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COVID-19 vaccine for kids 5 to 11: What to know about the omicron variant and more

About 5 million children ages 5 to 11 have received a COVID vaccination, according to a White House estimate.

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For the most up-to-date news and information about the coronavirus pandemic, visit the WHO and CDC websites.

In order to stay ahead of the new omicron variant, health officials in the US are urging all adults to get COVID-19 boosters, and for the unvaccinated to go get vaccinated -- including children as young as age 5, who are now eligible for a coronavirus vaccine. 

Pfizer's vaccine for kids is one-third of a regular dose, a slightly different formula and given with a smaller needle. It was authorized by the US Food and Drug Administration and recommended by the US Centers for Disease Control and Prevention after data showing an encouraging safety profile and high effectiveness was reviewed by independent committees to the CDC and FDA. 

At a White House COVID-19 Response Team press briefing Tuesday, coordinator Jeff Zients said that 5 million kids ages 5 to 11 will have had their first shot. When asked about the safety and risk of myocarditis for kids receiving the vaccine, CDC Director Dr. Rochelle Walensky said: "We haven't had anything that's come to us as a signal, and we continue to watch that carefully." 

Children are included in the Biden administration's plan to combat both omicron and the still-dominant delta variant circulating this winter. For kids, the plan includes implementing more "test to stay" policies that keep children in school who have been exposed to COVID-19, without sending them home for 14 days to quarantine, through frequent testing and other public health measures. The CDC will release more information on such policies in the coming weeks, according to the White House. Another part of the Biden administration's plan is launching "hundreds of family vaccination clinics" so kids can get vaccinated alongside their parents who are going in for a booster shot

While omicron is likely to decrease the vaccines' effectiveness to some degree at preventing infection, and more information about the new variant needs to be analyzed before scientists can speak definitively about the new variant, delta remains the dominant variant in the US. For the week ending Dec. 2, children made up 22.4% of COVID-19 cases, according to the American Academy of Pediatrics. 

Here's what we know about COVID-19 vaccines for kids. 

Do young kids even need a COVID-19 vaccine? 

Children remain at low risk of severe COVID-19 disease and death compared with the adult population. (Of states that reported data to the AAP, 0.1% to 1.9% of COVID-19 cases in children resulted in hospitalization.) But children can experience complications from COVID-19, including long COVID and multisystem inflammatory syndrome

Kids ages 5 to 11 are also at least as likely to be infected with COVID-19 as adults are, according to data presented at a meeting of FDA advisers -- more than 1.9 million children in that age group have been infected since the beginning of the pandemic. According to CDC data from Dec. 1, 199 children ages 5 to 11 have died from COVID-19 in the US. 

There are also racial disparities in how sick children get from COVID-19. Children ages 5 to 11 who are Black, Native American or Hispanic are three times more likely to be hospitalized with COVID-19 than white children, according to the presentation. Of children ages 5 to 11 hospitalized with COVID-19, about one in three will require an ICU admission.

The pandemic has had other effects on children, including mental and emotional tolls. In mid-October, the AAP, American Academy of Child and Adolescent Psychiatry and Children's Hospital Association declared a national emergency in child and adolescent mental health, with children from communities of color being disproportionately affected. Given the role that in-person learning plays in a child's development, the CDC prioritized in-person learning for students this fall, and it has guidance on prevention. 

Can children age 4 or younger get vaccinated?

Not yet. Fauci has previously said that he expects vaccines to be available to children under 5 by early 2022. 

Everyone 5 and older can get vaccinated. It may have taken a few days for your local pharmacy or health clinic to get Pfizer's vaccine for kids ages 5 to 11 in stock, however, because it's different from Pfizer's vaccine for everyone else (more on that below). However, the program is up and running now and you should be able to find the smaller dose of the vaccine at a clinic near you

Kids age 12 and up have been eligible for Pfizer's COVID-19 vaccine for a while. The other mRNA vaccine, Moderna, and the only single-dose vaccine on the US market, Johnson & Johnson, aren't available to kids yet.

Where can I get my child vaccinated for COVID-19? 

The COVID-19 vaccine for kids under 12 will be free regardless of immigration status, just like it is for adults. It will be available in pediatricians' offices, doctor's offices, public health clinics and places accessible to children. (Mass vaccination sites that provided COVID-19 shots to adults will not be used as part of the child vaccine program.) A good place to start would be calling your pediatrician or local health clinic for a recommendation on where to go. 

Parents may also use this vaccine finder link to find a clinic that has the child vaccine available. 

How is Pfizer's vaccine for young kids different?

Pfizer's vaccine is one-third the dose of the vaccine given to everyone age 12 and older (but it's still given in two shots, three weeks apart). The needle used to administer the vaccine will also be smaller. Additionally, the cap on the vial the vaccine comes in will be orange instead of purple and gray to avoid mix-ups. 

The formula of the vaccine also varies slightly from the formula for adults. Pfizer's vaccine for kids can be stored up to 10 weeks in a fridge, making it easier to administer. For more information about Pfizer's vaccine for younger children, check out this fact sheet by the FDA

Should I worry about myocarditis? 

At the White House briefing Tuesday, CDC Director Dr. Rochelle Walensky said that health officials are continuing to "comb those data" regarding myocarditis in younger kids, but that "we haven't had anything that's come to us as a signal." 

Myocarditis and pericarditis, or inflammation of the heart muscle, is a rare side effect linked to the Moderna and Pfizer vaccines and is mostly seen in adolescent males and men under 30. (Importantly, cases of myocarditis following vaccination have been mostly mild and gone away quickly. Myocarditis can occur after infection with a virus, including COVID-19.) In one study, the CDC said that 54 kids out of one million males ages 12 to 17 experienced myocarditis following a second dose of Pfizer. In general, kids under 12 have a lower risk of myocarditis from other causes compared to adolescents, the CDC says, and the benefits of vaccinating for COVID-19 outweigh any known and potential risks. 

By contrast, kids ages 5 to 11 have a higher risk of MIS-C, a potentially serious complication of COVID-19.

"The bottom line is that getting COVID is much riskier to the heart than anything in this vaccine, no matter what age or sex you have," Dr. Matthew Oster said after a presentation on myocarditis prior to the CDC's recommendation. 

Side effects in kids ages 5 to 11 were mostly mild and similar to the side effects adults may experience after vaccination, according to the CDC

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Do I need to give consent in order for my young child to get vaccinated? 

Yes, parents generally need to consent to their children receiving medical care, which will include Pfizer's COVID-19 vaccine. This is especially true for younger children. 

However, if you have a teenager or child old enough to express a desire to get a COVID-19 vaccine and you haven't given consent, they may have legal precedent to seek one out, depending on which state you live in

In Tennessee, the rights of minors versus their parents when it comes to vaccine decisions came under the spotlight last summer when the state's vaccine director, Michelle Fiscus, was allegedly fired, in part, for sending out a memo explaining Tennessee's "mature minor doctrine," which is the state's writing on how minors may seek medical care without the consent of their parents in some cases. 

If my child is immunocompromised or has a health condition, can they get a third shot? 

A third dose of Pfizer's vaccine isn't authorized or recommended for immunocompromised children ages 5 to 11. Additionally, the boosters currently recommended for fully-vaccinated Americans are only for adults age 18 or older. No minor is eligible for a booster. 

If your child is at least 12 years old, "moderately or severely" immunocompromised and vaccinated with Pfizer, according to the CDC, they should get a third dose of Pfizer. Moderna is only authorized for people age 18 and older. Examples of people who are immunocompromised include people receiving treatment for cancers in the blood or tumors, organ transplant recipients, stem cell transplant recipients, people with untreated or advanced HIV infection and people taking drugs that could suppress the immune response, per the CDC. 

Does Pfizer's full FDA approval extend to kids?

The FDA's approval of the vaccine by Pfizer and its partner, BioNTech, only applies to people as young as 16 years old. While Pfizer remains the only vaccine authorized for use in kids as young as 5 years old, vaccinating that age group is still under emergency use authorization rather than total approval. This is because, along with other factors, full FDA approval requires data on how the vaccine fares six months out, per NPR. Pfizer's vaccine was only authorized for kids age 12 to 15 in May. 

This means that a vaccine mandate that hinges on full approval of a coronavirus vaccine, such as the one announced for school kids in California, won't apply to kids younger than 16 for a while.

My child has allergies. Can they get the vaccine?

"If the child has a history of anaphylaxis or other severe allergies, then the observation time after the injection may be 30 minutes instead of 15," Dr. Anne Liu, an infectious disease specialist with Stanford Hospital and Clinics and the Lucile Packard Children's Hospital, said in August. So you might be asked to stick around the waiting room with your child for an extra 15 minutes so health care providers can monitor vaccine recipients for the (extremely rare) allergic reaction that can occur after any vaccination. 

Additionally, Liu said, children who are prescribed an EpiPen for any reason should bring it to their vaccine appointment. 

As for adults, children with an allergy to an ingredient in Pfizer's COVID-19 shouldn't take it. Find a list of ingredients in Pfizer's vaccine for kids ages 5 to 11 on the FDA's fact sheet

Can my child get the COVID-19 shot at the same time as other vaccines?

Yes, according to the CDC, your child may get other vaccines when they go in for their coronavirus shot without waiting 14 days between appointments. Flu shots can be given to children age 6 months and older. 

Correction, Oct. 25: A previous version of this story included a sentence implying incorrect information about available vaccines for children age 12 and older. Only Pfizer's vaccine is currently available for kids ages 12 to 17.

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.