If you’re the parent of a baby or toddler, you might be wondering whether you should get your child vaccinated against COVID-19.
You probably have plenty of questions, as well as some concerns, about whether it's safe, necessary and even effective (just to name a few). And you may be worried about some things you’ve heard.
"There’s a lot of misinformation out there right now that can be confusing and even frightening for parents," says Gina Posner, M.D., F.A.A.P., a pediatrician at MemorialCare Medical Group in Fountain Valley, California, and a member of the What to Expect Medical Review Board.
Here's what parents of kids under 5 need to know about the COVID-19 vaccine for their little ones, including whether there’s any truth to some of the most common myths circulating.
Why is it so important for children to get the COVID-19 vaccine?
Although babies and toddlers who get COVID-19 are less likely to become seriously ill than adults, they’re not immune. There have been about 800 deaths in kids under the age of 5 since the pandemic started, according to the latest stats from the Centers for Disease Control and Prevention (CDC).[1]
"This age group has had a higher risk of death and hospitalization than kids ages 5 to 11," points out Dr. Posner. "It may statistically not seem like a lot of deaths, but for every parent who has lost a baby or toddler to COVID-19, it’s one too many."
A September 2023 study published in JAMA underscores the effectiveness of the vaccine. The study, which looked specifically at the Pfizer-BioNTech shot, estimated that the immunization reduced hospitalization rates by 33 percent among children ages 6 months to 4 years between July 2022 and May 2023.
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Earlier research from the New England Journal of Medicine yielded similar findings. It found that kids ages 12 to 18 who had received two doses of it were about 40 percent less likely to be hospitalized with the Omicron variant than their unvaccinated peers. The difference was even greater for children ages 5 to 11: Those who had gotten the Pfizer vaccine were 68 percent less likely to be hospitalized.[2]
An updated shot those eligible (i.e., everyone ages 6 months and up) helps bolster the protection the vaccine offers against COVID-19, says the CDC.
Updated, monovalent shots targeting the latest circulating strains of COVID-19 were approved by the FDA and recommended by the CDC in September 2023. They're available for everyone ages 6 months and up.[3]
Babies and toddlers can get either vaccine (Moderna or Pfizer-BioNTech), depending on availability in their area and their families' preference, the CDC says. Dosing schedules for children ages 6 months through 4 years will differ based on the type of vaccine your child receives, along with whether they've already gotten a COVID-19 shot in the past.
For children who have previously been vaccinated against COVID-19, the CDC recommends:
The Pfizer-BioNTech (Comirnaty) vaccine: Young children 6 months to 4 years who have had one previous dose should get a second dose three to eight weeks after the first, and a third dose at least eight weeks after the second. Children ages 6 months to 4 years who have had two or more previous doses should get an updated vaccine at least eight weeks after their last dose. Children 5 and up should get an updated vaccine (with either the Pfizer or the Moderna shot) at least eight weeks after their second dose.
The Moderna (Spikevax) vaccine: Young children 6 months to 4 years who have had one previous dose should get a second dose four to eight weeks after the first. Children ages 6 months to 4 years who have had two or more previous doses should get an updated vaccine at least eight weeks after their last dose. Children 5 and up should get an updated vaccine (with either the Pfizer or the Moderna shot) at least eight weeks after their second dose.
For children who have not yet been vaccinated against COVID-19, the CDC recommends:
The Pfizer-BioNTech (Comirnaty) vaccine: Young children 6 months to 4 years should get a second dose three to eight weeks after the first, and a third dose at least eight weeks after the second. Children 5 and older should get one dose.
The Moderna (Spikevax) vaccine: Young children 6 months to 4 years should get a second dose four to eight weeks after the first. Children 5 and older should get one dose.
In October 2023, the FDA also approved an updated version of the Novavax for the 2023-2024 season for emergency use for children and adults ages 12 and up. Unlike the Pfizer and Moderna vaccines, which are mRNA vaccines, the Novavax vaccine is a subunit protein vaccine. Subunit protein vaccines contain antigens that stimulate the immune system to launch a protective response against a virus.
Talk to your health care provider if you have questions about getting your child a COVID-19 shot.
What are some common myths about the COVID-19 vaccine for children?
Myth: My child doesn’t need the vaccine because COVID-19 isn’t as severe in kids.
Unfortunately, that’s not always the case. While severe illness isn’t common, it can still happen. During the Omicron surge, COVID-19-associated hospitalization rates in kids ages 5 to 11 were about twice as high among unvaccinated as among vaccinated children. Thirty percent of hospitalized kids had no underlying medical conditions, either.
Younger infants are particularly vulnerable. COVID-19 causes more hospitalizations in babies under 6 months compared to any other age group except adults over 75, says Rajeev Fernando, M.D., an infectious diseases consultant based in Southampton, New York, and a member of the What to Expect Medical Review Board.
Children have also developed multisystem inflammatory syndrome in children (MIS-C), a serious condition linked to COVID-19 where different body parts can become inflamed, including the heart, lungs, kidneys, brain, skin, eyes or gastrointestinal organs.
To date, more than 9,500 children in the U.S. have developed COVID-19-related MIS-C, according to CDC data, and sadly, 79 have died from the condition. More than 20 percent of all cases have occurred in kids under the age of 5, and half of all cases have been in those between ages 5 and 13.
"The problem with COVID-19 is that it’s new, and we really don’t know the long-term health effects," says Dr. Posner, who also points out that the rates of Parkinson’s disease went up after the Spanish influenza. "You really want to do everything in your power to prevent your kids from having future problems."
Myth: The vaccine was developed too quickly to be safe for kids.
That's simply not the case. The two COVID-19 vaccines approved for kids, Pfizer and Moderna, are what are known as mRNA vaccines. They contain messenger RNA (mRNA), which is made up of nucleic acid, a natural substance in our cells that instructs them to make proteins. The mRNA from the vaccine carries instructions that tell your child’s cells to produce harmless pieces of "spike" protein that look like the spikes on the actual COVID-19 virus.
Your little one’s immune system realizes they shouldn’t be there and makes antibodies to get rid of them, antibodies that will continue to protect your child from COVID-19 in the future.
But even though the use of mRNA vaccines started with the COVID-19 vaccine in 2020, the technology itself has been studied for decades, points out Tina Feeley, M.D., a pediatrician in Chestnut Hill, Massachusetts, and a member of the What to Expect Medical Review Board.
“It’s also important to remember that the COVID-19 vaccine has gone through the most intense safety monitoring in U.S. history,” she adds. The American Academy of Pediatrics (AAP) echoes this, saying in a news release in June 2022 that it “supports [the CDC’s] recommendation and encourages pediatricians to promote vaccination and give COVID-19 vaccines.”
Myth: The vaccine could change my child’s DNA.
Not true, according to the AAP and other leading medical organizations. The COVID-19 vaccines don’t interact with your DNA at all.
"The mRNA in the vaccines never enter the cells’ nucleus, where your DNA is stored," explains Dr. Posner. Once your child’s immune cells have used the mRNA’s instructions, they break it down quickly and it leaves the body.
Myth: The vaccine could impact my child’s future fertility.
These claims don’t stand up to science. "There is currently no evidence that any vaccines, including COVID-19 vaccines, cause fertility issues [and] problems getting pregnant," CDC Director Rochelle Walensky wrote in an article for What to Expect. "You do not need to delay or decline COVID-19 vaccination if you are hoping to become pregnant."
In February 2021, leading experts from the American College of Obstetricians and Gynecologists (ACOG), the American Society for Reproductive Medicine (ASRM), and the Society for Maternal-Fetal Medicine (SMFM) all have joined together to release a statement stressing that there is no evidence the COVID-19 vaccine causes fertility issues.
According to the CDC, recent studies have found no difference in pregnancy success rates among women who have antibodies from a recent COVID-19 vaccine and women who had no antibodies.
In fact, if anything seems to impact fertility, it's COVID-19 itself, says Dr. Posner, since some research shows that men experience decreased sperm count in the months following a COVID-19 infection. Another study found that COVID-19 infections are tied to a temporary decline in fertility for men that could last for up to 60 days.
Myth: The vaccine could give my child COVID-19.
No. The vaccines don’t contain the actual virus itself.
"There is absolutely no way that your child could get COVID-19 from the vaccine," stresses Dr. Feeley.
Myth: We don’t know the long-term side effects of the vaccine on my child.
In general, serious side effects that could cause long-term health problems are extremely rare after any immunization, and the same has been true for the COVID-19 vaccine, the CDC says.
Safety surveillance of more than 245,000 COVID-19 vaccine doses given over the course of nine months to children under 5 also did not show any adverse events in the 21 days after vaccination, which mirrored clinical trial results of the Pfizer-BioNTech and Moderna vaccines, according to a June 2023 Pediatrics review.
Side effects that happen a little longer after vaccination (but are still relatively short-term), particularly an inflammation of the heart muscle known as myocarditis, have occurred very rarely and generally mildly in some older age groups, namely teen boys and young men.
But the chance of heart inflammation linked to the vaccine has been extremely rare in kids ages 5 to 17: only 635 reported cases out of 54.8 million doses, according to according to CDC data published in May 2022.[4] And the June 2023 Pediatrics review found no reports of myocarditis among children under 5. In clinical trials of the vaccine, there were no reported cases of myocarditis in the 5-11 age group among the more than 3,000 children who participated.[5]
"Your child is much more likely to develop myocarditis after having been infected by the COVID-19 virus, rather than from the vaccine," Dr. Posner says.
She also points out that it’s not possible to get pediatric multisystem inflammatory syndrome (MIS-C) from the vaccine. The same isn't true of the COVID-19 virus.
That said, if you have any concerns after your child receives the vaccine, you should check in with your pediatrician.
Myth: My child doesn’t need the vaccine because he or she already had COVID-19.
The CDC stresses that everyone eligible for the vaccine should get the vaccine, even if they already had COVID-19. Right now, that includes pregnant women and other adults, along with all children 6 months and older.
It’s true that the body gains some protection from COVID-19 after infection. But experts don’t know for sure how long that protection actually lasts. Getting the vaccine may make you less likely to get COVID-19 again, the CDC adds.
Talk to your pediatrician about how long to wait between a case of COVID-19 in your child and the vaccine, if your little one was unvaccinated or partially vaccinated at the time of infection with the virus.
Myth: I’m worried about the immediate side effects the vaccine could have on my child.
Mild, short-term side effects can happen with any vaccine, and some younger children may have them with the COVID-19 shot too, though plenty of kids (and adults) haven't had any noticeable ones at all.
The short-term side effects that may occur after a dose of the COVID-19 vaccine include:
Sore arm at the injection site
Fever
Muscle aches
- Fatigue
These typically surface within 24 to 48 hours of receiving the injection and disappear within a day or two.
“These are side effects that we often see with any vaccine,” says Dr. Posner. “But it’s important to remember that your child may have a mild fever and body aches from the vaccine for just a day, but if they actually got the virus, they could be sick for a lot longer.”
Myth: My little one could be allergic to the vaccine.
Allergic reactions to the vaccine have gotten a lot of press, but they are very, very rare. Most of the time, they are mild: a rash, itching and, less frequently, hives. True life-threatening reactions are incredibly uncommon.
One major European study from March 2023 that looked at rates of anaphylaxis in children under 17 found that, among the more than 41 million COVID-19 vaccine doses given to kids, just 371 resulted in a severe allergic reaction.
During the first nine days of the vaccine roll-out in 2020, for example, there were 21 cases of anaphylaxis after the administration of a reported 1,893,360 doses, according to the CDC. That’s only 11 cases out of every million doses.
“We think that COVID-19-vaccine-related allergic reactions are caused by polyethylene glycol (PEG), an ingredient in the vaccine,” explains Dr. Feeley. Check with your doctor if you're still concerned and want more information.
You needn't worry that your child will be more likely to have an allergic reaction if he or she already has allergies, either. A 2021 study published in the journal JAMA Network Open found that of 140 people who reported severe allergic symptoms after vaccination, less than 5 percent had a history of high-risk allergy.
Myth: The vaccine could impact my daughter’s menstrual cycle.
It is true that the COVID-19 vaccines are linked to a very small, temporary increase in menstrual cycle length. A January 2022 Obstetrics & Gynecology study found that women who received a COVID-19 vaccine had an average increase in cycle length of nearly one day for each dose. If they got two vaccine doses within the same menstrual cycle, their cycles tended to increase a little bit more: about two days on average.
The affected women's cycles went back to the way they were originally a month or two after vaccination. (Menstrual cycles can also be very mildly and temporarily affected by some medications women take, like certain antibiotics, but these changes also typically go away after a month or so.)
“There’s no reason to think that a vaccine your daughter gets at age 3 is going to impact her periods a decade later, when she starts menstruating,” reassures Dr. Posner.
Myth: The vaccine's side effects are worse than getting COVID-19.
That may be true if your little one is lucky enough to be completely asymptomatic or gets a super mild case, says Dr. Posner, neither of which is a guarantee at all. Your child could just as easily be very sick for a week or two and have symptoms linger for longer still, even with a less severe case of COVID-19.
Because the virus affects different children and adults very differently, it can be tough to predict what course it would take for your child. Furthermore, vaccine side effects appear to be less common among younger age groups.
“My practice didn’t get calls from parents about vaccine side effects in kids aged 5 to 11,” notes Dr. Posner. “It’s not like what we were seeing in adults.”
And since the vaccines approved for kids under 5 are even lower doses, she adds, chances of side effects should be even less for the littlest kids.
Myth: You can still get COVID-19 if you get the vaccine, so it’s pointless for me to vaccinate my child.
"Personally, I hope they find a vaccine that prevents you from getting COVID-19 at all, because it’s really not something anyone wants,” says Dr. Posner. "But in the meantime, the vaccines prevent you from getting really sick and needing to be hospitalized. I’ll take it."
If you’re concerned, talk to your pediatrician. But considering how safe and effective the current COVID-19 vaccines are, doctors everywhere are encouraging parents to vaccinate their babies, toddlers and preschoolers against COVID-19.
"I’ve seen kids sick enough to be intubated, and I’ve seen kids with long COVID-19," says Dr. Posner. "That’s enough to convince me that all my patients should be vaccinated."
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