It has been the talk of playgrounds, the concern at preschools and the question posed at dinner tables across the country: When will children age 6 months to 4 years be eligible to receive a COVID-19 vaccine? According to recent news from the U.S. Centers for Disease Control and Prevention (CDC), the time has come.
Drugmakers Pfizer and Moderna recently submitted applications to the U.S. Food and Drug Administration (FDA) for emergency use authorization (EUA) of their COVID-19 vaccines in children over 6 months old. The FDA provided EUAs for both vaccines — Moderna’s for kids age 6 months to 5 years and Pfizer’s for age 6 months to 4 years — and the CDC followed with a recommendation of the vaccines for this age group. The Moderna COVID-19 vaccine for children and adolescents age 6 to 17 was given EUA shortly after.
“Vaccinating children age 6 months to 5 years will offer added protection to those around them, including very young siblings who are not eligible for vaccination and family members who may be at increased risk of serious illness,” says Dr. Howard Smart, chair of the Pediatrics Department at Sharp Rees-Stealy Medical Group. “Vaccinating toddlers and young children can also help keep them in day care or preschool and safely participating in favorite activities, playdates and family gatherings.”
The difference between pediatric and adult doses
According to the EUA applications, the Moderna pediatric vaccine is given in two doses, four weeks apart. Each dose is 25 micrograms, which is just 25% of the adult dose. Pfizer’s pediatric vaccine is given in three doses, each just 3 micrograms — far less than the 30-microgram shots adults receive and 7 micrograms less than the dose used for children age 5 and older. The first and second dose are given three weeks apart and the third dose is given eight weeks later. Specially designed syringes and other supplies will be used to vaccinate younger children.
Both the Pfizer and Moderna vaccines are considered safe and effective for this age group. In trials performed by the drugmakers, the vaccines were well tolerated by those age 6 months to 5 years, with participants experiencing mild side effects comparable to those seen among older children. No cases of myocarditis or pericarditis — rare post-vaccine cardiac side effects seen in a small number of mostly male adolescents and young adults — were reported among this age group.
Why do young kids need COVID-19 vaccines?
While children rarely experience severe illness due to COVID-19 infection, the American Academy of Pediatrics reported that cases have spiked during the 2022 omicron variant surge. In California, more than 293,000 children under 5 have been diagnosed with COVID-19, and 25 children in this age group have died since the beginning of the pandemic.
Additionally, some children who tested positive for COVID-19 experience multisystem inflammatory syndrome (MIS-C), a rare, life-threatening condition that can cause dangerous inflammation in the eyes, skin, blood vessels and heart. And the CDC reports that children are as likely to get infected with COVID-19 as adults, which can lead to short-term and long-term health complications.
Although children age 5 to 11 have been eligible to receive Pfizer’s age-appropriate two-dose vaccine series since November 2021, the California Department of Public Health reports that just over 35% of children in that population in California are fully vaccinated. Preteens and teens age 12 and older are eligible for both the vaccine and an additional booster dose, which significantly increases protection. And while more than 67% of those age 12 to 17 in the state have received both doses of the vaccine, only 36% have received a booster.
“Allowing children in the youngest age group to receive a COVID-19 vaccine could be the final step needed to truly slow the spread of COVID-19,” says Dr. Smart. “Approximately 18 million children are under the age of 5 in the U.S., which means 18 million more people could be helping to end the pandemic.”
How kids up to 5 years can get vaccinated
Vaccination appointments can be scheduled via MyTurn and at local pharmacies, community clinics and some doctors’ offices. Parents do not need to contact a child’s doctor for approval to receive the vaccine from another source.
“I know some parents may have concerns about getting their children vaccinated,” says Dr. Smart. “However, throughout the pandemic, it has become clear that getting the vaccine is much safer than catching COVID-19 if unvaccinated. Vaccination greatly lowers the risk of severe illness, hospitalization and death for people of all ages. I encourage parents to talk with their child’s doctor about the safety and efficacy of the vaccines and weigh them against the known risks of COVID-19 infection.”