FAQs for COVID Vaccines for Children ages 6 months through 4 years.

FAQs for COVID Vaccines for Children ages 6 months through 4 years.

by | Jun 20, 2022 | Infection Control, News, Resources, Vaccines | 0 comments

We’re excited to share we finally have two great options for COVID vaccine protection for children ages 6 months through 4 years. The FDA granted emergency use authorization for both the Pfizer and Moderna vaccines for this age group last week, and this weekend the CDC advisory committee recommended the vaccine, as expected.

COVID Vaccines for Littles: FAQs

Ok, you’ve had some really awesome questions, so we wanted to share some facts about the vaccines and make sure your questions are answered. If you have any more, send them our way and we’ll get you the answers.

First, the facts:

  • Two SAFE and EFFECTIVE vaccines were approved for children ages 6mo-4yo: Pfizer and Moderna
  • This news is different, because up until now, children have only had the option of Pfizer
  • Here’s a side by side comparison:
    Pfizer Moderna
    Type of Vaccine mRNA vaccine mRNA vaccine
    Dosage 3 mcg (1/10 of an adult dose) 25 mcg (¼ of an adult dose)
    Efficacy 80%, but only effective after 3rd dose 40-50% effective
    # of doses 3 2
    Schedule 2 weeks between first 2 doses, 2 months before the 3rd dose 4 weeks apart

NOTE: The dose is a standard dose for each vaccine and is the same across the approved age range 6mo through 4yrs. We don’t have to do any calculations based on your child’s weight. We just give the prescribed volume based on their age.

Now to your questions…

Do we have to have our infants/children vaccinated?

The quick answer is no, it’s totally your choice. Based on our review of the safety and efficacy of the vaccines that were studied, as well as the very low risk of any significant adverse reactions, we highly recommend having your child 6 months or older vaccinated against COVID.

If COVID doesn’t really affect kids that badly, why should I choose to vaccinate? 

Kids do bounce back quickly from COVID, thankfully. But there are more children that die annually from COVID than from the flu and from meningitis, which we routinely vaccinate children against. So, being unvaccinated is also a risk. Kids that have chronic medical conditions are more vulnerable, but there have been healthy children as well who had COVID and did not do well. It happens to some kids, and we can’t predict which ones are more likely to get very ill from COVID.

We know the vaccine significantly reduces the risk of serious illness, hospitalization, and death from COVID. Of all children who’ve been hospitalized with COVID, most were between 6 months and 4 years old. The vaccine also helps reduce transmission to more vulnerable grandparents or immunocompromised siblings or classmates. Having your child vaccinated might even help you feel confident getting them out more: into sports, other after-school activities, and just fun stuff like going out to the movies or dining at a restaurant indoors … imagine.

Also, remember that having COVID infection is not completely benign. There is MIS-C, the multi-systemic inflammatory syndrome that can occur after COVID infection. Children can have Long COVID, too. And, of course, being infected makes your child a likely source of infection to others, including you, your parents, and others in the community. Finally, has your kid been left out of daycare/preschool/school for being a close contact and you’ve had to scramble to find childcare? That scenario should be less frequent for you as more and more children get vaccinated.

Here, the benefits clearly outweigh the risks of getting the vaccine.


Why does the efficacy seem low?

Efficacy in adult recipients were very high when the vaccine was released. While the numbers are lower than for adults, both studies demonstrated something called immunobridging, which means that both vaccines elicited the same immune response seen in young adults.

The difference in efficacy between the vaccines is likely due to the differences is dosage and shcheduling. Both vaccines meet the high standard of approval set by the FDA and CDC for preventing serious disease and death.

Are the vaccines safe?

The safety data of the vaccines are both excellent. Moderna was tested in 2500 children (6mo-2yo) and 4200 children (2yo-6yo), Pfizer in 1678 chilldren. No adverse side effects were reported in either study. There was no evidence of myocarditis in study participants, and we know now that myocarditis from the vaccine is exceedingly rare and more likely in teenage boys, not this population.

If I got the COVID vaccine while I was pregnant, is it still ok for my baby to get the COVID vaccine now? 

Yes! Just like you get your Tdap shot in the third trimester so antibodies get to your baby across the placenta and protect them when they’re born until they can get their own shots, your COVID vaccine protected them too! But now, finally, they can get their own shot, and this type of active immunity is even more reliable than the passive immunity of maternal vaccines.

If my kiddo is almost 5, should we just wait and get the bigger dose? 

No, you should get whatever is available as soon as it’s available. Any protection is better than none. If your child turns 5 between doses, then they’ll qualify for the higher dosed booster. Remember, we give shots based on age, not weight. There’s now no reason to leave them unprotected.

How can I help my child prepare to get the vaccine?

We advocate for honest communication with your child if they’re verbal. Even from age 1 they understand more than you think. How about something like:
“We’re going to the doctor’s office to get your COVID vaccine. It’s a shot in your arm (or thigh) that will help protect you and make you stronger so you don’t get sick as often. We’ll get another shot later, and when you get all your COVID shots, we’ll get to go out and do [fill in miscellaneous fun things] more because you’ll be safer.”

Side effects? 

In both studies, side effect profiles were similar.

Most common:

  1. Irritability
  2. Drowsiness
  3. Fever
  4. Injection site pain

Since Moderna’s dose is higher, side effects were seen more often in this study group.

Tylenol and Motrin are ok to give for fevers, irritability, and injection site pain. But most kiddoes will just need to rest, typically after the 2nd (and possibly 3rd doses). Use our dosing calculator for the most accurate dose.

If we already had COVID, do we still need the vaccine?

Yes, we still recommend getting the vaccine. There’s a difference between natural immunity from being infected with COVID and vaccine-induced immunity from getting one of these vaccines. Both are a form of active immunity, meaning your body’s immune system produces antibodies to protect against future illness, but what we’re learning about COVID is that neither lasts forever.

There’s no minimum time frame after getting COVID, and your child can get their vaccine as soon as their isolation period is over. If you want to wait, then it’s ok to wait up to 3 months after natural infection to start the vaccine series, but it’s not necessary.

So, which one do I choose? 

Short answer: whichever is available. We know both the Pfizer and Modern vaccines are safe and effective.

Long answer, it depends what’s most important to you.

If both are available:

  • With Pfizer your child will likely have less side effects but won’t really have any immunity until after the third dose, which will be up to 3 months after the shot series begins.
  • With Moderna, your child will likely have more side effects with the larger dose but will have a good amount of protection in just 4 weeks. So if you’re traveling and in need of quicker protection and can’t wait nearly 3 months for the Pfizer vaccine to reach it’s 80% efficacy, then Moderna would be the choice.

Also of note, Moderna is working on a bivalent booster dose for adults that will likely be translated to a booster for kids. The benefit of a bivalent booster is that it accounts for omicron and newer variants that have arisen since the dawn of COVID vaccines, so it should offer more targeted immunity for the strains circulating now.

Short answer again: You can’t make a wrong choice.

Shout out to my friend and very well-informed nurse practitioner Laura Reichhardt for pointing me in the direction of this very informative article written by Katelyn Jetelina, epidemiologist, who breaks down the key differences between Modern and Pfizer quite nicely. Please read that for a deeper dive into the numbers and nice clear explanations about the vaccines and their efficacy.

Bottom Line

  • The vaccines are both safe and effective for children as young as 6 months.
  • We’ll have both shots available in our office
  • Text us if you’re interested in being on our call list for scheduling as soon as the shots arrive in our office, possibly as soon as next week
  • Any other questions? You know what to do 🙂