A COVID-19 vaccine for young children is here. Here's what we know about how it works

An estimated 28 million five- to eleven-year-old children are eligible to get vaccinated against COVID-19 now

By Nicole Karlis

Senior Writer

Published November 4, 2021 3:00PM (EDT)

Small boy getting a vaccine on his arm by a pediatrician wearing gloves. (Getty Images/Luis Alvarez)
Small boy getting a vaccine on his arm by a pediatrician wearing gloves. (Getty Images/Luis Alvarez)

For many American children age five to eleven, their weekend plans might at last include getting inoculated against the coronavirus.

On Tuesday evening, the Centers for Disease Control and Prevention's director Dr. Rochelle Walensky approved the recommendation for young children to be eligible for Pfizer-BioNTech's COVID-19 vaccine, clearing the way for immediate vaccination of nearly 28 million children across the country.

The news may come as a relief to many parents, as the virus has not spared little kids. According to the American Academy of Pediatrics (AAP), as of October 28, 2021, nearly 6.4 million American children tested positive for COVID-19 since the beginning of the pandemic, representing 16.6% of all cases. Among states reporting their data, children have made up an estimated 1.7% to 4.2% of all hospitalizations, and up to 0.26% of all COVID-19 deaths. (The statistics have a larger range because, as noted by the AAP, the definition of "child" varies in each state).

While severe illness and death from COVID-19 is far more rare in children than in adults, it does happen occasionally. With vaccination, such tragedies are far, far less likely. Indeed, the availability of the Pfizer vaccine for kids will undoubtedly help relieve anxiety for families, bring more kids back to schools, and help slow the spread of the COVID-19.

"Together, with science leading the charge, we have taken another important step forward in our nation's fight against the virus that causes COVID-19," Walensky said in a statement. "We know millions of parents are eager to get their children vaccinated and with this decision."

While millions of parents might be eager, they also might have questions about the first pediatric COVID-19 vaccine roll-out in the country. Below, we answer a few of them.

Can children get any vaccines like adults?

No, five to eleven-year-olds are only authorized to receive the Pfizer-BioNTech COVID-19 pediatric vaccine, which is given at a lower dosage than the adult version, as explained by the CDC. Adolescents between the ages of 12 years and 17 years do receive the same dosage of Pfizer-BioNTech COVID-19 vaccine as adults.

Meanwhile, American adults over the age of 18 have their choice of the Pfizer-BioNTech, Moderna, or ​​Johnson & Johnson vaccines.

How many doses will my child receive?

Similar to the process for adults and adolescents, it is a two-dose vaccine. Children will receive their second shot of the Pfizer-BioNTech COVID-19 vaccine three weeks after their first shot. Kids are considered fully vaccinated two weeks after they receive the second dose.

What's different about this vaccine compared to the one for adolescents and adults?

The main difference is the dosage, but the active ingredients are the same. In clinical trials, Pfizer found that a 10-microgram dose for five- to eleven-year-olds was the sweet spot — meaning the balancing point between a strong immune response and few side effects. The pediatric dosage is one-third of the 30-microgram dose that has been used for those 12 and older.

Pfizer said this smaller dosage demonstrated a "strong immune response in this cohort of children one month after the second dose." Another difference is that this pediatric version includes smaller needles that are specifically designed specifically for children, making it easier to administer on kids who are afraid of needles.

Where can my child get vaccinated?

The short answer is it depends on where you live. Some states, like California, have already started to offer vaccinations for young children at school clinics, pharmacies, pediatrician offices and county-run vaccination sites. In New York City, city-run vaccination sites for children will start on Thursday. Parents should talk to their local pediatrician about where to get their child vaccinated. Starting on November 6, Walgreens will begin offering Pfizer's COVID-19 vaccine to children in thousands of stores nationwide. The federal vaccine finder website that helps people find vaccines near them hasn't offered the pediatric vaccine yet, but it's a good idea to keep checking it as another option to make an appointment for your child.

Should my child get vaccinated if they've already had COVID-19?

Yes. Young children who had COVID-19 should still get the vaccine, public health officials advise.

"We absolutely recommend that children, even children who have had the disease before, get vaccinated," Walensky of the CDC said on Wednesday during a White House press briefing.

Does my child need parental consent to get vaccinated?

This is another question that has an answer dependent on your geographical location. Most likely, yes, but very few states and cities have exceptions. For example, Philadelphia allows minors age 11 and up to self-consent for the COVID-19 vaccine, according to data collected by the Kaiser Family Foundation, which has a list of the consent requirements listed by each state. As noted, most states allow certain groups of children — such as those who are emancipated or not living with a parent or guardian — to self-consent for medical services.

Do both parents need to be present?

No. Generally, either parent can give consent for a child to be vaccinated. However, this matter can be messy if the parents are divorced, as WebMD reported.

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By Nicole Karlis

Nicole Karlis is a senior writer at Salon, specializing in health and science. Tweet her @nicolekarlis.

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