, researchers found the vaccine to be safe, well-tolerated and produce a good antibody response in children under age 5. Experts will continue to monitor the COVID‑19 vaccine in children to ensure its safety.

Why should parents vaccinate children under 5 for COVID‑19?

While young children have less risk of serious complications from COVID‑19 than adults, that risk is not zero. This is especially true for children with health conditions that put them at high risk for illness, such as obesity, asthma, neurological disorders and heart defects.

The FDA reports that children under 5 have accounted for 3.3% of reported COVID‑19 cases to date, but hospitalization and death rates in this age group are higher than in older children and teens. During the Omicron spike, children ages 6 months to 4 years accounted for 24% of all pediatric hospitalizations in the ICU due to COVID‑19.

In addition to preventing serious illness, vaccinating children under age 5 include will help reduce community spread of COVID‑19. It can also help protect children if a new, more contagious variant emerges.

"During the Omicron surge, we saw more children hospitalized with COVID‑19 than at any other time during the pandemic," says Dr. Kahn. "It's important to remember that we don't know what the future is going to bring. We've seen that a new variant can drastically change the course of the pandemic, and it's important to take the steps you can to keep children healthy."

Is the COVID‑19 vaccine for children under 5 the same as adults?

The COVID‑19 vaccines for young children are the same as the vaccines for adults, but given in a smaller dose.

The Pfizer COVID‑19 vaccine for children ages 6 months to 4 years is one-tenth the adult dose and given in a series of three shots (the second dose is given 3 weeks after the first, and the third dose is given 8 weeks after the second). The Moderna COVID‑19 vaccine for children ages 6 months through 5 years is one-fourth the adult dose and given in a series of two shots (given one month apart). Both types of COVID‑19 vaccines were shown to be safe and effective in young children.

Are there side effects of the COVID‑19 vaccine for young children?

Young children may experience some side effects after getting the COVID‑19 vaccine. Side effects are typically mild and are normal signs the vaccine is building protection against COVID‑19. These side effects typically occur within 1-2 days after vaccination and go away within a few days. Some children don't experience any side effects.

When they do occur, possible COVID‑19 vaccine side effects can include:

  • Pain, redness or swelling at the injection site
  • Tiredness
  • Headache
  • Muscle pain
  • Chills
  • Fever
  • Nausea
  • Swelling or tenderness of lymph nodes near injection site

COVID‑19 vaccine side effects may show up differently in young children who cannot verbally tell you if they are feeling sick. Instead, your baby or toddler may act irritable, tired or not eat as much.

If your child experiences any of these side effects after vaccination, they can take an age-appropriate dose of pain-reducing medication such as Tylenol or Motrin. You can also provide comfort by cuddling your child and letting them rest. If you are concerned by any side effects, call your pediatrician for guidance.

My child already had COVID‑19. Should they get the vaccine?

Yes, your child should get the COVID‑19 vaccine even if they've already had COVID‑19. Getting vaccinated after infection can help prevent reinfection and future illness.

If I got the COVID‑19 vaccine when pregnant or breastfeeding, should my infant or young child still get vaccinated?

Studies have found that a mother's antibodies can pass along to a baby in the womb if the mother gets vaccinated while pregnant. However, that protection does fade over time. While breastfeeding may offer some protection from COVID‑19, antibodies from breast milk do not get into a baby's bloodstream. Therefore, vaccination is still recommended for this children ages 6 months and older.

Where can I get my young child the COVID‑19 vaccine?

The COVID‑19 vaccine for young children may be available at some pediatrician offices, and at local health centers and pharmacies. You can call your pediatrician to see if they have the vaccine or check with other community vaccination sites.

You will not need to pay for your child's COVID‑19 vaccine. It is given at no cost to the recipient.

What should I do if I have questions about the COVID‑19 vaccine for my child?

If you have questions about vaccinating your child, Dr. Kahn recommends you talk to your pediatrician. You can also turn to trusted sources for data and information, such as the CDC website or American Academy of Pediatrics (AAP).

More COVID‑19 resources

Children's Health is committed to remaining a trusted source of health information and care for you and your family during this time. See additional COVID‑19 vaccine FAQs and more resources to keep your family healthy at the Children's Health COVID‑19 hub.

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