3 Things Parents Should Know About Bivalent Boosters for Young Children

The bivalent COVID-19 booster shot was recently authorized for children as young as 6 months, meaning the updated vaccine is now available to almost all age groups.

The bivalent vaccine has two parts: the original vaccine, plus a new vaccine that provides coverage against the omicron variant.

We talked to UNC Health pediatric infectious diseases specialist Peyton Thompson, MD, MSCR, about what parents of children younger than 5 need to know. Here are three facts we learned.

1. Eligibility for the bivalent booster depends on the type of vaccine and number of shots your child has already received.

If your child received the Moderna primary series, made up of two shots, they are eligible for a Moderna bivalent booster two months after finishing the primary series. If your child is immunocompromised, they will have a different vaccination schedule.

If your child received Pfizer, it’s different. The Pfizer vaccine series is made up of three shots for this age group. It is now recommended that the Pfizer bivalent vaccine be the third dose. However, children in this age group who’ve already received all three doses of the original Pfizer vaccine are not eligible for the bivalent vaccine.

“The thought is that they’re well enough covered because they’ve gotten the three doses, and there could be some cross-protection against omicron,” Dr. Thompson says.

2. Side effects of all COVID-19 shots are minor and temporary.

Side effects from the bivalent booster are minor and similar to other vaccines. They may include irritability and crying in the youngest children (under age 3) and feeling tired in the older age group (older than age 3).

“The side effects are the same across all age groups. The main side effects are swelling and redness at the site of injection,” Dr. Thompson says. “Then feeling tired, and muscle or body aches. Fever is less common. These are side effects we would expect with any of our routine childhood vaccines.”

There is no need to pre-medicate before your child gets the vaccine, but it is fine to give acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) after vaccination for aches or fever, Dr. Thompson says.

3. Vaccines are the best protection against severe illness from COVID-19 and the flu.

RSV, or respiratory syncytial virus, and the flu have surged among children and created a shortage of beds at pediatric hospitals. COVID-19 cases are back on the rise.

“Right now, we’re seeing a ‘tripledemic’ with RSV, flu and COVID. It’s pretty scary for these little ones who get hospitalized for these illnesses, and even more so for their caregivers. You can get multiple viruses at once, which is really tough on these little babies and their immature immune systems,” Dr. Thompson says. “That’s why it’s important to get vaccinated—to protect these babies from what we can protect them against.”

If your child is eligible for a flu shot and a COVID-19 vaccine or booster, get them. It’s safe to get them at the same time, Dr. Thompson says. There is not yet a vaccine for RSV, but receiving the other vaccines can reduce the potential impact of viruses on your child’s respiratory system.

“Studies continue to support the fact that vaccines prevent severe illness, hospitalization and death, and that’s what we care about. We know you can still get flu despite flu vaccination, but you don’t get the severe cases that land you in the hospital. And that’s the same we’re seeing with COVID,” Dr. Thompson says. “Even though we don’t see 100 percent efficacy of these vaccines, some protection is definitely better than none.”


To find out where to get the COVID-19 or flu vaccines for this age group, visit http://www.vaccines.gov/ or talk to your doctor. Need a doctor? Find one near you.