Kids Health

The COVID Vaccine for Children Under 5 Has Been Approved: What Now?

covid vaccine"
covid vaccine
Graphics by: Anna Wissler
Graphics by: Anna Wissler

Editor’s Note: Always seek the advice of your child’s pediatrician or other qualified health provider with any questions you may have regarding the health of your child. 

It’s here! The COVID-19 vaccine has been approved for children under 5. The U.S. Food and Drug Administration and Centers for Disease Control and Prevention authorized Pfizer’s three-dose vaccine series and Moderna’s two-dose vaccine series for children under the age of 5 on June 17. Pfizer’s vaccine is for children aged 6 months-4 years old (Pfizer already had a vaccine authorized for 5-year-olds)—and Moderna’s is for kids aged 6 months-5 years old.

But what now? With the approval comes hesitation from parents (this parent included). As a fully vaccinated adult, I am 100% pro-vaccine, but I have to admit, I’m slightly nervous about my 3-year-old daughter getting vaccinated. I know I’m not alone.

For other parents trying to decide what’s best for their family, we gathered the latest research and reached out to an expert in pediatric medicine, Dr. Mahim Jain, to answer some common questions parents have about the COVID-19 vaccine for children under the age of 5.

Meet the expert
Dr. Mahim Jain
The Kennedy Krieger Institue
Dr Mahim Jain is a member of the Osteogenesis Imperfecta Clinic at Kennedy Krieger Institute and an assistant professor in the Department of Pediatrics at The Johns Hopkins University School of Medicine. Dr. Jain is also The Kennedy Krieger Institute vaccination expert when it comes to COVID-era opportunities.

Tell us about the COVID vaccine for children under 5 and how similar it is to the vaccines administered to adults and older children.

Dr. Jain: The vaccines are the same vaccination older children have received but in lower doses. The vaccination is recommended in either two doses (Moderna) or three doses (Pfizer/BioNTech) based on studies that evaluated both the safety and effectiveness of the vaccination. The noted side effects are similar to other childhood vaccines.


With many children having asymptomatic cases of COVID-19, why should parents consider vaccinating their young ones?

Dr. Jain: There are many reasons to vaccinate children under 5. It is correct to note that young children have a lower risk of severe COVID-19 illness, however, the risk is not zero. This is noted for children with risk factors, which can include medical respiratory illnesses such as asthma, diabetes, obesity, and children with developmental disabilities. Children have a rare risk for the development of multisystem inflammatory syndrome (MIS-C) where children develop inflammation throughout the body, including the brain and heart, and can result in life-threatening complications. In addition, children have been observed to have long COVID-19 symptoms.

As we know, children can act to spread COVID-19 to family members, and most concerning, to family members who are older or who have comorbidities that place the family member at risk of severe COVID-19 illness. It is also suggested that a lower burden of COVID-19 illness can result in fewer variants emerging. Finally, young children are often in classrooms or participate in social events with children who have risk factors, such as developmental disabilities.


covid vaccine

Source: CDC | Pexels


What is your advice to parents who are hesitant to vaccinate their children under 5 years old?

Dr. Jain: The data that was reviewed by the FDA prior to the authorization for vaccination in young children showed side effects such as soreness at the injection site and some potential systemic symptoms such as fever or fatigue after vaccination. This is in line with the risk of other childhood vaccinations.

There was not an observed risk of severe side effects, and there were not any observed cases of myocarditis from the vaccine in the completed studies. The vaccine is felt to be safe and also effective in children under 5 years old. If there are questions related to specific medical issues in a child, I recommend that parents speak with their pediatrician or physician that can help answer specific concerns.


What about children with disabilities? Should they be vaccinated?

Dr. Jain: Developmental disabilities pose an independent risk factor for developing severe COVID-19 illness. This was observed in studies from the start of the pandemic and is felt to be a strong, independent risk factor. Given the risk of severe illness in this population, vaccination is generally recommended.


Young children get a lot of vaccines, should the COVID vaccine be given at the same time?

Dr. Jain: The current recommendations are that this vaccine can be given with other childhood vaccines, but working with your pediatrician, you may decide to space out vaccinations if your child is anxious. Parents can be assured that reported side effects are the same as other childhood vaccinations.


If my child under 5 has already had COVID-19, do they still need the vaccine?

According to an edition of CNN Health, CNN Medical Analyst Dr. Leana Wen, an emergency physician and a professor of health policy and management at the George Washington University Milken Institute School of Public Health, says that yes, children who have had COVID-19 still need to be vaccinated. Dr. Wen explained that vaccination after recovery from infection provides more durable and longer-lasting protection than recovery alone.


We now know the vaccine for children 5-11 years old was only found to be moderately effective against the Omicron variant, what do we know about the effectiveness of this vaccine?

An article published in Yale Medicine, with expert advice from Dr. Leslie Sude and Thomas Murray, MD, PhD, a pediatric infectious diseases specialist, broke down the effectiveness of each vaccine. Here are a few key points from the article:

Pfizer: Following a third dose, children 5 and under elicited a strong immune response, and efficacy was 80.3% in preventing symptomatic infection. It’s important to note that parts of the studies took place before the Omicron variant was predominant.

Moderna: Interim results show that the vaccine was 51% effective against symptomatic infection among children ages 6 months-2 years, and 37% effective among those who are 2-5 years. In both age groups, two doses were compared favorably to the immune response adults ages 18-25 had after two doses. The studies were conducted during the Omicron wave.

Vaccine efficacy was significantly lower for both vaccines in these age groups, compared with their efficacy in adults. (In the clinical trials used for the FDA EUAs of Pfizer’s and Moderna’s COVID-19 vaccines for adults, the efficacy was 94% and 95%, respectively.) “It’s important to be clear about what we know about the vaccines so far, in terms of what they do and don’t do,” Dr. Murray said in the article. “The vaccines remain very helpful in reducing the severity of disease…for adults, and we expect the same with children. But we don’t know how these vaccines will perform in real life with respect to protection from being infected.”

5 Ways to Get Your Child Comfortable with Going to the Doctor
Click to Read