Children get a smaller dose of COVID-19 vaccine than teens and adults that is the right amount for their age group. Moderna requires 2 doses spaced 1 month apart.  Pfizer requires 3 doses with the second dose 3 weeks after the first, and the third dose at least 8 weeks after the second dose. 

FDA evaluation of Moderna and Pfizer vaccine for individuals 6 months through 17 years of age is available here. 

Here are key reasons to consider vaccinating your child:

• Children are susceptible to Covid infection.  Well over 2 million cases of Covid infections have occurred in U.S. children under age 5.
• More hospitalizations (over 20,000 young children) and deaths (over 400) occurred in this age group as a result of Covid infections than from any other infectious disease.  
• Covid hospitalizations during a typical 4-month window of the pandemic have been 2-3 times higher than influenza hospitalizations during any flu season over the past decade.  There have also been 2-3 times more deaths per year from Covid than from a typical influenza season.
• During the Omicron wave, children under age 5 had a significantly higher rate of hospitalization than older children or teens.  This is likely due in large part to a lack of vaccination in the youngest age group.  
• More than half of hospitalized children (63%) had no underlying health conditions.
• Children are susceptible to long-term health problems from Covid infections.  Most studies show >5% of infected children will have symptoms lasting longer than 1 month.
• Over the past 2 ½ years, Covid is the single leading cause of death among American children younger than age 6.
• Both Moderna and Pfizer vaccines show effectiveness in young children comparable to that in older children and adults.
• Safety studies for both vaccines were very reassuring, with only one child in each study having a serious reaction out of 8,000 children vaccinated (see below for details).  There were no cases of myocarditis.  There were no deaths among vaccinated children.
• Mild fevers and irritability occur in <10% of children after vaccination.  This is comparable to other routine pediatric vaccinations.

Here are areas where current information cannot provide definitive answers:

•  Due to limited follow up studies and the unpredictability of circulating Covid variants, exact effectiveness in disease prevention and hospitalizations cannot be calculated.  The best current evidence indicates that:
  • 1) Vaccination of children under age 5 will reduce symptomatic infections by 40-50%.  This is consistent with effectiveness for older age groups against the currently circulating Covid variants.  
  • 2) Based on longer-term data in older populations, it is likely that vaccination of young children will reduce illnesses severe enough to result in hospitalization by 70-75%.
• Safety data was judged to be very reassuring by pediatric and infectious disease experts at the FDA and CDC.  “Desirable consequences of vaccination clearly outweigh the undesirable effects.”   The American Academy of Pediatrics strongly supported approval of the vaccines for young children.  However, until hundreds of thousands of children are vaccinated, definitive statements on benefits and risks cannot be made.  There was one child in each manufacturer’s study that had fevers high enough to require brief hospitalization.  One of these children also had a seizure episode after her first vaccine dose.  Seizures are known to rarely occur with other routine child vaccines.  Decades of follow up research has shown that fever-induced seizures do not result in long-term health problems.  This child’s parents chose for her to receive a second vaccination.  She did not have any reaction following that dose.

What else should parents consider? 

• Children with many types of underlying health conditions (chronic respiratory problems, including asthma, conditions that impair the immune system, sickle cell disease, genetic conditions, cancer, etc.) are at greater risk for complications due to a Covid infection.  Vaccination has additional benefits for such children, and parents should discuss vaccination with their child’s physician.
• For households with immunocompromised older children or adults, decreasing the infection rate for any family member helps protect everyone.
• Under current CDC guidance, anyone who is up to date on vaccinations are exempt from quarantine in daycare and school settings.
• We now have 2 years of data on vaccinations in older populations.  Although findings in adult and adolescent populations do not always translate to pediatric populations, no new side effects have occurred outside of the initial study period in these age groups.  This also holds for all other pediatric vaccinations (influenza, measles, chicken pox, etc.).  No new side effects have been discovered after initial FDA approval of other pediatric vaccinations.
• It is very likely that children in this age range will require a booster dose several months after their initial vaccination series to optimize longer term protection.  Even though Pfizer’s initial series is 3 doses, many national experts have expressed opinions that an additional dose will be needed.  Both Pfizer and Moderna are beginning booster trials, so more information will be available in late 2022 or early 2023.
• More information is available at CDC's website.

The following vaccines are available as a primary series:

Pfizer-BioNTech/Comirnaty

• This is a two dose series with the doses given 3 weeks apart
• FDA approved for ages 12 years and older, under an Emergency Use Authorization for children under 12 years.
• More information

Moderna/Spikevax

• This is a two dose series with the doses given 4 weeks apart
• FDA approved for ages 18 years and older, under an Emergency Use Authorization for children under 18 years.
• More information

Novavax

• This is a two dose series with the doses given 3 weeks apart
• Available for people 12 years and older
• Under an Emergency Use Authorization
• More information

Note: the Johnson & Johnson (Janssen) vaccine is no longer available at Frederick County Health Department clinics. 

Update 8/13/2021: third doses are now authorized in the updated EUA for people who are moderately or severely immunocompromised. Updated CDC guidance This includes:

1. Active treatment for solid tumor and hematologic malignancies
2. Receipt of solid-organ transplant and taking immunosuppressive therapy
3. Receipt of CAR-T-cell or hematopoietic stem cell transplant (within 2 years of transplantation or taking immunosuppression therapy)
4. Moderate or severe primary immunodeficiency (e.g., DiGeorge, Wiskott-Aldrich syndromes)
5. Advanced or untreated HIV infection
6. Active treatment with high-dose corticosteroids (i.e., ≥20mg prednisone or equivalent per day), alkylating agents, antimetabolites, transplant-related immunosuppressive drugs, cancer chemotherapeutic agents classified as severely immunosuppressive, TNF blockers, and other biologic agents that are immunosuppressive or immunomodulatory

Additional notes:

1. Third dose must be of the same type and amount of vaccine as the first two doses. 
2. Third dose must be more than 28 days after second dose. 
3. Pfizer is available for people 12 years and older, and Moderna for people 18 years and older. 
4. Proof: self-attestation of having one of the conditions listed above, no prescription or doctor's note required.
5. If you've received Johnson & Johnson/Janssen vaccine: Currently there are not data to support the use of an additional mRNA COVID-19 vaccine dose after a primary Janssen COVID-19 vaccine in immunocompromised people.  

Immunocompromised individuals may still have a reduced immune response and need to take steps to reduce their risk of exposure, such as:

1. Wearing a mask
2. Staying 6 feet apart from others they don't live with
3. Avoiding crowds and poorly ventilated indoor spaces until advised by their healthcare provider.

Real Answers to Rumors

• Rumors that mRNA vaccines alter a person’s genes are completely FALSE.  Our genes are only present in the nucleus.  The mRNA in vaccines cannot enter the nucleus of cells and in no way interact with our DNA.  Also, mRNA leads to the production of proteins in our bodies, not the production DNA.  Rumors of genetic alteration have absolutely no scientific basis.
• Rumors that mRNA vaccines alter human reproduction are completely FALSE.   Not only is there no plausible mechanism for mRNA vaccines to impact any part of reproduction in either females or males, 2 years of follow up studies have documented that people receiving mRNA vaccines are just as likely to have healthy pregnancies as those who are not vaccinated.  mRNA vaccines also have no impact on a teen’s normal transition through puberty.
• Rumors that previous infection with Covid provide protection against future Covid (natural immunity) that is equal or better than protection provided by vaccination is FALSE.  Multiple studies in the U.S. and other countries have clearly established that vaccination produces better and longer lasting protection against infection than natural immunity from a previous infection.  For children under age 5 who have been previously infected with Covid, studies show vaccination increases antibody levels 40-50 times higher than previously infected children who remain unvaccinated.
• Statements that scientists and physicians don’t understand the way in which mRNA vaccines work in the human body are FALSE.  Although Covid vaccines are the first widely used mRNA vaccines, research on the development of these vaccines began over 30 years ago.  The way in which mRNA vaccines produce immunity in humans is far better understood than the way that polio and measles vaccines worked when they were introduced in the 1950’s and 1960’s.  It was this understanding of how mRNA provides the blueprint for protein production in our cells’ cytoplasm that led to the idea of safe and effective mRNA vaccines.  
• Just as there is no plausible means for mRNA vaccines to alter our genes or interfere with reproduction, there is no plausible means by which mRNA vaccines would alter children’s normal development.  As noted above, the foremost U.S. pediatric experts at the CDC and the American Academy of Pediatrics have endorsed mRNA vaccines for all children 6-months and older.  
• It bears noting that similar to influenza, measles, and whooping cough vaccines, children younger than 6-months of age cannot mount an immune response to Covid vaccination. This is why vaccine approval doesn’t include this age group.   The best way to protect newborns is for women to receive vaccination while pregnant.  Multiple studies have proven that maternal antibodies produced as a result of vaccination cross the placenta and provide protection to newborns.   This protection continues for months after the baby is born.