Q&A: What parents should know about the COVID-19 vaccines for children and young adults

Kids six months and older are eligible to receive the COVID-19 vaccine thanks to authorization from the Food and Drug Administration (FDA) of the Pfizer-BioNTech (Pfizer) and Moderna vaccines for kids.

We know many parents are eager to get their young kids fully vaccinated, but we also recognize that many parents have questions.

John Pope, MD, MPH, vice president, chief medical officer and pediatrician at HonorHealth Scottsdale Shea Medical Center, helps answer some common questions about the vaccine in kids and teens, so you can make an informed decision.

Q. My child or teenager is healthy, so why should they get vaccinated?

A: Although children and teens are at lower risk of serious infection, it's still important to get them vaccinated. COVID-19 is currently a top ten cause of death among kids and teens in the U.S. Additionally, long-haul COVID-19 is now being reported in 7-8% of children who are infected. Of those kids who ended up hospitalized for COVID-19, 30% had no underlying condition. Children who are infected with COVID-19 are then at risk of developing multisystem inflammatory syndrome (MIS-C), a condition in which different parts of the body can become inflamed, including the heart, lungs, kidneys, brain, skin, eyes or gastrointestinal organs. Rates of hospitalization from COVID-19 are much higher than the flu, so this is definitely something you want your kids protected from. Help protect your whole family by getting everyone six months of age and older vaccinated.

Q&A - What parents should know about the COVID-19 vaccine for kids

Q. If my child or teen already had COVID-19, do they still need to be vaccinated?

A: Yes. Vaccination is recommended regardless of a history of COVID-19 infection. Most notably, current reports from the Centers for Disease Control and Prevention (CDC) have found that adults with a prior COVID-19 infection who were not vaccinated were five times more likely to get COVID-19 again, compared to vaccinated people with having a breakthrough infection. The protection you get from prior infection just isn’t as predictable as the protection from vaccination.

Q. What vaccine will my child or teen receive?

A: Based on the latest guidelines, you have a few options. Children six months through age five may receive two doses of the Moderna vaccine that equates to a quarter the dose of the adult version, or children six months through age four may receive three doses of the Pfizer vaccine that equates to just a tenth of the adult dose. Kids over these age brackets can also receive Moderna or Pfizer, though dosing requirements vary based on age and if they are immunocompromised. Talk to your child’s doctor for more information and to find out what is best for your child. You can also check out the latest recommendations from the CDC.

The different dosages aren’t based on weight, but on immune maturity. Efficacy rates have proven to be very good and side effects are much like those we see in adults but at lower rates.

Q. Will my child need a booster shot?

A: Booster shots vary by age, whether your child is immunocompromised and which vaccine series was used. You can also check out the latest CDC recommendations here. COVID-19 vaccine boosters further enhance your child’s protection that may have decreased over time, so they’re a good idea to get if your child is eligible. Additionally, the newest bivalent COVID-19 booster from Pfizer (available to those five and older) and Moderna (available to those six and older) offers a new formula that better targets currently circulating variants. Talk to your child's pediatrician to determine what is right for your child.

Q. How can I know the vaccine is safe for my child or teen?

A: COVID-19 vaccines have been involved in the most intensive vaccine safety monitoring in U.S. history, which includes robust studies in children and teenagers. Ongoing studies continue to follow vaccinated children and teens very closely for any rare or unexpected outcomes. No significant safety concerns came from clinical trials in kids under five years of age. Additionally, we have seen millions of children over the age of five safely receive the COVID-19 vaccine.

The way both the Pfizer and Moderna vaccines works is through mRNA and nanotechnology - mRNA vaccines give the body instructions to produce one very specific part of a virus (in this case, the "spike protein") to induce an immune response. Because mRNA breaks down quickly in the human body, it doesn't get into the nucleus of the cell or into our genes. Safety profiles of this type of vaccine are very reassuring.

Q. Who should not get the vaccine?

A: Your child or teen should not get the vaccine if they have had a severe allergic reaction after a previous dose of the vaccine or if they have had a severe allergic reaction to any ingredient of the vaccine. Talk to your child’s pediatrician if you have any concerns, and rest assured, your child or teen will be monitored for 15-30 minutes after they receive the vaccine to watch for and treat any rare adverse reactions.

Q. How effective is the vaccine in children and teens?

A: COVID-19 vaccines are effective and well tolerated in children. The immune response in vaccinated babies and children up to five years old mimics what we see in kids five and older. In both groups, clinical trial participants made high levels of antibody response to the vaccine, and their immune response was just as strong as what has been seen in older teens and young adults. The vaccines are expected to be highly effective in preventing hospitalization and serious issues.

Q. How soon after vaccination will my child be protected?

A: It's important to remember that the complete vaccine series is needed for the best level of protection. We want your kids to stay as safe as possible, so don't skip any doses and keep in mind that protection is best two weeks after the final vaccine dose. In the meantime, continue to mask indoors, keep your gatherings small (and ideally only with other households who are fully vaccinated and boosted), avoid meeting indoors, or make use of good ventilation when you can't meet outside.

Q. What side effects should I expect?

A: Your child or teen may have some side effects, which are normal signs that their body is building protection. You can expect mild pain at the injection site, redness or swelling. Your child or teen may also experience mild tiredness, headache, muscle pain, chills, fever or nausea. Rest assured, these side effects should go away in a day or two. Ask your child’s pediatrician if you should offer non-aspirin pain relievers or try other methods to comfort your child. It is not recommended that you give your child or teen pain relievers before vaccination for the purpose of trying to prevent side effects. It’s also important to note that some kids and teens don’t have any side effects, but that doesn’t mean the vaccine isn’t working.

Q. Should I plan on my child or teen having to miss school, daycare or other activities to recover from potential side effects?

A: Many kids and teens have little to no side effects and won’t need to miss school, daycare or other activities. However, if your child isn’t feeling well after their vaccine, they may want to stay home. It might be helpful to schedule their vaccine appointment on a Friday or Saturday to have the least impact possible.

Q. Are there any long-term side effects I should know about?

A: No serious adverse reactions related to vaccination were reported in the Pfizer or Moderna clinical trials for children. One concern we’ve heard about has been whether or not the vaccine alters a person’s DNA, and long-term effects associated with that. Remember that the Pfizer and Moderna vaccines are mRNA vaccines, which use only a gene from the virus to generate an immune response. It’s important to understand that the mRNA from a COVID-19 vaccine never enters the nucleus of a recipient’s cells, where your DNA is kept, so the vaccine does not interact with a person’s DNA in any way. This means that, like all other childhood immunizations, COVID-19 vaccines won’t interfere with puberty or future fertility. The CDC continues to closely monitor the safety of COVID-19 vaccines in kids, teens and adults.

Q. Can you explain the risk for myocarditis?

A: Myocarditis, or heart inflammation, is a very rare complication that has been linked to the mRNA vaccines. We only expect to see about 26 cases per 1 million doses administered. No kids have died from this complication, and most cases fully recover within about a month. It’s important to understand that the chances of getting myocarditis from the vaccine are actually much smaller than getting it from an active COVID-19 infection. The benefits of vaccination by far outweigh the risks. Based on clinical trials in the youngest age group, thousands of children were vaccinated and none had serious allergic reactions, heart inflammation or other serious problems related to the vaccines.

Q. Can my child or teen get COVID-19 or spread it from the vaccine?

A: It’s not possible to get COVID-19 from the vaccine. The Pfizer vaccine is an mRNA vaccine, which uses only a gene from the virus to generate an immune response. It’s not possible to get COVID-19 or to spread COVID-19 to someone else from the vaccination.



Next steps

The CDC recommends that everyone six months of age and older should get a COVID-19 vaccine to help protect against the disease. The American Academy of Pediatrics also supports this decision.

If you have more questions, check out more frequently asked questions about the vaccine on our website. We also encourage you to discuss any concerns with your child’s pediatrician, so you can make a decision that’s right for you and your family.

Are you ready to get your child or teen vaccinated?

COVID-19 vaccines are available at many locations throughout the state, including traditional settings like retail pharmacies, larger doctor’s offices and neighborhood health centers that help bring the vaccine close to individuals’ homes or workplaces. Walk-ins are accepted at many locations, while others require an appointment, so we encourage you to check before you go.

Find vaccine locations and appointments from: