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On November 2, 2021, the Center for Disease Control granted approval for the Pfizer mRNA Covid vaccine in children 5-11 years of age. It is understandable that parents may have many questions regarding this vaccine in children, so read on to find out the answers to some of the most common questions I am being asked by parents.

Do you think that kids between the ages of 5-11 need a COVID vaccine?

It is true that children have still by and large done well since the Covid pandemic began over 18 months ago.  However, it is important to realize that children have not completely escaped this brutal disease which became even more evident during the most recent Delta variant surge.  As of mid October, there have been over 1.8 million children 5-11 years of age infected with Covid. There have been over 8,600 hospitalizations in this age group along with approximately 2,600 cases of Multisystem Inflammatory Syndrome in Children (MIS-C).  Sadly, 143 children between 5-11 years of age have died of Covid (this exceeds the number of deaths from seasonal flu in the same age group).  It is also important to point out the non-medical toll of Covid in children which includes quarantines and isolation, school closures, loss of in classroom learning, loss of therapy services for children, and the mental and emotional repercussions of the loss of parents and grandparents due to Covid.

Is there a difference in the adult vaccine and the 5-11 vaccine?

The Pfizer Covid vaccine authorized for 5-11 year olds is a 10 mcg dose which is ⅓ of the dose that is used in those 12 and older.  While the dose itself is much less, the dosing interval remains the same…two doses separated by 21 days.  Once a child is 2 weeks out from their second vaccine dose, they are considered fully vaccinated.

Are there any safety concerns I should be aware of for this vaccine?

Understandably, this is the most important question for me not only as a pediatrician, but as a mom.  The Pfizer study included an initial study group as well as a safety expansion group.  Between these two groups, 3,109 children 5-11 years of age received the vaccine during the trial while another 1,538 received a placebo.  The biggest side effect noted was redness on the arm and a sore arm for those in the vaccine group. Interestingly, children in the study who received the vaccine experienced less fever and fatigue than those in the 16-25 year age group.  There were no severe adverse reactions, no cases of myocarditis (heart inflammation), no anaphylaxis and no deaths in the study group.

Should I be concerned about myocarditis?

Myocarditis is inflammation of the heart muscle. It can be seen after many viruses, and we know that actual Covid infection can lead to severe myocarditis.  It has been noted that a VERY rare side effect of mRNA Covid vaccines has been myocarditis particularly in older adolescent and young adult males.  So just how rare is this side effect? It is estimated that there could be 60 cases of myocarditis out of every 1 million second doses of Covid vaccines given to males 12 years and older.  Given how very rare this side effect is, it would not be expected that we would have seen any cases in the Pfizer 5-11 year old study.  However, studies out of Israel suggest that the chance of myocarditis in the 5-11 year olds will be even more rare especially given the lower dose of the vaccine.  There are at least 5 post authorization studies here in the US that will follow for rare side effects such as myocarditis.

When can children get their Covid vaccine?

Once a child meets the age criteria, then they can get their vaccine at any time. The CDC has said that the Covid vaccine can be given at the same time as any other childhood vaccines including the influenza vaccine.  For children who have had Covid, the recommendation at this time is that they can receive the Covid vaccine as soon as the 10 day quarantine period is over and the child is fever free from their Covid illness.  If your child was hospitalized and received any kind of antibody therapy for Covid, then you should discuss with your child’s doctor as far as timing of the vaccine.

The decision to vaccinate your children against Covid will be a personal choice for each family.  It is understandable that parents may have questions about covid vaccines in their children especially given the amount of information (much of it not scientific information) that can be found online.  I encourage all families to discuss any questions or concerns with your child’s pediatrician or other trusted healthcare provider.