The moment many moms and dads have been waiting for—since the very start of the pandemic—has finally arrived! The Food and Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC) just authorized COVID-19 vaccines for kids under 5. That means, roughly 18 million more kids will be eligible to receive the shot to protect themselves and to reduce their risk of spreading the disease to their family, teachers, and more! As has happened with every development in the COVID saga, some parents will take a wait-and-see approach, while others are incredibly relieved and are booking appointments ASAP.  

With the number of COVID cases once again rising, and masks disappearing from common use, it’s important that parents have the facts straight on the COVID vaccine for kids. No matter what you are planning to do, one thing is for sure, in this world where we are bombarded with misinformation form social media trolls and troublemakers, you want the very best insights to help you make your decision.

It’s reassuring to know that top authorities, like the American Academy of Pediatrics, fully encourage parents having their kids—and themselves—vaccinated. Nevertheless, to help you make an informed decision, let’s tackle some of the top questions you might have about the COVID-19 vaccine—and booster shot—for little babies and toddlers.

Do young kids need to be vaccinated?

Here are three good reasons why it makes sense to give kids—and adults—the shot:

COVID is risky for kids: Sure, kids get far less severe infections than older adults, but some do get very sick. The current Omicron variant has put the most kids in the hospital since the start of the pandemic. Almost 13.5 million children have been infected with COVID-19 since the start of the pandemic, 128,000+ have been hospitalized, and 1,536 children have died. To date, nearly 500 of them have been under 5 (COVID-19 is among the top 10 leading causes of death for children 5 to 11.)

Young kids can also get the rare (but sometimes deadly) COVID complication called Multisystem Inflammatory Syndrome in Children, where the heart, lungs, kidneys, and brain can get very inflamed. In addition, long-haul symptoms—like losing their sense of smell and taste—can be pretty terrible for a child to suffer.

COVID is risky for your family: Most infected kids have few or no symptoms...but they can still spread COVID to family members—and lose their own sense of smell or taste…or land in the hospital, or worse!

COVID is risky for your neighbors: Kids can quickly spread the illness because they’re not as reliable at wearing masks, washing hands, and they often seem perfectly well…even though they are infected. Spread of the infection to playmates, teachers, and other close contacts can ignite passage of the virus through an entire community. And when people get sick, the virus quickly duplicates millions and billions of virus particles…and that is when dangerous mutations can occur. What we have seen is that one major mutation can hurt tens of millions of people throughout our communities, the country, and the world!

Do children’s vaccines differ from the adult versions?

As of June 2022, kids under 5 have two vaccine options:

  • The Moderna vaccine. Kids 6 months to 5 years can receive one-fourth the strength of an adult dose, administered in two shots, four weeks apart.

  • The Pfizer vaccine. This vaccine is one-tenth the strength of the adult vaccine. Children 6 months to 4 years get two doses—three weeks apart—and the third and final dose at least two months after the second dose. 

For bigger kids, there will (soon) be three COVID-19 vaccine options:

  • The Pfizer vaccine. This is for kids 5 to 11 years of age. The dose is one-third of the adult dose and it’s given in two shots, 21 days apart. Fact: For many illnesses, like polio and tetanus, we give kids the same exact vaccine dose as adults. But with COVID, the studies show kids do just fine with a lower dose.

  • The Moderna vaccine. This is for kids 6 to 11 years of age. The dose is half the adult dose and is given twice, with 28 days between the first and second dose. (This is slated to be approved by the CDC shortly.)

  • The Moderna Vaccine. Teens (12 to 17 years) get the same dose as adults, given in two doses, four weeks apart. (This is slated to be approved by the CDC shortly.)

Should 4- and 11-year-olds wait for their birthdays so they can receive a larger dose of the COVID-19 vaccine?

No. All eligible children—including those on the cusp of an older age bracket—should get their COVID vaccines as soon as possible. And if your 4- or 11-year-old has a birthday between their first and last doses, they’ll receive the dosage amount appropriate for their just-turned age. 

How effective is the COVID-19 vaccine in children?

Here’s the most important point: the vaccines are very effective at preventing severe illness. They keep kids from being hospitalized and dying. Researchers estimate that being fully vaccinated reduced risk of hospitalization by more than two-thirds. One study found that 92% of 5- to 11-year-olds hospitalized with COVID during the Omicron surge were unvaccinated.

What about protection from less severe infections? For the under-5 set, Pfizer is 80% effective against symptomatic COVID (after the three shots). It is moderately effective (31%) at protecting 5- to 11-year-olds from the Omicron variant. The Moderna was a bit less effective, protecting 51% of kids 6 months to 2 years old and 37% ages 2 to 5 years old. The coming Moderna vaccines for older kids is roughly 88% effective in 6- to 11-year-olds and 93% effective in 12- to 17-year-olds.

However, it’s important to understand that vaccine effectiveness for any vaccine wanes over time…making boosters a must.

Is the COVID-19 vaccine safe for children?

YES! The COVID-19 vaccine seems new, but the amazing mRNA tech behind it has been studied for decades. The 3,000+ 5- to 11-year-olds who got the vaccine during the clinical trials usually had minimal side effects, including pain at the shot site, mild fatigue, and headache. There were no serious reactions and no deaths. And the same results held true for younger kids, too. Since kids rarely have long-term side effects from COVID infection, the CDC notes that it’s “extremely unlikely following any vaccination, including COVID-19 vaccination.”

What about the heart problems linked with COVID-19 vaccinations?

A true infection with the actual COVID-19 virus rarely causes myocarditis (inflammation of the heart). Children are much more likely to develop heart issues after a COVID infection than after receiving the vaccine. The latest numbers from the CDC show that the rate of myocarditis in children is uncommon: Out of a million vaccine doses, roughly four instances of myocarditis occurred in 5- to 11-year-olds after the second vaccine. And there have been no reported cases among the infants and toddlers involved in the vaccine trials. The expert panel that reviewed the evidence concluded that the benefits of COVID-19 vaccine for children outweigh the risks.

Do children who’ve already had COVID-19 still need the vaccine?

Yes! Unfortunately, children and adults can be infected with the COVID-19 virus more than once. While folks likely have some immunity after recovering from the virus, it’s unclear how long that protection lasts.

Do children really need a COVID booster?

Yes. All 5- to 11-year-olds should get a booster dose of Pfizer’s COVID-19 vaccine at least five months after they received the initial two shots. Research has shown that this third dose significantly bolsters antibodies against the virus—including the more contagious Omicron variant. This is especially important because more kids have gotten sick, experienced longer term effects, and been hospitalized during the Omicron wave than with prior variants. While there’s no booster available for younger children yet, experts contend that a booster dose will most likely be needed.

Where can my child get the COVID-19 vaccine?

Adult COVID-19 vaccine providers, like pharmacies and community health centers, have been doling out big-kid vaccines, as well as pediatricians and primary care providers. Your doctor will likely be able to point you toward options near you, or you can use vaccines.gov to search for locations by zip code. Right now, children over the age of 3 can get their COVID-19 vaccine from a pharmacist, but younger children need to visit their pediatrician, family doctor, or a similar provider to get the shots.

About Dr. Harvey Karp

Dr. Harvey Karp, one of America’s most trusted pediatricians, is the founder of Happiest Baby and the inventor of the groundbreaking SNOO Smart Sleeper. After years of treating patients in Los Angeles, Dr. Karp vaulted to global prominence with the release of the bestselling Happiest Baby on the Block and Happiest Toddler on the Block. His celebrated books and videos have since become standard pediatric practice, translated into more than 20 languages and have helped millions of parents. Dr. Karp’s landmark methods, including the 5 S’s for soothing babies, guide parents to understand and nurture their children and relieve stressful issues, like new-parent exhaustion, infant crying, and toddler tantrums.

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Disclaimer: The information on our site is NOT medical advice for any specific person or condition. It is only meant as general information. If you have any medical questions and concerns about your child or yourself, please contact your health provider.