On October 29, 2021, the U.S. Food and Drug Administration (FDA) issued an emergency use authorization (EUA) for the Pfizer-BioNTech COVID-19 vaccine to include children 5 to 11 years of age. This vaccine now has EUA for ages 5 to adults. Pamela Zeitlin, MD, MPhil, PhD, pediatric pulmonologist and chair of the Department of Pediatrics at National Jewish Health for Kids, outlines important points to know about vaccinating your children.
For now, the only vaccine that the FDA has approved for 5- to 17-year-olds is the Pfizer-BioNTech COVID-19 vaccine. This vaccine requires two doses, separated by three weeks, injected into the muscle. When Dr. Zeitlin works at National Jewish Health children’s vaccination clinics, “I encourage all of our kids to come back in three weeks, and they all say they will, so that’s good!”
Fortunately, Dr. Zeitlin noted, “The Pfizer-BioNTech COVID-19 vaccine looks very, very safe, and as time has gone by, the safety has held.” The other good news, she said, is that it’s very effective, with best effectiveness two weeks after the second dose. And the vaccine is good against the Omicron variant. The testing has continued, and the data look good at the moment for children 5 years and up.
Side effects for 5- to 17-year-olds can be similar to those for adults. After the first dose of their COVID-19 vaccine, Dr. Zeitlin finds that her patients can have a little bit of soreness in the arm where vaccine was injected, but it doesn’t limit activity. She recommends waiting 24 hours after the vaccine to resume very strenuous activity, for example, no weightlifting right after getting the vaccine. “It’s your muscle that’s taking the vaccine. You can move it around and massage it, but maybe wait for very heavy exercise,” she recommended.
She’s finding after the second dose that there are more side effects reported, such as low-grade fever, muscle aches in general around the body, sleepiness, fatigue, shaking and chills. “So we often recommend that kids take it easy after the second dose. Don’t have anything major scheduled,” said Dr. Zeitlin. Some parents worry that their children will have a hard time with the second shot. “Kids are reporting fewer side effects to us than adults. It’s good to know what could happen, but don’t expect your child to have the same reaction that you did. Everybody’s different.”
A very small number of people with a history of allergies have developed severe allergic reactions after receiving the vaccine. As a result, vaccine clinic staff at National Jewish Health for Kids will ask about your child’s history of allergic reactions and ask you to remain at the vaccine site 15 to 30 minutes after receiving the shot to make sure your child does not develop an allergic reaction. All vaccination sites are equipped with medications to treat allergic reactions.
You might wonder why your 5- to 17-year-old should be vaccinated against COVID-19, since they’re less likely to have a severe or fatal infection. But Dr. Zeitlin explained, “It matters tremendously. I’m on the front lines. I care for children who are in the hospital with active COVID-19 infections who have been quite sick and in the ICU on very high oxygen flows. I saw one yesterday. Some of the children have very severe illnesses; some of them even die, and the vaccine is good protection.”
Dr. Zeitlin reminds parents, “We still vaccinate against polio and measles. When people let up on vaccination in different communities, then outbreaks occur, and children suffer. They can have very serious, lasting consequences from a measles infection, such as losing their hearing. We can all be encouraged that COVID-19 rates have declined in this country, but it’s nowhere near extinguished. The Omicron variant is highly contagious. We recommend vaccinating your children to prevent serious illness. COVID may be on the run, but we need to run it into the ground.”
Lasting consequences from COVID-19, or long-haul COVID, are real. Dr. Zeitlin noted that, “Even if your child has mild symptoms, in a couple of months they can come up with exercise intolerance, unusual fatigue and muscle and joint pains. We have a special program for that at National Jewish Health. But you don’t want your children to get it at all. People say COVID-19 doesn’t affect kids — but it definitely does.”
“I’ll have parents worry that the vaccine hasn’t been fully approved by the FDA; they’ll say, ‘It hasn’t been fully evaluated.’ And I tell them, ‘There’s been plenty of real-world monitoring of the vaccine safety.’ It’s much safer to be vaccinated than to go out and risk getting COVID,” said Dr. Zeitlin.
Dr. Zeitlin fields questions from parents about getting the COVID-19 vaccine for their children who have different specific circumstances, including:
Children Younger Than 5
Feb. 1, 2022, Pfizer BioNtech submitted clinical trials data to request EUA from the FDA to vaccinate children 6 months through 4 years of age.
Children Who’ve Had COVID-19
You can still get COVID-19 even after having had the virus. Dr. Zeitlin said, “The CDC recommends the vaccine for people who have had COVID-19, but if they were treated with monoclonal antibodies or convalescent plasma, wait 90 days after symptoms have ceased.”
Children with Chronic Conditions
If you have a child with a chronic condition such as asthma, diabetes or heart disease, they should be vaccinated against COVID-19, because, Dr. Zeitlin offered, “There’s no increased risk they’ll react to the vaccine.”
“If your child is immune deficient, there’s concern that he or she won’t respond fully to the vaccine,” said Dr. Zeitlin. “Get the vaccine, and work with your provider — test for antibodies to check how it’s working.”
There are still children who remain at home because their parents don’t want to send them to activities until they are vaccinated. Those children could be missing out on socializing with their friends, sports, summer camp and travel. The safest way to do any of those activities is, if you are eligible, to get vaccinated.
The Centers for Disease Control and Prevention (CDC) previously recommended that people separate the COVID-19 vaccine by two weeks from other vaccines, such as those for HPV, tetanus or meningitis. However, the CDC recently announced that COVID-19 vaccine co-administration with other vaccines is safe. Dr. Zeitlin pointed out, “This really opens up more flexibility for families and care providers, especially as kids get their vaccines before they go to school or college. If they happen to get one of those, but they also need to go get a COVID-19 vaccine at the same time, it’ll be ok now.”
Once your 5- to 17-year-old is vaccinated, Dr. Zeitlin reminds parents, “Follow the rules wherever you are. A vaccinated person can still get the virus and not know it; they won’t feel sick. But they could transfer it to their younger siblings or unvaccinated friends and loved ones. Still practice plenty of hand-washing and general hygiene. Wearing masks whenever they’re supposed to is a good idea.” In homes where there are siblings not yet eligible for vaccination, “The more members of the family that are vaccinated, the safer it will be in that home.”
This article was reviewed and approved by Pamela Zeitlin, MD (February 2022)
The information on our website is medically reviewed and accurate at the time of publication. Due to the changing nature of the COVID-19 pandemic, information may have since changed. CDC.gov and your state’s health department may offer additional guidance.