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June 25, 2022, 4:09 p.m. EDT

COVID vaccines for kids under 5 — what parents need to know

By Nicole Lyn Pesce

The youngest American children can now get their COVID shots. 

The Food and Drug Administration and the Centers for Disease Control and Prevention have both authorized Pfizer (NYS:PFE) and Moderna’s (NAS:MRNA) COVID-19 vaccines for kids under 5, and the Biden administration said that 10 million initial COVID vaccination doses could start being administered to young children beginning Tuesday, June 21. The kids’ versions of the vaccines are a fraction of the strength of adult vaccinations, and will be given in two or three doses.

This news comes as reported COVID-19 cases in children in the U.S. (almost 88,000 for the week ending June 9, 2022) remain “far higher” than they were this time last year, according to the American Academy of Pediatrics . More than 30,000 children under 5 have been hospitalized with COVID-19, and nearly 500 deaths have been reported in that age group .

There are currently about 20 million U.S. children in the age range between 6 months and 5 years old. And some parents have been frustrated by the delay to get their youngest children vaccinated; Pfizer’s vaccine was authorized for children and adolescents ages 5 through 15 in the U.S. last year. 

But it’s understandable that many parents and caregivers also probably have questions about giving their children the vaccines. Just one in five parents of kids under 5 said they plan to vaccinate a child right away , according to a recent Kaiser Family Foundation survey. Just over half of parents with kids in this age group said they needed more information about the vaccines’ safety and effectiveness for young children — although with back-to-school just a few months away, health officials are urging parents to get their children vaccinated without delay.

“I am very sympathetic to parents who want a little more time. But the bottom line is there’s a very contagious variant out there. There’s a lot of infections,” Dr. Ashish Jha, the White House Coronavirus Response Coordinator under President Biden, told NPR . “And we’re, like, two to three months away from school beginning again. Given how much time it takes to build up immunity, that’s not that far away.”

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So MarketWatch has compiled a list of common questions, and drawn on guidance from the FDA, the CDC and the American Academy of Pediatrics to provide the answers. 

“People should have questions. Any time we provide parents with the option of vaccinating their kids, they have the right to ask, ‘Is this safe, and is this necessary,’” said Dr. Adam Ratner, a father and the director of pediatric infectious diseases at Hassenfeld Children’s Hospital at NYU Langone. “I ask that, too. And [a COVID-19 vaccine] is a clear case where it is both safe and necessary.”  

This is what you need to know about COVID-19 vaccines for kids under 5. 

When will COVID vaccines be available for kids under five?  

Vaccinations for children ages 6 months to 5 years old were expected to begin on Tuesday, June 21. The federal government previously made 10 million doses of the vaccines available ahead of the FDA and CDC decisions, and every state except Florida has pre-ordered vaccine doses for kids under 5. (Doctors, pharmacies and community centers in Florida can still directly order COVID-19 vaccines for young children from the federal government, and Florida health department spokesperson Jeremy Redfern told the Associated Press that hospitals can receive the doses within a week.) 

Dr. Ashish Jha, the White House Coronavirus Response Coordinator, said that there might be limited vaccination appointments available for infants and young children at first. But every parent who wants to get their child vaccinated should be able to do so in the next few weeks. 

The CDC added that all children, including children who have already had COVID-19, should get vaccinated.

Which COVID vaccines are available for young children?  

Children under 5 can now receive either the Pfizer or Moderna COVID-19 vaccines, which are a fraction of the adult dosage (and administered using smaller needles) to make them more tolerable for kids. Vaccines are not available to babies younger than 6 months, however, because it’s believed that the mother’s vaccination during pregnancy continues to protect the baby for the first several months of their life.

The Pfizer vaccine is given to children 6 months to 4 years old, and is administered in three doses that are one-tenth the level that adults receive. The first two doses are spaced three weeks apart, and the third shot is eight weeks later. A child can be considered immunized to COVID two weeks after the third dose of the Pfizer vaccine — so, just over three months after the initial dose.

The Moderna vaccine is given to children 6 months to 5 years old, and is administered in two doses (one-fourth the level that adults receive) that are four weeks apart. A child can be considered immunized to COVID two weeks after the second Moderna shot — so, six weeks after the initial dose.

Where can I find a COVID vaccine for kids under 5 near me?  

The CDC is encouraging parents to reach out to their family doctor, local pharmacy or health department, or to visit vaccines.gov to find the nearest COVID-19 vaccines available for their kids. CVS (NYS:CVS) has said that it will also offer vaccinations for children 18 months and up at its MinuteClinic locations. You can also find your local health department here .

Which COVID vaccine should my child get?  

The CDC recommends both vaccines equally, and Dr. Peter Marks, head of the FDA vaccine division, also said that parents should feel comfortable with either vaccine, and get their children whichever shot is available. 

Ratner agreed, although he also noted that the two-dose Moderna vaccine might appeal more to parents, “because getting to one extra doctor visit is asking a lot,” he said. “So that may be a decisive thing if you’re at a place where your pediatrician has access to both of them. But really, either one will provide protection.” 

Are the vaccines safe?

The CDC states on its site that the COVID-19 vaccines have undergone — and will continue to undergo — “the most intensive safety monitoring in U.S. history.”

The American Academy of Pediatrics also released a statement strongly recommending the authorized COVID-19 vaccinations for all infants, children and adolescents 6 months of age and older who do not have contraindications to receiving a COVID-19 vaccine. The AAP noted that the vaccines were evaluated by “a long-standing, rigorous, and transparent process by the U.S. Food and Drug Administration and the Centers for Disease Control and Prevention.”

“These two vaccines have great safety records across all ages,” agreed Ratner, whose own family has been vaccinated. 

“The day I got my vaccine, after working with people with COVID-19 from the beginning of the pandemic, I was very relieved,” he told MarketWatch. “The day I cried with relief was the day my daughter got the vaccine.” 

What are the side effects of COVID vaccines in kids?  

Common side effects include pain at the injection site, irritability and crying, loss of appetite and sleepiness, the FDA said. Few children who received either vaccine developed a fever higher than 102 degrees Fahrenheit, and there were no cases of myocarditis or pericarditis (heart inflammation or inflammation in surrounding tissue) in either the Pfizer or Moderna trials.

In fact, the risk of serious illness and long-term health effects from developing COVID-19 is higher than the risk of severe side effects from the vaccines. “The [COVID] vaccinations end up being protective against myocarditis, because COVID itself causes myocarditis at way higher rates than the vaccine does,” said Ratner, who also noted that other more severe side effects are “extremely rare.”

Why does my child need a COVID vaccine? Aren’t cases more serious in adults?  

“There has been this misconception since the beginning of the pandemic that kids are not affected by COVID-19,” said Ratner. 

“And since the very beginning of the pandemic, I and other pediatricians have been taking care of kids who are seriously ill with COVID-19, and some of them have underlying conditions, but not all of them; not by a long shot,” he added. “There are absolutely previously well kids who require hospital admission, some who require going into the intensive care unit, and some who unfortunately die of COVID.” 

The winter surge of COVID cases driven by the omicron variant hit children hard, for example, peaking at 1,150,000 cases in one week . And while cases among have dropped since then, they are still much higher than they were at this time one year ago, with almost 88,000 child COVID-19 cases reported the week ending June 9 – compared to 14,400 the week of June 10, 2021. More than 30,000 children under 5 have been hospitalized with COVID-19, and nearly 500 deaths have been reported in that age group

Plus, Ratner noted that vaccinating children in this young age group also helps prevent community spread of COVID-19. “When kids get COVID, even if they don’t get particularly sick from it, which is often the case, they’re really good at spreading it,” he said. Vaccinating kids in this age group protects them from the rare cases of COVID that go on to be severe, he explained, as well as mitigating the spread of COVID-19 in the community. 

“The available data suggests these are very safe vaccines, and we know that COVID can be dangerous, including in children,” he said.

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