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Ask the Expert: COVID-19 vaccines and kids under 5

Jun 29, 2022

On June 17, the FDA authorized both the Pfizer and Moderna COVID-19 vaccines for children ages 6 months to 5 years old. Shortly after, the CDC added its recommendation for this age group, news anxious parents have been awaiting for nearly a year and a half.

Description of the following video:

Aaron Carroll sitting at a desk in an in-home office 

Carroll: Hi this is Aaron Carroll, chief health officer and professor of pediatrics at Indiana University and today we’re going to answer some questions about the new COVID vaccines for little children.

Text on screen: Should I get my child vaccinated?

Carroll: Should you even get your child vaccinated? Is it even that important? Well while children have a lower risk of hospitalization and death they still do have a risk and being vaccinated is significantly better than getting infected with COVID. The benefits significantly outweigh the risks. If it were my child, I’d absolutely get them vaccinated. On top of that they may be around other people who are at higher risk including grandparents or relatives or friends with chronic conditions and of course the less COVID we all have the safer it is for everyone else so you need to think not only about protecting your kids to protect themselves but also to protect the ones they love. 

Text on screen: When should my child get the vaccine if they’ve recently had COVID?

Carroll: So if your child has just had COVID should you get vaccinated now or wait? Well you can get vaccinated as soon as you’re out of isolation but there is some evidence and the American Academy of Pediatrics does recommend that you think about waiting up to three months before getting the COVID vaccine. Some studies show that waiting between getting infected and getting vaccinated can mean that the vaccination will work even better but I wouldn’t go longer than three months. Get vaccinated as soon as you can at that point.

Text on screen: Which vaccine should I choose for my child?

Carroll: So with vaccines for both Pfizer and Moderna being approved, what should you choose? Which is the most effective? Well, it’s impossible really to say which is more effective they’re both very effective but they are different. The Pfizer vaccine has a smaller dose which means it’s a little bit less likely to cause side effects but because of that you actually have to get three doses so it can take really up to three months to get totally vaccinated. The Moderna has a slightly higher dose but it is more likely to cause side effects but you’re more likely to be fully vaccinated in a shorter period of time and so it won’t take as many visits to the doctor. They’re both good but whichever one you prioritize is the one you should get for your child.

Text on screen: Where can I get my child vaccinated?

Carroll: So where can you get your child vaccinated? While it seems like it’s difficult to do so at the moment, more places are giving the COVID vaccine to small children every day. Best and only and simplest thing you should do is to call 2-1-1 which will help you get an appointment at a place that’s convenient for you. Again just call 2-1-1.

Text on screen: Indiana University iu.edu

With both vaccines available, parents have questions about which vaccine to give their child, when to vaccinate and how to get appointments. We asked Indiana University Chief Health Officer Dr. Aaron Carroll, a professor of pediatrics, common questions about the COVID-19 vaccines for children in this youngest age group.

Question: With both Pfizer and Moderna being approved, which one should I pick? Which one is most effective for this age group?

Answer: Both vaccines have worked well in this age group based on the clinical trials completed. As far as which one to give your child, it really depends on what you feel most comfortable with. The Pfizer vaccine is three doses, with each dose being a smaller amount than the Moderna doses. Moderna is two doses with a dosage higher than the Pfizer vaccine each time. The Pfizer vaccine may have fewer side effects but will take longer for your child to be fully vaccinated. Moderna is a faster path to being fully vaccinated but may have more side effects following vaccination.

Q: Why should I get my young child vaccinated now after all this time? Is it really that important?

A: Thankfully, most children experience mild or moderate disease if infected with the virus that causes COVID-19. There are, however, many healthy children who have been hospitalized due to COVID-19. While the number is low, there’s just no way to know if your healthy child will have a mild or severe infection or suffer the effects of long COVID, which does occur in kids. Getting your child vaccinated reduces the risk of both severe disease as well as long COVID, so, yes, it’s still very important to get children vaccinated.

Q: My child just had COVID recently. Should I vaccinate now or wait?

A: The most important thing is to still get your child vaccinated even if they’ve had COVID-19 in the past. If your child had COVID within the last three months, some research is now saying that the vaccines may offer better protection if given around three months after getting the virus. You shouldn’t wait any longer than that, however, to get your child vaccinated after a COVID-19 infection.

Q: Where can I get my child vaccinated?

A: With the recent authorization and recommendation for the vaccine in this younger age group, physician offices and community providers are now working to get vaccine and set up appointments. Right now, the best resource for scheduling an appointment and finding a vaccine location in your area is calling 211. This is a statewide resource and can provide information regardless of where you are in Indiana.

Q: My child will be 5 in a few months. Should I wait and get him vaccinated then?

A: No, there’s no reason to wait to start the vaccination process. It’s better to get the protection you’re able to now than continue to wait for the next age group. If for some reason your child turns 5 between doses of the vaccine, your pediatrician or vaccine provider may use the dosage for the older age group in future doses.

Q: What side effects should we watch out for? Were there any serious side effects in the clinical trials?

A: Side effects from the vaccine in this age group will likely be similar to older groups: pain at the injection site, fever, fatigue and headache. These side effects are very temporary and definitely do not outweigh the benefits of your child being vaccinated.

Many parents have focused on myocarditis as a side effect of vaccination. While none of the children in the clinical trials experienced this, myocarditis occurs so rarely that the trial groups were not large enough to really focus on this. It’s also important to remember that there is a higher risk of myocarditis from actually being infected with COVID-19, and myocarditis from a COVID infection is likely going to be more severe. Again, this very small risk does not outweigh the benefits of getting vaccinated.

Q: Are these vaccines safe?

A: As I’ve said many times before, safety is not binary; there is no safe or unsafe. These vaccines, however, are some of the most studied vaccines in our history, and the clinical trials all showed positive outcomes among participants. There were no deaths in any of the trials, and the vast majority of participants only had minor, temporary side effects. As both a parent and a pediatrician, I would have no hesitations about giving either of these vaccines to my own children or a patient.

Q: Should we vaccinate now or wait until fall/winter?

A: There is no predicting which way this pandemic will turn, so it’s best to base your health decisions on what is happening right now and the advice of medical professionals and organizations like the CDC in real time. COVID-19 is still in our communities, there is finally a vaccine for some of our youngest children, and there’s just simply not much of a reason to wait any longer.

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