Pediatric and Adolescent COVID-19 Vaccine FAQ

Although many children experience less severe illness from COVID-19, some children suffer serious complications. Babies younger than 1 and children with certain underlying medical conditions are more likely to become very ill from COVID-19.

There is also growing evidence that as many as 25% of children suffer from symptoms such as respiratory issues, fatigue, and stomach problems for weeks or months (sometimes referred to as “long haul” disease). And, just like adults, children who have few or no symptoms can still transmit the virus to others. The surest way to protect children and our communities from the harmful effects of COVID-19 is to get vaccinated.

Vaccines, along with mask-wearing, physical distancing, and other precautions will help ensure your child’s return to things they’ve missed such as sports, camp, and other group activities in the future.

After reviewing data and results from Pfizer and Moderna from over 8000 children, the Food and Drug Administration (FDA) authorized the Pfizer and Moderna COVID-19 vaccines for children ages 6 months to 17 years old.

Then, the Advisory Committee on Immunization Practices (ACIP) committee for the Centers for Disease Control and Prevention (CDC) reviewed the findings and recommendation from the FDA and agreed that the use of the vaccines in children ages 6 months to 17 years is both safe and effective.

The vaccines for children aged 6 months to 16 years will be under an emergency use authorization (EUA), which is granted to products during public health emergencies. People ages 16 years and older are eligible for fully licensed Pfizer and Moderna vaccines. The Johnson & Johnson vaccines are authorized under EUA for people 18 and older.

The vaccines do not include any living or dead materials from the virus itself and therefore cannot cause infection. Instead, the mRNA vaccine works by teaching our cells to make a harmless piece of a “spike protein,” which is located on the surface of the virus that causes COVID-19.  After our cells start to display this “spike protein,” the body starts an immune response which causes antibodies to be made to protect us from getting infected if our bodies are exposed to the virus.

The mRNA from the vaccine is in the cell temporarily. Once the “spike protein” is made and on the surface of the cell, mRNA is broken down quickly and the body permanently gets rid of it. The mRNA vaccine does not go into the nucleus of our cells or become part of our genetics in any way.

There is no evidence that this vaccine will affect development or fertility. The CDC is following tens of thousands of women who have taken the vaccine, including many who have become pregnant since having the vaccine. No issues have been found.

Based on clinical trials, Pfizer and Moderna reported that the side effects of the COVID-19 vaccine are similar in children and adults. While some children won’t experience any reactions to the vaccine, others may experience a sore arm, some redness and/or swelling at the injection site, and maybe a low-grade flu-like illness (including fever and headache). These side effects tend to be mild and temporary, and are similar to those experiences after routine vaccinations. Side effects after the second shot may be more intense than the ones after the first dose. All side effects are most often gone within 48 hours.

While many people are concerned about the long-term effects of vaccines, based on all vaccines that have been created so far, there have been no side effects from vaccination that have been found more than 6 weeks after vaccination.

The COVID-19 vaccines have been studied for 12 months so far, with no significant side effects beyond the first several days of the vaccine. Vaccine ingredients are broken down in our bodies very quickly, leaving the good effect of an immune system that is prepared to fight the germ that was vaccinated against.

The FDA’s EUA approvals for children are based upon the child’s age. The following table indicates the dosage and vaccine schedule for each vaccine and age group.

COVID-19 infection in children has been usually less severe than in adults, and far fewer children have died from COVID-19. However, COVID-19 can make children very sick and can sometimes require hospitalization for dehydration or difficulty breathing.

Some children have had a post-COVID complication called multisystem inflammatory syndrome (MIS-C), and some kids have had persistent fatigue and other symptoms known as "long COVID." Vaccination helps prevent these syndromes.

Even among children who have had mild virus, they have missed school or daycare for 10 to 14 days. They can also transmit COVID-19 to their friends and family, some of whom may themselves be as at risk of severe illness from COVID-19, like the elderly or people with a weakened immune system.

The COVID-19 vaccine can help decrease the likelihood of these scenarios and help control the pandemic.

According to the CDC, it is safe for all age groups to get the COVID-19 vaccines and other vaccines on the same day. If getting multiple vaccines in the same visit, the vaccines must be given at different injection sites according to age group recommendations. The COVID-19 vaccine side effects are generally the same when given alone or with other vaccines.

Ongoing study data show evidence that children can get added protection by getting vaccinated after having been infected with COVID-19.

According to the CDC, for children who have been infected with COVID-19, their next dose can be delayed 3 months from when symptoms started or, if they did not have symptoms, when they received a positive test. This possible delay can happen with a primary dose or a booster dose.

The vaccines were very effective in clinical trials. In the group receiving the active vaccine, there were no serious cases of COVID-19 and no hospitalizations. The vaccines are very effective at preventing any symptomatic COVID-19 cases. More data will be available as more children are vaccinated.

Both the Pfizer-BioNTech and Moderna vaccines are authorized for children ages 6 months to 4 years old.

Both the Pfizer and Moderna pediatric vaccines for children ages 6 months to 4 years have lower dosage recommendations than they do for older children. This lower dose causes an immune response while preventing side effects from the vaccination.

• The Pfizer vaccine dose for children 6 months to 4 years is 3 micrograms (compared to 10 micrograms for kids ages 5 years to 11 years, and 30 micrograms for those 12 years and older). Children ages 6 months to 4 years will receive a 3-dose series with the first and second being 21 days apart and the third at least 8 weeks from the second dose.
• The Moderna vaccine dose for children 6 months to 5 years is 25 micrograms (compared to 50 micrograms for children ages 6 to 11 years, and 100 micrograms for children ages 12 years to 17 years). This is a 2-dose series that is recommended to be given 28 days apart.

For more information about vaccine dosing, please see “What are the vaccine dosages for children?” above.

Currently, the FDA does not recommend a booster dose for children aged 6 months to 4 years old.

For more information, see our Booster Shots page.

Both the Pfizer-BioNTech and Moderna vaccines are authorized for children ages 6 months to 17 years.

Both the Pfizer and Moderna pediatric vaccines for children ages 5 to 11 have lower dosage recommendations than they do for those 12 years and older. This lower dose causes an immune response while preventing side effects from the vaccination.

• The Pfizer-BioNTech vaccine dose for children ages 5 to 11 years is 10 micrograms (compared to 30 micrograms for those 12 years and older). Children ages 5 years to 11 years need to get the 2-shot series 3 to 8 weeks apart.
• The Moderna vaccine dose for children ages 5 to 11 years is 50 micrograms (compared to 100 micrograms for those 12 years and older). This is also a 2-shot series given at least 28 days apart.

For more information about vaccine dosing, please see “What are the vaccine dosages for children?” above.

Your child is eligible to receive either the Pfizer-BioNTech or the Moderna vaccine. Both vaccines are a 2-dose series, with Pfizer having a third dose of a booster if your child is not immunocompromised. For patients that are immunocompromised, 1 to 3 extra primary and booster doses are recommended.

If your child moves from a younger age group to an older age group during the primary series or between the primary series and receipt of booster doses, your child should receive the vaccine dosage for the older age group for all future doses.

In May 2022, the FDA authorized the use of a single booster dose of the COVID vaccine for children ages 5 years to 11 years for the Pfizer-BioNTech vaccine.

• For the Pfizer vaccine, the booster should be given at least 5 months after the final dose in the primary series. If your child is moderately or severely immunocompromised then at least 3 months after the final dose in the primary series.
• If your child received the Moderna 2-dose vaccine series then no booster is recommended at this time for children ages 6 years to 11 years.

For more information, see our Booster Shots page.

The Pfizer-BioNTech vaccine and Moderna vaccine are both approved for use in individuals 6 months through 17 years of age.

• The Pfizer vaccine dose for children ages 12 and older is 30 micrograms. Children ages 12 and older will receive a 2-shot series given 3 to 8 weeks apart.
• The Moderna vaccine dose for children ages 12 and older is 100 micrograms. This is a 2-dose series that is recommended to be given 28 days apart.

For more information about vaccine dosing, please see “What are the vaccine dosages for children?” above.

For information about booster shots, see our Booster Shots page.