UNC Health Talk

7 Things Parents Need to Know About the COVID-19 Vaccine for Children

The wait is finally over. Children ages 5 to 11 are now able to get a COVID-19 vaccine. The U.S. Food and Drug Administration has authorized the Pfizer vaccine for this age group under an emergency use authorization. The Centers for Disease Control and Prevention has also recommended the vaccine for young children.

We asked UNC Health pediatric infectious diseases specialist Peyton Thompson, MD, MSCR, what parents should know. Here are seven things we learned.

1. The Pfizer vaccine is effective and safe in children.

In the Pfizer clinical trial of 2,268 children ages 5 to 11, the vaccine was found to be safe and effective in preventing symptomatic COVID-19. In the study, made up of children who did not have evidence of a prior COVID-19 infection, three cases of COVID-19 occurred among 1,305 vaccine recipients, and 16 cases of COVID-19 occurred among the 663 placebo recipients. The vaccine was 90.7 percent effective in preventing COVID-19.

“The data is quite promising and shows robust immune responses to the vaccine in children ages 5 to 11. It is both effective and safe in this age group,” Dr. Thompson says.

2. Vaccine side effects in young children are similar to those in teens.

The clinical trial data for this age group show no serious side effects. Children in the trial experienced very similar side effects to what researchers have seen in studies of teens and adults who get the Pfizer vaccine. They include a sore arm, headache, feeling tired, muscle aches and chills. Side effects were more often reported after the second dose than the first.

“About 1,400 vaccine recipients were followed for safety for at least two months after the second dose, and there were no serious side effects. There were no cases of myocarditis, an inflammation of the heart muscle, in the Pfizer COVID-19 clinical trial for this age group,” Dr. Thompson says.

Children may experience flu-like symptoms after their shots, so avoid scheduling a vaccine appointment the day before a big test, dance recital, camp, travel or an important sporting event—just in case.

“There is no need to premedicate before your child gets the vaccine, but it is fine to give Tylenol or ibuprofen after vaccination for arm pain or muscle aches,” Dr. Thompson says.

3. The dose for this age group is one-third of the adult dose.

Children will be given a lower dose of the vaccine—10 micrograms, compared with 30 micrograms in people ages 12 and older.

“In the clinical trial, children’s immune responses were observed by measuring the antibody levels in their blood and comparing them with a control group of 16- to 25-year-olds who were given two shots of the larger 30-microgram dose,” Dr. Thompson says. “Children have really robust immune systems, which means they can get a lower vaccine dose and still produce the same number of antibodies.”

4. The vaccine is recommended even if your child has had COVID-19.

Clinical trial data support vaccination for those who have previously been infected with COVID-19.

“We know you can get the virus more than once. Plus, it remains unclear how long protection from infection lasts,” Dr. Thompson says. “There is also concern that infection may not offer protection against newer variants. Getting a vaccine after having COVID-19 will provide an additional boost to your child’s immune system against the virus.”

If your child had COVID-19, they should NOT come to a medical facility until all of the following are true:

  • It has been 10 days since they first had signs of COVID-19 or a positive COVID-19 test.
  • They have been fever-free for 24 hours without using fever-reducing medications.
  • Their other symptoms of COVID-19 are getting better.

5. Vaccination offers the best protection for your child and family.

Although most children typically don’t get as sick with COVID-19 as adults do, that’s not the case for everyone. More than 5 million children have been infected during the pandemic, and COVID-19 cases among children have risen more than 240 percent since July.

In addition, some children and teenagers get extremely sick, and about 400 children have died. Children who experience symptomatic infections can also have long-term side effects, such as fatigue, shortness of breath and brain fog.

“The timing of this is significant because we’ve seen COVID cases among children rise over 240 percent since July, and while hospitalization and death are less common among children infected with COVID than among adults, rates of both are increasing,” Dr. Thompson says. “Each hospitalization and each death are tragic and now preventable through vaccination.”

6. Children younger than 5 are likely to be eligible in 2022.

Vaccinating children ages 5 to 11 will be beneficial for keeping schools open and helping to end the pandemic, but younger kids probably won’t be eligible until early next year.

Clinical trials are underway to evaluate the safety and effectiveness of the Pfizer and Moderna vaccines in children under 5. Researchers are testing even smaller doses for this age group; Pfizer is testing 3 micrograms in the youngest children, just a tenth of the adult dose.

7. It’s important to continue vigilance to protect kids.

Because children younger than 5 cannot yet receive a vaccine, it’s important for families to continue to follow COVID-19 safety precautions. The best way to do this is to get vaccinated yourself and to ask your child’s caregivers to get vaccinated as well. Unvaccinated caregivers should be masked around young children at all times, and young children should not be in crowds with people who might be unvaccinated.

Beyond vaccination, “everyone should wear masks indoors and in crowded outdoor areas, practice frequent hand-washing and maintain physical distancing, which will decrease their risk of exposure to COVID-19,” Dr. Thompson says. “And since we’re entering flu season, make sure everyone in your family gets a flu shot.”


Visit unchealthcare.org/vaccine for the latest information on the COVID-19 vaccines.