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Have questions about the COVID vaccine for kids under 5?


The Richmond and Henrico Health Districts have received shipments of the Moderna vaccines and expect delivery of the Pfizer vaccine soon. You can find a full list of RHHD vaccination events here:


COVID numbers are ticking back up, just as many families are traveling and gathering at parks, pools, and backyard events for summertime fun. Fortunately, this timing also coincides with the U.S. Food and Drug Administration’s  authorized emergency use of the Moderna COVID-19 Vaccine and the Pfizer-BioNTech COVID-19 Vaccine for the prevention of COVID-19 to include use in children down to six months of age.

Many caregivers have been anxiously awaiting this announcement, while some still have a few questions. If you’re in the latter group, here is some insight and encouragement.

Why do kids need the COVID vaccine?

Kids have been getting sick from COVID-19, with some requiring care in the hospital. Omicron has been especially hard on little ones. According to the Centers for Disease Control and Prevention, kids under 5 were hospitalized during the omicron wave at five times the rate they were during the previous peak of the pandemic.

The vaccine is the best way to prevent severe illness. It’s also critical in helping to stop the spread of the virus and prevent new–and potentially more dangerous–variants from emerging.

How do we know it’s safe?

The development of safe, effective COVID-19 vaccines has been a top priority for researchers and built upon significant prior experience working with other coronaviruses. This vaccine, like all vaccines, has gone through a rigorous series of trials to earn its EUA. EUAs are granted for specific age groups only once the vaccines have proved to be safe and effective for them.

Pfizer’s clinical trials included more than 1,600 children in the 6-month to 5-year age group and the three-dose series had a safety profile similar to the placebo.

How does the dosage compare to what’s been given to other age groups?

Kids under age 5 receive a series of three shots, with a dosage of three micrograms per shot. The first two doses are given three weeks apart, followed by the third a least two months later.

Children ages 5-11 have been given 10 micrograms per shot in a series of two doses, with a booster recently approved for this age group. People 12 years and older receive 30-microgram doses. The progressively smaller doses for the younger age groups were determined to provide the best balance between safety and immunogenicity–or ability to cause a protective immune response.

Pfizer initially proposed a two-dose series for kids ages 6 months to 5 years but conducted further studies when it proved only 30-40% effective in preschoolers. Preliminary clinical trial results showed the three-dose regimen was 80% effective at preventing illness in this youngest population during the omicron outbreak.

Can the COVID vaccine cause heart issues?

While there have been reports of myocarditis (inflammation of the heart muscle) following COVID vaccinations in the older age groups, it’s important to note a few things:

  • There were no instances of myocarditis in kids during the clinical trials.
  • Approximately 1,000 occurrences among hundreds of millions of teens and adults receiving the vaccines means this is a very rare complication.
  • Most cases of heart inflammation related to the vaccine have been mild and resolved quickly.
  • Myocarditis is much more common and severe with COVID-19 illness than with the vaccine.

What about problems with fertility down the road?

There is no peer-reviewed evidence that the COVID vaccine–or any vaccine–affects fertility. The COVID vaccine triggers a response in the immune system but doesn’t interact with the body’s DNA or have any hormonal properties that would cause it to impact fertility.

Can kids get their COVID vaccine at the same time as other vaccines?

The CDC says it’s safe to get the COVID vaccines at the same time as other immunizations, including the flu shot. Data from other vaccines show that the way our bodies develop protection is similar whether vaccines are given alone or with other vaccines. Side effects are similar too.

If you’d prefer to stagger your child’s COVID and other vaccines, that’s okay! The most important thing is that they get them in a timely manner.

Should kids get the vaccine even if they’ve already had COVID?

Yes. There will be some natural immunity from having COVID, but it doesn’t last forever. The CDC recommends vaccination for people who have had and recovered from COVID-19 in the past as an extra layer to protect from getting it again, and potentially more severely than before.

Where can kids get their COVID vaccine?

COVID vaccines are available at no cost at health care providers and pharmacies throughout the community. The best approach is to check with your child’s pediatrician or primary care provider for information about availability. If your child is a CHoR patient, complete this interest form and we’ll contact you to schedule a vaccine appointment.

If you have specific questions about your child’s health and the COVID vaccine, talk with their pediatrician or primary care provider. They’re equipped to help you make the decisions that are best for your family.

Keep up with the latest COVID vaccine information for your family.

Suzanne Lavoie, MD, an infectious diseases specialist and professor of pediatrics and internal medicine at Children’s Hospital of Richmond at VCU, lives in Short Pump and has four kids ages fifteen to twenty. She has been a physician at CHoR for thirty years.

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