Q&A COVID-19 vaccine for children

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MYTH: The COVID-19 vaccine for children is not safe.

FACT: The COVID-19 vaccine for children between the ages of 5 to 11 years has undergone thorough evaluations by both FDA and CDC. COVID-19 vaccines have and will continue to undergo the most intensive safety monitoring in U.S. history.

MYTH: It is safer for my child to build immunity by getting infected with COVID-19 than to build immunity by getting the vaccine.

FACT: Getting children ages 5 years and older vaccinated against COVID-19 is the best way to protect them from COVID-19.

MYTH: COVID-19 vaccines cause fertility and other reproductive issues.

FACT: There is no evidence that any of the COVID-19 vaccines cause fertility problems in women or men.

MYTH: Because children are not seriously harmed by COVID-19, getting vaccinated is not worth the risk.

FACT: The benefits of COVID-19 vaccination for children ages 5 through 11 years outweigh the known and potential risks.

Why do children 5 and older need to be vaccinated for COVID-19?

There are approximately 28 million children between the ages of 5 and 11 years old in the United States, and there have been nearly 2 million cases of COVID-19 within this age group during the pandemic. Children who get COVID-19 can get very sick, require hospitalization, and even die. Also, younger school-aged children who get infected can spread COVID-19 to people in their households and school settings. With many children back in school and participating in extracurricular activities, COVID-19 vaccination is critical to preventing infection and serious illness, as well as slowing the spread of COVID-19.

Are children at risk of getting sick from COVID-19?

Children ages 5 through 11 years are at risk of getting very sick from COVID-19. As of October 2021, children ages 5 through 11 years have experienced more than 8,300 COVID-19 related hospitalizations and nearly 100 deaths from COVID-19. In fact, COVID-19 ranks as one of the top 10 causes of death for children aged 5 through 11 years. Additionally, children can experience both short and long-term conditions after infection.

Children who get COVID-19 can also develop serious complications like multisystem inflammatory syndrome (MIS-C)—a condition where different body parts become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs. From April 2020 to October 2021, more than 2,300 cases of MIS-C have been reported in children ages 5 through 11 years. Children with underlying medical conditions are more at risk for severe illness from COVID-19 compared with healthy children.

Are COVID-19 vaccines safe for children ages 5 to 11?

Yes. The vaccines are safe for children in this age group. Clinical trials were conducted with thousands of children and no serious safety concerns were identified.

Before recommending COVID-19 vaccination for children, scientists conducted clinical trials. The FDA gave the Pfizer-BioNTech COVID-19 vaccine emergency authorization to use in children ages 5 through 15 years old and full approval to use in people ages 16 years and older. Learn more about the process of developing, authorizing, and approving COVID-19 vaccines.

Based on data from the clinical trial, children may have some side effects from COVID-19 vaccination, which are similar to what adults have experienced and the side effects that many children experience after routine vaccination. These side effects are normal signs that their body is building protection and may affect your child’s ability to do daily activities, but they should go away in a few days. Some children will not have side effects. Serious side effects are rare but may occur.

The benefits of COVID-19 vaccination outweigh the known and potential risks.

What are the ingredients in COVID-19 vaccines?

The COVID-19 vaccines currently available for adults, adolescents, and children contain active ingredients as well as inactive ingredients and vary by manufacturer.

All COVID-19 vaccine ingredients are safe. Nearly all of the ingredients in COVID-19 vaccines are ingredients found in many foods – fats, sugars, and salts. The Pfizer-BioNTech COVID-19 vaccine also contains a harmless piece of messenger RNA (mRNA). The COVID-19 mRNA teaches cells in the body how to create an immune response to the virus that causes COVID-19. This response helps protect you from getting sick with COVID-19 in the future. After the body produces an immune response, it discards all of the vaccine ingredients, just as it would discard any substance that cells no longer need. This process is a part of normal body functioning.

All COVID-19 vaccines are manufactured with as few ingredients as possible and with very small amounts of each ingredient.

None of the vaccines contain eggs, gelatin, latex, or preservatives. All COVID-19 vaccines are free from metals such as iron, nickel, cobalt, lithium, and rare earth alloys. They are also free from manufactured products such as microelectronics, electrodes, carbon nanotubes, or nanowire semiconductors.

Is there a fertility or developmental concern with vaccinating children before they reach puberty?

No. There is no evidence that any vaccines, including COVID-19 vaccines, can cause female or male fertility problems. There is no evidence that vaccine ingredients or antibodies developed following COVID-19 vaccination will cause any problems with becoming pregnant. Similarly, there is no evidence that the COVID-19 vaccine affects puberty.

Professional medical organizations serving people of reproductive age, including adolescents, emphasize that there is no evidence that COVID-19 vaccination causes a loss of fertility. These organizations also recommend COVID-19 vaccination for both men and women who want to have a baby in the future.

Are there concerns about myocarditis or pericarditis after vaccination in children?

The benefits of COVID-19 vaccination outweigh the known and potential risks. Rare cases of myocarditis (inflammation of the heart muscle) and pericarditis (inflammation of the outer lining of the heart) in adolescents and young adults have been reported more often after getting the second dose than after the first dose of either the Pfizer-BioNTech or Moderna COVID-19 vaccines. These reactions are rare; in one study, the risk of myocarditis after the second dose of Pfizer-BioNTech in the week following vaccination was around 54 cases per million doses administered to males ages 12 through 17 years. In general, adolescents ages 12 through 17 years have a higher risk for myocarditis than children ages 5 through 11 years. Therefore, we are not sure if the cases of myocarditis that occurred after COVID-19 vaccination in adolescents will predict the cases that could occur in children after COVID-19 vaccination.

How will vaccine safety be monitored in this age group?

COVID-19 vaccines have undergone – and will continue to undergo – the most intensive safety monitoring in U.S. history. CDC and FDA are using new and established safety monitoring systems. Parents and caregivers can register and enroll their child in v-safe, a free and easy-to-use smartphone-based app. V-safe allows them to report how their child is feeling in the days and weeks after vaccination. Additionally, patients, caregivers, and vaccine providers can report serious health events occurring after vaccination to the Vaccine Adverse Event Reporting System (VAERS). CDC and FDA review VAERS data to identify potential safety concerns.

Is it safe to get a COVID-19 vaccine at the same time as other vaccines, like flu?

Children can get a COVID-19 vaccine and other vaccines, including a flu vaccine, at the same visit. Studies have shown that side effects after getting vaccinated are generally the same when COVID-19 vaccines are given alone or with the flu vaccine.

Should children get a booster dose of the COVID-19 vaccine?

Everyone ages 12 years and older should get a COVID-19 booster shot. Currently a booster shot is not recommended for children younger than 12 years of age.

How does COVID-19 vaccine dosage work for children? What should a parent do if a child will turn 12 years of age in between the first and second doses?

Unlike many medications, vaccine dosages are based on age at the time of vaccination and not size or weight. If a child turns from 11 to 12 years of age in between their first and second dose, the second dose should be the Pfizer-BioNTech vaccine for people 12 years and older. However, if the child receives the Pfizer-BioNTech COVID-19 vaccine for children ages 5 through 11 for their second dose, they do not need to repeat the dose.

Where can I get a COVID-19 vaccine for my child?

Parents and caregivers can use vaccines.gov to find doctor’s offices, local pharmacies, healthcare clinics, and local health departments where the COVID-19 vaccine for children ages 5 through 11 years is available.  This free resource provides accurate and up-to-date information about vaccination services in your area. You can also text your ZIP code to 438829, or call 1-800-232-0233 to find locations near you in the U.S.  

Does a parent or guardian have to give consent before a child can receive a COVID-19 vaccine?

Children age 14 and older can consent for themselves in Oregon.

There is no federal legal requirement for a parent, guardian, or caregiver to consent for COVID-19 or any other vaccination.  However, this does not mean that consent is not required for select age groups.  State or local laws and policies, as well as vaccine provider policies, around minor consent for vaccination have existed for a long time and will also apply to COVID-19 vaccination of children.

Are COVID-19 vaccines for children free?

Yes, COVID-19 vaccines are available for everyone at no cost, including the Pfizer-BioNTech vaccine for children ages 5 through 11 years. COVID-19 vaccines will continue to be given to all eligible people living in the United States, regardless of insurance or immigration status.  While a vaccination site may ask to see your health insurance card, it is not required for your child to receive a vaccine.

Will children younger than 12 receive a vaccine card?

Yes, all vaccine recipients, including children ages 5 through 11 years, will receive a CDC vaccination card upon initial vaccination. Parents should take a photo of the card and then keep it in a safe place.

Is the Pfizer-BioNTech COVID-19 vaccine for children ages 5 through 11 years the same one that’s given to adolescents and adults?

Children ages 5 through 11 years receive an age-appropriate dose of the Pfizer-BioNTech vaccine.

The Pfizer-BioNTech vaccine for children ages 5 through 11 years has the same active ingredients as the vaccine given to adults and adolescents. However, the vaccine for children comes in a different vial with a different color cap. The Pfizer-BioNTech vaccine that is given to adults and adolescents cannot be used for children ages 5 through 11 years.

Just like adults and adolescents, children get the second dose three weeks after the first dose.

What is a buffer and how is it used in the COVID-19 vaccine for children?

Buffers help maintain a vaccine’s pH and allow the vaccine to remain stable at refrigerated temperatures. The Pfizer-BioNTech vaccine for children ages 5 through 11 years uses a different buffer than the vaccine for people 12 years and older. A different buffer was used to allow the vaccine for children to remain at refrigerated temperatures for longer periods of time than the adult vaccines. The COVID-19 vaccine for children contains tromethamine (Tris) –a commonly used buffer in other medications and vaccines (including the Moderna COVID-19 vaccine). The Food and Drug Administration (FDA) has determined that tromethamine does not present any safety or effectiveness concerns for children or adults.