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When will children under 5 be able to get vaccinated for COVID-19?

Pfizer's vaccine is only authorized for children 5 and up. That could soon change.

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The FDA could give approval for a COVID-19 vaccine for children under 5 as soon as late February.

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

A COVID-19 vaccine for children under 5 could be available by the end of February or the beginning of March, according to White House medical advisor Dr. Anthony Fauci.

In a Jan. 19 interview with Blue Star Families, Fauci said that while he wouldn't "outguess" the FDA's regulation process, "My hope is that it's gonna be within the next month or so, and not much later than that."

The US Food and Drug Administration approved Pfizer's COVID-19 vaccine, Comirnaty, for all Americans ages 5 and up in October 2021.

The pharmaceutical giant is currently testing a vaccine and booster in children ages 6 months to 5 years old and said it expects to have more data on the results by April.

Pfizer's Comirnaty is currently the only vaccine authorized for children. Moderna's and Johnson & Johnson's shots are still only authorized for adults age 18 and up. 

Pfizer researcher Alexandra Gurtman also said the company was also looking at a booster shot for children ages 5 to 11, given six months after their second dose. Right now only kids 12 and older can get a Comirnaty booster, after the CDC recommended it earlier this month.

"This booster dose will provide optimized protection against COVID-19 and the omicron variant," CDC Director Dr. Rochelle Walensky said in a statement. "I encourage all parents to keep their children up to date with CDC's COVID-19 vaccine recommendations."

The CDC recommends a third dose of the Pfizer vaccine for children who are at least 5 years old and moderately or severely immunocompromised, which is in line with guidance for immunocompromised adults. It also shortened the time that someone who got Pfizer's two-dose vaccine needs to wait for a booster shot from six months to five. 

As the COVID-19 landscape continues to evolve, here's what we know about COVID-19 vaccines for kids. Plus, learn about the possibility of a fourth booster shot and how to find an at-home COVID-19 test

When can my child get a booster shot?

Children as young as 12 can get now get a third dose of Pfizer's COVID-19 vaccine, given at least five months after their second shote. Most kids younger than 12 can't get a booster, although children 5 and up who are immunocompromised are eligible for a booster 28 days after their second dose. 

Where can my kid get a booster shot?

Since only Pfizer's COVID-19 vaccine is currently approved for anyone under 18, it's generally only available in doctor's offices and public health clinics, not pharmacies and other mass vaccination sites.

Call your pediatrician or local health clinic for a recommendation on where to go. Parents may also text their ZIP code to 438829 or use this vaccine finder link to find a clinic near them that has the child vaccine available. 

Can children age 4 or younger get a COVID-19 vaccine?

Not yet. White House medical advisor Dr. Anthony Fauci previously said that he expects vaccines to be available to children under 5 by early 2022. On Dec. 17, Pfizer announced that it was testing a third-dose protocol with children as young as 6 months old. A two-dose series using a 3-microgram version of Pfizer's vaccine proved effective in children 6 to 24 months, but not with 2-to-5-year-olds.

Results from a vaccine booster test for kids under 5 could be available by early April, Reuters reported. If they prove effective, it would open the door for FDA authorization of COVID-19 vaccines for kids under 5.

In December the FDA authorized Eli Lilly's monoclonal antibody treatment for young children, even newborns, if they're infected or were exposed and are at high risk of severe COVID-19. Children who are at high risk for COVID-19 include kids who are obese or have diabetes, asthma or other underlying health conditions.

However, monoclonal antibodies are understood to not be as effective in treating the omicron variant of COVID-19.

Do kids really need a COVID-19 vaccine? 

According to recent CDC data, 1.5 million children ages 4 and under are currently infected with COVID-19. While it's true children are much less likely to get severely sick from the virus compared to adults, Fauci said, "the risk is not zero." 

The CDC reports 362 children ages 5 and under years have died from COVID-19; 230 kids ages 5 to 11; 266 kids ages 12 to 15; and 273 kids ages 16 to 17.

An infection, even a mild case, requires quarantining and potentially sending classmates out of the classroom and back to remote learning. And kids can experience dangerous complications from COVID-19, including long COVID and MIS-C

According to a report from the American Academy of Pediatrics, in January COVID-19 cases in children reached their highest case count since the beginning of the pandemic: Nearly 7.9 million children have tested positive for COVID-19 since the beginning of the pandemic, or one in 10 children, the AAP reported. (The AAP says the definition of "child" varies by the states reporting.) 

There are also racial disparities in how sick children get from COVID-19: Kids 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 an FDA advisory panel. Of that group, about one in three will require admission to the ICU.

Are booster shots safe for children?

In a statement following its authorization of booster doses for kids 12 to 15, the FDA said it reviewed real-world data from more than 6,300 children in Israel, ages 12 to 15, who received a booster shot at least five months after their second dose of Pfizer.

No additional safety concerns were reported to date in those individuals, according to the FDA. 

"These additional data enabled the FDA to reassess the benefits and risks of the use of a booster in the younger adolescent population in the setting of the current surge in COVID-19 cases," the agency said. "The data shows there are no new safety concerns following a booster in this population."

What side effects can kids get from a COVID-19 vaccine or booster? 

Vaccine side effects in kids ages 5 to 11 are mostly mild and similar to those adults may experience, according to the CDC, including soreness at the injection site, fever, muscle soreness, nausea and fatigue. In a Dec. 13 report from the agency, the CDC reviewed reports from safety monitoring systems on more than 8 million doses of Pfizer's vaccine given to kids ages 5 to 11, confirming that children's immune systems respond well to the vaccine with common mild side effects, and that serious adverse events are rarely reported. 

Inflammation of the heart muscle, known as myocarditis, and of the muscle's outer lining, called pericarditis, are rare and typically mild side effects linked to the Moderna and Pfizer vaccines, mostly in adolescent males and young men ages 12 to 29. (Myocarditis can also occur after infection with COVID-19.)

In one study, the CDC said that 54 recipients out of a million males ages 12 to 17 experienced myocarditis following the second dose of Pfizer-BioNTech's Comirnaty vaccine. In contrast, kids ages 5 to 11 who catch COVID-19 have a higher risk of multisystem inflammatory syndrome, or MIS-C, a potentially serious complication involving inflammation of the heart, lungs, kidneys, brain, skin, eyes or other organs. 

"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 are," Dr. Matthew Oster, a pediatric cardiologist at Children's Healthcare of Atlanta, told the CDC in November, ABC News reported.

How is Pfizer's child vaccine for kids under 12 different?

Though it's still delivered in two shots given three weeks apart, Pfizer's vaccine for kids 5 to 11 is one-third the dose given to everyone 12 and up. Pfizer's vaccine for kids can also be stored for up to 10 weeks in a fridge, making it easier to administer, and the cap on the vial is orange instead of purple and gray to avoid mix-ups. 

And if it helps to put your kids at ease, the needle used to administer the child's dose of vaccine is also smaller. 

For more information about Pfizer's vaccine for younger children, check out this fact sheet by the FDA

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

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

However, depending on which state you live in, there may be a legal precedent for teens and other kids to request the vaccine without your permission: Tennessee's vaccine director, Michelle Fiscus, was fired in August allegedly in part for sending out a memo detailing Tennessee's "mature minor doctrine," which explains how minors may seek medical care without the consent of their parents. 

If my child has a serious health condition, can they get a third shot? 

The CDC recommended a third dose for children as young as 5 who are "moderately to severely" immunocompromised, 28 days after their second shot. This guidance for immunocompromised children (including kids who've had an organ transplant or are taking medications that suppress the immune system) is in line with guidance for adults whose bodies don't mount a good immune response to the COVID-19 vaccines.

My child has allergies. Can they get the vaccine?

Yes, though you might be asked to stick around the waiting room so health care providers can monitor them for (extremely rare) allergic reactions that can occur after any vaccination. 

"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," said Dr. Anne Liu, an infectious disease specialist with Stanford Hospital and Clinics and the Lucile Packard Children's Hospital. Children who have been prescribed an EpiPen for any reason should bring it to their vaccine appointment, Liu added. 

As with adults, children with an allergy to an ingredient in Pfizer's COVID-19 shouldn't take it. You can 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?

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

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.