Health Encyclopedia

COVID-19 vaccines for children ages 6 months and older

Definition

COVID-19 vaccines are used to prepare the body's immune system to protect against COVID-19.

Alternative Names

Vaccines for COVID-19 - children and teens; COVID-19 vaccinations for children and teens; COVID-19 shots for children and teens; Vaccinations for COVID-19 - children and teens; COVID-19 immunizations for children and teens; COVID-19 prevention - vaccines for children and teens; mRNA vaccine for children and teens - COVID-19

Information

COVID-19 vaccines protect people from getting COVID-19. These vaccines "teach" your child's body how to defend against the SARS-CoV-2 virus, which causes COVID-19.

WHY CHILDREN AND TEENS SHOULD GET VACCINATED

It's true that most children and teens are at lower risk from becoming very sick from COVID-19. But low risk does not mean no risk. Children and teens can:

• Become infected with COVID-19
• Become seriously ill from COVID-19 and need to be hospitalized
• Have serious short- and long-term effects or complications from COVID-19
• Die from COVID-19, although this is very rare
• Spread COVID-19 to others, including those at risk for serious illness, such as grandparents

Children with underlying medical conditions are more at risk for severe illness from COVID-19. So, vaccination is very important to help protect against the virus.

There are many good reasons to have your child or teen get a COVID-19 vaccination:

• It will protect your child from serious illness if they do get COVID-19.
• It will protect other people in the family at risk for serious illness from COVID-19.
  
• It is a safer way to build protection than from getting COVID-19.

ABOUT COVID-19 mRNA VACCINES FOR CHILDREN AND TEENS

Children ages 6 months to 17 years can get either the Pfizer-BioNTech or Moderna mRNA vaccine.

• COVID-19 mRNA vaccines use messenger RNA (mRNA) to tell cells in the body how to briefly create a harmless piece of "spike" protein that is unique to the SARS-CoV-2 virus. Cells then get rid of the mRNA.
• This "spike" protein triggers an immune response inside the body, making antibodies that protect against COVID-19. Your child's immune system then learns to attack the SARS-CoV-2 virus if they are ever exposed to it.
• There are two mRNA COVID-19 vaccines currently approved for use in the United States, the Pfizer-BioNTech and the Moderna COVID-19 vaccines.
  

The COVID-19 vaccine given to children and teens has the same active ingredients as the vaccine given to adults. Dosage is based on the child's age on the day of vaccination. It is not based on the child's size or weight.

The original mRNA vaccines, (monovalent and bivalent vaccines), are no longer available. The updated (2023-2024 formula) mRNA vaccines, also called homologous vaccines, are currently in use. These updated (2023-2024 formula) vaccines protect against the original COVID-19 virus and certain variants of the COVID-19 virus.

SUBUNIT VACCINE

Children ages 12 years and older can also get the Novavax vaccine.

The Novavax vaccine is a protein subunit vaccine. The vaccine includes harmless pieces of the "spike" protein that causes COVID-19. The vaccine triggers the body to develop antibodies to protect you from the virus. The updated (2023-2024 formula) vaccine protects against the original COVID-19 virus and certain variants of the COVID-19 virus. The original Novavax (monovalent) is no longer available. The updated (2023-2024 formula) is currently in use.

VACCINATION SCHEDULE

Your child's vaccination schedule is based on age and vaccination history.

Children who DID NOT get the original vaccine can have the following shots.

• Children ages 6 months to 4 years can receive 3 doses of the updated Pfizer-BioNTech vaccine or 2 doses of the updated Moderna vaccine.
• Children age 5 to 11 years can receive 1 dose of the updated Pfizer-BioNTech vaccine or the updated Moderna vaccine.
• Children ages 12 years and older can get 1 dose of the updated Pfizer-BioNTech or Moderna COVID-19 vaccine.
• Children ages 12 years and older can also get the Novavax vaccine in 2 doses, given 3 to 8 weeks apart. 
  

Children who DID get the original vaccine can have the following shots:

• Children ages 6 months to 4 years who got 2 or 3 doses of the original Pfizer-BioNTech vaccine should get 1 dose of the updated Pfizer-BioNTech COVID-19 vaccine.
• Children ages 6 months to 4 years who got 1 dose of the original Pfizer-BioNTech vaccine, should get 2 doses of the updated Pfizer-BioNTech COVID-19 vaccine.
• Children ages 6 months to 4 years who got 1 or 2 doses of the original Moderna vaccine, should get 1 dose of the updated Moderna COVID-19 vaccine.
• Children ages 5 to 11 years who got 1 or more doses of the original Pfizer-BioNTech or Moderna vaccine, should get 1 dose of the updated Pfizer-BioNTech or Moderna COVID-19 vaccine.
• Children ages 12 years and older should get 1 dose of the updated Pfizer-BioNTech, Moderna, or Novavax COVID-19 vaccine regardless of which original vaccine they received.

VACCINE MYTHS

COVID-19 vaccines:

• DO NOT contain any live virus, and they cannot give children COVID-19
• DO NOT affect or interfere with children's genes (DNA)
• DO NOT affect or interfere with fertility or future fertility in children

To get up-to-date accurate information about COVID-19 vaccines, go to the Centers for Disease Control and Prevention (CDC) website:

• Vaccines for COVID-19 - www.cdc.gov/coronavirus/2019-ncov/vaccines/index.html
• Bust Myths and Learn the Facts about COVID-19 vaccines - www.cdc.gov/coronavirus/2019-ncov/vaccines/facts.html

VACCINE SIDE EFFECTS

While COVID-19 vaccines will not make children sick, they may cause certain side effects and flu-like symptoms. This is normal. These symptoms are a sign that your child’s body is making antibodies against the virus. Common side effects include:

• Pain, redness, or swelling on the arm (or leg up to age 3) where they got the shot
• Tiredness
• Headache
• Muscle pain
• Chills
• Fever
• Loss of appetite
• Swollen lymph nodes

Some side effects from the shot may affect your child's ability to do daily activities, but they will go away in a few days. Even if your child has side effects, they should get the second shot. Any side effects from the vaccine are far less dangerous than the potential for serious illness or death from COVID-19.

HOW TO GET THE VACCINE

There are several ways to find vaccination providers near you.

• Ask your child's health care provider if they offer COVID-19 vaccines for children and teens.
• Check your local pharmacy's website or call them to see if they offer vaccines for children and teens.
• Contact your local health department.
• Go to the CDC website Vaccines.gov.
• Call 1-800-232-0233 to find vaccine locations near you.

VACCINE SAFETY

The safety of vaccines is the top priority, and COVID-19 vaccines for children have passed rigorous safety standards before approval. They continue to be closely monitored to ensure they are safe and effective.

Serious health events from COVID-19 vaccines, such as an allergic reaction, are rare.

Rare cases of myocarditis (inflammation of the heart muscle) and pericarditis (inflammation of the outer lining of the heart) have been reported in children and teens ages 5 years and older after getting a COVID-19 vaccine.

• This reaction has tended to occur more often in male adolescents and young adults ages 12 to 39 years.
• It occurs more often after the second dose, usually within 7 days after vaccination. Studies show that this rare risk may be reduced by waiting 8 weeks between the first and second dose.
• With proper care and rest, most people who had the reaction got better quickly.
• For people who had this rare reaction, it is important to talk with a cardiologist (heart doctor) about how and when to return to exercise and sports.

Symptoms of myocarditis and pericarditis include:

• Chest pain
• Shortness of breath
• Fast-beating heart, fluttering, or pounding heart

If your child or teenager has any of these symptoms, get medical help right away.

References

Centers for Disease Control and Prevention website. Interim clinical considerations for use of COVID-19 vaccines in the United States. www.cdc.gov/vaccines/covid-19/clinical-considerations/interim-considerations-us.html. Updated October 6, 2023. Accessed October 10, 2023.

Centers for Disease Control and Prevention website. Myocarditis and pericarditis after mRNA COVID-19 vaccination. www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/myocarditis.html. Updated September 12, 2023. Accessed October 10, 2023.

Centers for Disease Control and Prevention website. Bust myths and learn facts about COVID-19 vaccines. www.cdc.gov/coronavirus/2019-ncov/vaccines/facts.html. Updated September 27, 2023. Accessed October 10, 2023.

Centers for Disease Control and Prevention website. Stay up to date with COVID-19 vaccines. www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html. Updated October 4, 2023. Accessed October 10, 2023.

US Food & Drug Administration website. Novavax COVID-19 vaccine, adjuvanted. Novavax COVID-19 vaccine, adjuvanted (2023-2024 formula) authorized for individuals 12 years of age and older. www.fda.gov/vaccines-blood-biologics/coronavirus-covid-19-cber-regulated-biologics/novavax-covid-19-vaccine-adjuvanted. Updated October 4, 2023. Accessed October 10, 2023.

Review Date:2/22/2023
Reviewed By:Frank D. Brodkey, MD, FCCM, Associate Professor, Section of Pulmonary and Critical Care Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Editorial update 10/10/2023.

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