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Question

What do parents need to know about the COVID vaccine for babies and young kids?

Devika Bhushan, MD, FAAP

Answer

As a pediatrician and parent of a young child, I joined many of you in feeling sheer relief when COVID vaccines for children 6 months and older became available in 2022.

For a long time, pre-vaccine, many of us with young children felt like we were frozen in the year 2020—still living in the early months of the pandemic. We deeply worried when our kids got sick. If it was COVID, maybe our child would be among those to get really sick. We made and remade plans due to sick or exposed close contacts, outbreaks at child care or school, juggling time off work and other conflicts.

Now, we have updated COVID vaccines for the best protection possible.

The updated 2023-2024 COVID vaccine for ages 6 months and up is recommended by the American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC). So, although our kids can still get COVID, we can rest easier knowing vaccination prevents most serious illness.

Where to get an updated COVID vaccine

This is the first year that the COVID vaccine is on the commercial market. If your family has trouble accessing updated COVID shots this season, here are some ways to find them near you:
  • Text your zip code to 438829

  • Visit https://www.vaccines.gov

  • Call 1-800-232-0233 or TTY 1-888-720-7489

  • If you have private health insurance, check that the vaccine is covered before your child's appointment. (Public insurance covers the vaccine.)

  • If you need coverage, sign up by Dec. 15, 2023, at HealthCare.gov for coverage beginning Jan. 1, 2024.

Infants under 6 months old still are not protected

Infants under age 6 months are not eligible for the COVID vaccine and they have immature immune systems that put them at higher risk if they get infected. Layers of protection help in the first few months of life, such as:

  • Getting the vaccine if you are pregnant, and asking anyone else around the new baby to get vaccinated

  • Asking sick people to stay away from young babies

  • Having visitors take an at-home COVID test before visiting

  • Asking visitors to wear a mask to protect babies from all respiratory illnesses—not just COVID

What's happening with COVID right now?

We have seen more COVID infections, hospitalizations and deaths among children than for many other vaccine-preventable diseases. Black, Hispanic or Latino, and American Indian/Alaska Native children are especially affected. About 15.6 million children under age 18 years tested positive for COVID as of May 2023. That's nearly 1 in 5 of all infections—and more than 2,200 deaths.

Many kids do have mild symptoms. But some get very sick, including with multisystem inflammatory syndrome in children (MIS-C). Signs of MIS-C may include fever, stomach pain, vomiting, diarrhea, rash, conjunctivitis (pink eye), and low blood pressure. MIS-C usually requires hospital care, and it can lead to death.

It's not possible to predict which kids will get MIS-C or otherwise get very ill from COVID—most kids with MIS-C were healthy before the infection.

Kids and teens who recover can also develop long COVID and other health problems for the first time, like diabetes.

The good news is that the COVID vaccine prevents serious infection, complications like long COVID and MIS-C, and death.

Closing gaps in access to COVID vaccines

A CDC report found differences in which children under age 5 years got the COVID vaccine by the end of last year. These differences were based on their race and ethnicity. Among children who had received at least 1 dose, only 7% were Black, whereas Black children make up nearly 14% of the population. About 20% were Hispanic, whereas Hispanic children make up 25.9% of the population.

Learn how to access vaccines for your child here. Children will have the highest level of protection about two weeks after they get the last dose.

What should parents know about COVID vaccine safety for kids under 5?

The U.S. Food and Drug Administration has reviewed data on the vaccine for children under age 5. We can be confident that the vaccines are safe and effective. There were no significant safety concerns in the vaccine trials. We also now know that millions of children and teens have safely received a COVID vaccine.

The vaccine dose for our littlest ones is much smaller than the adult dose. The Moderna and Pfizer vaccine showed a robust antibody response in kids, meaning it provides great protection against serious outcomes and death.

Since vaccines became widely available, we know there is a very rare, temporary side effect of inflammation around or in the heart (pericarditis and myocarditis). This rare side effect occurs mainly in preteen, teen and young adult males. Symptoms can include chest pain, feeling like your heart is racing or pounding, or shortness of breath. Most people respond quickly to medicine, rest and make a full recovery.

It is worth noting that COVID infections lead to a much, much higher rate of heart and other serious health problems than vaccines. Vaccines can actually help protect us from these effects.

The bottom line: I am confident that the COVID vaccine is overall safe and greatly reduces the risk of serious harm from an infection. That is why I got my son vaccinated as soon as he was eligible—starting when he was 1 year old and the vaccines first came out. (He did very well, with side effects just like other routine vaccines.)

What else can parents do to protect kids under 5?

Many children and teens still need to get the updated COVID vaccine.

Here are other safety steps—especially if anyone in your home has a high-risk health condition or is not able to get the vaccine:

  • Use this tool to check the COVID-19 community level where you live, to help you choose the best level of protection that you need.

  • Anyone 2 years and over may choose to wear a mask or respirator at any time to have an added layer of protection against many respiratory illnesses. Children under 2 are too young to be masked. One tip is to use the rain cover on a stroller to give them an added layer of protection in public—especially in crowded indoor settings like airports.

  • Avoid contact with large groups indoors. Keep gatherings small and with other households who are up to date on COVID (and other) vaccines.

  • See friends and family outdoors when possible. If indoors, make use of good ventilation—open windows, use filters and window fans.

  • Consider traveling by road instead of by plane or train.

Being a parent or caregiver these days is one of the hardest jobs imaginable. I'm sending all fellow parents love and solidarity. Let's remember to take care of and be kind to ourselves and each other. Remember that you're doing the best you can with the resources you have—and so are our kids.

More information

Devika Bhushan, MD, FAAP

​Devika Bhushan, MD, FAAP is an equity- and resilience-focused pediatrician, public health leader, parent, and Indian American immigrant who served as California’s Acting Surgeon General in 2022. She leads a community focused on resilience and well-being at askdrdevikab.substac​k.com and youtube.com/@​drdevikab​.​

Last Updated
11/10/2023
Source
American Academy of Pediatrics (Copyright © 2022)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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