The COVID-19 vaccine for kids under 12: What parents should know

Kids under 12, ages 5-11 years, are now able to receive the COVID-19 vaccine. In this Q&A of commonly asked questions, Dr. Angela Dangvu, a pediatrician in the CHOC Primary Care Network, helps parents know what to expect when getting their younger children vaccinated.

When will the COVID-19 vaccine be available for kids under 12?

At this time, the Pfizer-BioNTech (Pfizer) vaccine is the only vaccine authorized for use in children ages 5 – 11 years. It is also the only vaccine authorized for kids ages 12-17 years. The Moderna and Johnson & Johnson Jansen (J&J Jansen) vaccines are currently only authorized for people ages 18 and older.

Is the Pfizer-BioNTech COVID-19 vaccine available for children under 12?

Yes. Pfizer-BioNTech has received emergency authorization to administer their COVID-19 vaccine to kids ages 5-11 years from the Food and Drug Administration (FDA).

Is the J&J Janssen COVID-19 vaccine available for children under 12?

No. The one-dose J&J Janssen COVID-19 vaccine is recommended for adults ages 18 years and older. J&J Janssen is currently conducting research on the vaccine’s response in younger age groups.

Is the Moderna COVID-19 vaccine available for children under 12?

No. Moderna’s two-dose COVID-19 vaccine is recommended for adults ages 18 years and older. Moderna is currently conducting research on their vaccine’s response in kids as young as 6 months of age.  

Can children get the Pfizer COVID-19 vaccine? Is it safe?

Yes. The Pfizer vaccine has proven to be safe and effective for children ages 5-11 years. 

Pfizer’s clinical trials showed that after the two-dose vaccine, kids ages 5-11 years generated a robust immune response that matched what was previously observed in adolescents, teens, and adults.

The Pfizer vaccine, as well as the Moderna vaccine which is authorized for people ages 18 years and older, is an mRNA vaccine. When the vaccine is injected, mRNA – a strip of genetic material – enters a body’s cell and prompts the cell to build copies of spike proteins. These spike proteins are the bumps that protrude from the surface of coronavirus particles. The body’s immune system then learns to spot these spike proteins and produces antibodies that block the virus from entering healthy cells in the future.

We have no reason to expect that children would tolerate the vaccine less favorably than adults would.

Will the COVID-19 vaccine affect my child’s fertility?

Definitely not. Because it is an mRNA vaccine (see explanation above), the vaccine does not get incorporated into or change the DNA of the body’s cells in any way. There is no reason to worry that the vaccine will affect fertility or future offspring. Read more about the COVID-19 vaccine and fertility.

Does the COVID-19 vaccine cause myocarditis?

Myocarditis, or inflammation of the heart muscle, appears to be a very rare side effect of the mRNA COVID-19 vaccine. Get more information about myocarditis.

Are COVID-19 vaccines free?

Yes. COVID-19 vaccines are free and available for everyone at local pharmacies, primary care practices, and vaccine clinics. You may need to schedule an appointment to receive the vaccine.

CHOC has opened a COVID-19 Vaccine Clinic on our Orange campus for kids 5 years of age and older. Ask your provider for details, or call our Vaccine Call Center (Mon – Fri, 9 a.m. – 5 p.m.) at 714-509-4668.

Do children receive the full-size dose of the Pfizer COVID-19 vaccine?

According to Pfizer’s clinical trial data, the company has determined that kids ages 5-11 years should receive a 10-microgram dose size – one-third of the COVID-19 vaccine dose that everybody else receives.

With the one-third-sized dose, children have demonstrated the same amount of robust immunity to COVID-19 as adolescents, teens and adults.

Are the vaccine vials for children ages 5 to 11 the same as for older children and adults?

No. Vials of the vaccine for younger children will contain 10 microgram doses, while the vials for older children, teens and adults contain 30 microgram doses. This means that pharmacies and doctors’ offices will have separate stocks for these populations. They won’t, for example, be able to draw a smaller dosage amount from an adult vial to give to a younger child. They will also need to use smaller needles to administer the vaccine to younger children.

What are the COVID-19 vaccine side effects for kids under 12?

Pfizer states that its COVID-19 vaccine was well-tolerated by its clinical trial participants. The side effects are generally comparable to those observed in the 16-25 age group. The most commonly reported side effects include:

  • Pain where the shot was given
  • Fatigue
  • Headache
  • Chills
  • Muscle pain
  • Fever
  • Joint pain

Any side effects should be relatively short-lived and ease within 24 hours. Because teens and children have more robust immune systems, it’s possible that they may feel these side effects more strongly than adults would. This is a sign that their immune system is mounting a response against the virus.

When will the COVID-19 vaccine be available for children under 5?

The Pfizer company is conducting a separate clinical trial for children younger than 5 years of age, receiving a 3-microgram dose of the COVID-19 vaccine. They are expecting to have the results as soon as the end of this year.  

If their results are favorable, they will submit their data to the FDA for approval to administer the vaccine.

Are children less likely to get COVID-19 than adults?

With increased community transmission of COVID-19 and its variants, more kids have been contracting COVID-19 compared to this time last year. However, it is much rarer for children to get seriously ill than adults.

Some children have needed hospital care for COVID-19. This is especially true for children with underlying health conditions such as weakened immune systems, obesity or chronic lung conditions.

It is important for children to receive the vaccine to protect themselves and their families from community spread. It will also help families have the peace of mind to return to more typical activities like spending time with friends and family and participating in sports. 

How does COVID-19 affect children?

Most children who are infected with the COVID-19 virus only experience mild symptoms such as low-grade fever, fatigue, and cough. However, some children have experienced severe illness and required hospitalization. Children with underlying health conditions may be at an increased risk for developing complications and severe illness.

Although rare, some children — particularly males — have developed myocarditis.

What is multisystem inflammatory syndrome in children (MIS-C) in the context of COVID-19?

Multisystem inflammatory syndrome (MIS) is a rare but serious condition associated with COVID-19 in which different body parts become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs. MIS can affect children (MIS-C) and adults (MIS-A). Learn more about multisystem inflammatory syndrome in children (MIS-C) and COVID-19.

Can COVID-19 cause multisystem inflammatory syndrome (MIS-C) in children?

Multisystem inflammatory syndrome (MIS-C), is a considerably rare condition that some children and teens have developed following a COVID-19 infection. There is research being done to determine why some children develop MIS-C and others do not. 

Are children with underlying conditions and compromised immune systems more at risk for multisystem inflammatory syndrome (MIS-C) from a COVID-19 infection?

There is not enough data to determine if children with underlying health conditions are more at risk for developing MIS-C following a COVID-19 infection. However, children with underlying health conditions have a greater risk for developing severe illness from a COVID-19 infection. The best way to protect children against MIS-C is to receive the COVID-19 vaccine.

Will the COVID-19 vaccine protect kids from the delta variant?

Because the delta variant — as well as other variants — have proven to be highly infectious and contagious, research suggests that COVID-19 vaccines are slightly less effective against variants. However, the vaccines are highly effective at preventing severe illness from COVID-19 and its variants.

There are some cases in which fully vaccinated people are becoming infected with COVID-19 (called a breakthrough infection), but there is evidence that the vaccination will make the illness less severe. Vaccinated kids are also much less likely to contract COVID-19 than unvaccinated kids.

Why should my child get the COVID-19 vaccine?

Getting a COVID-19 vaccination can help protect your child from getting COVID-19 and spreading it to others. It can also keep your child from becoming seriously ill or needing hospitalization if they do contract COVID-19. It’s important to protect your family and community by getting yourself and your child under 12 years vaccinated. 

My child already had COVID-19. Should they have the vaccine?

Yes. We don’t know how long the immunity lasts from natural illness, and the vaccine is made to create a longer-lasting immune response.

What if my child has received convalescent plasma treatments?

Your child or teen should wait 90 days to get the vaccine after receiving convalescent plasma or monoclonal antibody treatments. Your child’s pediatrician can help you determine when it’s appropriate to get the vaccine.

Do I need to accompany my child to the vaccination?

Yes. Anyone under 18 must have a parent or legal guardian present to receive the vaccine.

What should we bring to my child’s COVID-19 vaccination appointment?

Please bring a form of documentation with your child’s name and birthdate on it. The name should match the name on your appointment confirmation.

You do not need a government-issued ID to receive a vaccine. Examples of acceptable documentation include the following: student ID, baptismal certificate, library card, a REAL ID, state driver license or identification card, passport, matricula consular, among others.

What should my child expect at the COVID-19 vaccination appointment?

After checking in and taking care of the paperwork, you and your child will be asked some questions about their health. The shot will be administered into the arm. After receiving the shot, the child will be monitored for 15 minutes to ensure no adverse reactions. They will also receive a card indicating when they received the vaccine and information about the vaccine.

What should I do with their vaccination card?

Take a picture of it just in case and store it in a safe place. There is no need to laminate it.

Do we really need to come back for a second COVID-19 vaccine?

Yes. Clinical trials that led to the Pfizer vaccine’s licensing incorporated two doses. So, the determined efficacy is based on two doses and we don’t yet know how effective one dose alone is. The Johnson & Johnson/Janssen vaccination is administered in one dose, but at this time it is only approved for people ages 18 and older.

Will children need to receive a booster vaccination in the future?

Right now, additional doses of the Pfizer and Moderna COVID-19 vaccines are recommended for people with compromised immune systems, who are in a high-risk age group for developing COVID-19 or who work in high-risk settings.

There is still research being collected on how long COVID-19 protection lasts with the vaccination. Watch for guidance from the U.S. Centers for Disease Control & Prevention (CDC).

Does getting the COVID-19 vaccine give you COVID-19?

No. The Pfizer vaccine, which is currently authorized for children ages 12 years and older, as well as the Moderna vaccine, which is authorized for people ages 18 years and older, is an mRNA vaccine. When the vaccine is injected, mRNA enters a body’s cell and prompts the cell to build copies of spike proteins.

Because of this, the Pfizer and Moderna COVID-19 vaccines may cause some symptoms like low-grade fever, body aches and tiredness. Like the flu vaccine, this is good because it shows that the immune system is initiating an appropriate immune response to the vaccine.

J&J Janssen’s vaccine is a viral vector, which uses a modified version of a different virus to deliver important instructions to cells. The viral vector is not the COVID-19 virus, but a different, harmless virus that will produce a spike protein that the body will create an immune response to. That immune response will protect the body if it comes in contact with COVID-19.

Can kids get the COVID-19 vaccine and the flu shot at the same time?

Yes. Children ages 12 years and older are eligible to get the COVID-19 vaccine, and they can receive the flu shot and COVID-19 vaccine simultaneously. They can also receive any other necessary vaccines at the same time too.

The physician will administer each vaccine in a different injection site, likely in the same arm, so it’s possible that your child will experience some soreness in the injection sites. If needing relief, give your child ibuprofen or acetaminophen to help with the pain. You can also place a cold, wet washcloth over the tender area.

Can my child take their normal medications before the COVID-19 vaccine?

Yes. Your child should continue to take their normal medications as prescribed.

Can my child take acetaminophen, ibuprofen or an antihistamine before the COVID-19 vaccine to offset any potential side effects?

No. It is best to avoid preventatively administering these medications – either before the vaccination or right afterward if no side effects are present – because there is a chance they can decrease the immune response.

If side effects do appear after the COVID-19 vaccination, what can I use to treat them?

It is fine to treat side effects once they surface with over-the-counter pain medicine. Either ibuprofen or acetaminophen is fine, so long as the child hasn’t had previous reactions to these medications.

Should my child stay home from school after the COVID-19 vaccine?

If they have a fever, the teen or child should stay home. Beyond that, so long as they are feeling well, there is no need to limit activities.

What if my child is exposed to COVID-19 after they’ve been vaccinated?

The CDC has updated its guidance and recommends that fully vaccinated people who have a known exposure to someone with suspected or confirmed COVID-19 to be tested three to five days after exposure, and wear a mask in public indoor settings for 14 days or until they receive a negative test result.

After receiving both COVID-19 vaccine doses, can my child stop wearing a mask?

No. It’s important that they continue to take precautions against COVID-19. Though they are highly effective, the vaccine is not 100 percent effective, and while among a group of people, it’s impossible to know who is and who isn’t vaccinated.

How will the COVID-19 vaccine change socializing for my child?

Teens, children and families alike can definitely have more peace of mind about the safety of resuming more typical activities, which will be wonderful for mental health. In group activities, vaccinated kids ages 5 years and older should still wear masks. In one-on-one activities where a child or teen and their friend are both fully vaccinated, they can feel comfortable removing their masks so long as no one in either household is high-risk and unvaccinated.

Learn more about the COVID-19 vaccine for teens, kids ages 12-15 years