COVID-19 Vaccination FAQ

With children and teens ages 5 years and older now eligible to receive the COVID-19 vaccine, parents may have questions about the vaccine and what to expect afterward. Below are some commonly asked questions and responses from CHOC experts about the vaccine, teens and kids.

COVID-19 VACCINE SAFETY

What vaccine will my teen or child receive?

At this time, the Pfizer vaccine is the only vaccine authorized for use in children and teens ages 5 years and older to prevent COVID-19. It is administered in two doses three weeks apart, injected into the arm muscle. The Pfizer vaccine, as well as the Moderna vaccine, which is authorized for people ages 18 years and older, is an mRNA vaccine. When the vaccine is injected, mRNA – a strip of genetic material – enters a body’s cell and prompts the cell to build copies of spike proteins. These spike proteins are the bumps that protrude from the surface of coronavirus particles. The body’s immune system then learns to spot these spike proteins and produces antibodies that block the virus from entering healthy cells in the future. Studies show that vaccine recipients achieve immunity about two weeks after receiving the vaccine’s second dose. Scientists are still learning about how long that immunity will last.

I have younger children. What is the status of vaccine research in children and adolescents?

Moderna has enrolled children as young as 6 months in clinical trial studies. Janssen and Astra Zeneca also have plans to study their vaccines in younger age groups

Is the vaccine safe for teens and children? Are there other risks for teenagers and children that might not be present for adults?

The Pfizer vaccine is absolutely safe for children ages 5 years and older. In clinical trials, enough teens and children participated to show that the vaccine is safe for 5-year-olds and older. We have no reason to expect that children would tolerate the vaccine less favorably than adults would.

The World Health Organization (WHO) and U.S. Centers for Disease Control (CDC) differ on whether children ought to receive the vaccine. Which should I follow?

If you live in the United States, follow CDC guidance. The WHO’s recommendation is not about safety or health issues with the vaccine – it’s about access. The WHO makes recommendations for the world, where in many parts, the COVID-19 vaccine is scarce and supplies must be allocated carefully, giving priority to those at highest risk for serious illness from COVID-19. The CDC makes recommendations for the United States, which is incredibly fortunate to have a plentiful supply of vaccines, including the Pfizer vaccine, which so far is the only one authorized for use in children ages 5 years and older.

If children and teens are less likely to get sick from COVID-19, why do they need a vaccine?

Even though it is rare for children to get seriously ill from COVID-19, children who are 5 years and older have needed hospital care for COVID-19. This is especially true for children and teenagers with underlying health conditions such as weakened immune systems, obesity or chronic lung conditions.

Having the vaccine may also give parents, teens and kids alike peace of mind to return to more typical activities like in-person instruction and participating in sports, which is great for mental health.

Are there any teens or children who shouldn’t get the vaccine? Should I talk to my pediatrician before scheduling the appointment?

There is no category of children or teenagers who shouldn’t get the vaccine, unless they have a known allergy to one of the vaccine’s components. Because it isn’t a live vaccine – a vaccine that uses a weakened form of a germ to prompt an immune response – people with weakened immune systems, either from illness or medication, may still receive the vaccine. There have been reports allergic reactions to the vaccine, but these occurrences are very rare. Vaccine recipients are monitored for 15 minutes after receiving the injection in case of any allergic reaction, and anyone with a history of severe allergic reactions to foods or medications (who carry an epinephrine auto-injector) are monitored for 30 minutes. Children and teens with other types of allergies beyond any vaccine component can feel safe receiving the vaccine. Parents are always encouraged to speak with their teen’s or child’s pediatrician if they have any questions or concerns.

Will this affect my child’s fertility?

Definitely not. Because it is an mRNA vaccine (see explanation above), the vaccine does not get incorporated into or change the DNA of the body’s cells in any way. There is no reason to worry that the vaccine will affect fertility or future offspring. Read about this in more detail here.

Does the COVID-19 vaccine cause myocarditis?

Myocarditis, or inflammation of the heart muscle, appears to be a very rare side effect of the mRNA COVID-19 vaccine.

In Pfizer’s clinical trial for kids ages 5-11 years, there were no cases of myocarditis—however the company acknowledges that the clinical trials may not have been large enough to pick up such a rare event. The analysis of the clinical trial data suggests that the benefits of the COVID-19 vaccine far outweigh the risks.

Get detailed information about that here.

The vaccine was developed quickly. Should I be concerned about that?

No. The vaccine was developed quickly because scientists received additional money and resources of support from the government. This allowed scientists to follow all the typical processes but overlap some steps, which sped up the process. Also, it was easy to find volunteers to participate in clinical trials because many were excited by the possibility of receiving the vaccine. None of these factors compromised the quality of the trials, and the same processes for safety and effectiveness were followed.

I’ve read about COVID-19 variants. Will the vaccine protect my teen or child against them?

We are still learning about how effective the vaccine is against variants. While there may be some decrease in immune response, the vaccine is still largely protective. An important step in fighting variants is to ensure as many people as possible get the vaccine. The more people who get sick – even mildly – with COVID-19, the more opportunity is presented for the virus to continue to mutate.

My teenager or child already had COVID-19. Should they have the vaccine?

Yes. We don’t know how long the immunity lasts from natural illness, and the vaccine is made to create a longer lasting immune response.

What if my teenager or child has COVID-19 now?

Your child or teen should wait until they are feeling better and no longer need to isolate based on guidelines from the Centers for Disease Control & Prevention.

What if my child or teen has received convalescent plasma treatments?

Your child or teen should wait 90 days to get the vaccine after receiving convalescent plasma or monoclonal antibody treatments. Your child’s pediatrician can help you determine when it’s appropriate to get the vaccine.

Are COVID-19 vaccines free?

Yes. COVID-19 vaccines are free and available for all kids 5 years old and older at local pharmacies, primary care practices and vaccine clinics. You may need to schedule an appointment to receive the vaccine.

Can my child or teenager receive the COVID-19 vaccine at CHOC?

Pediatricians in the CHOC Primary Care Network are offering the vaccine to children and teens 5 years old and older. Please call your CHOC pediatrician for an appointment.

Additionally, CHOC had opened a COVID-19 vaccine clinic on its Orange hospital campus for children 5 years old and older. Make an appointment through MyTurn. Enter the zip code 92868 to find the location.

Can my child take their normal medications before the shot?

Your child should continue to take their normal medications as prescribed.

Can my child take acetaminophen, ibuprofen or an antihistamine before the shot to offset any potential side effects?

No. It is best to avoid preventatively administering these medications – either before the vaccination or right afterward if no side effects are present – because there is a chance they can decrease the immune response.

Do I need to accompany my child to the vaccination?

Yes. Anyone younger than 18 years old must have a parent or legal guardian present to receive the vaccine.

What should we bring to my child or teen’s COVID-19 vaccination appointment?

Bring a photo ID and a document verifying your teen’s date of birth. See more details from the Orange County Health Care Agency about what documentation is required for minors. There’s no need to bring your child’s vaccine records, as they will receive a card specific to the COVID-19 vaccine. It would be helpful if the child or teen wears a short-sleeved shirt, as the injection is administered into the arm.

What should my child expect at the vaccination appointment?

After checking in and taking care of paperwork, the teen or child will be asked some questions about their health. The shot will be administered into the arm. After receiving the shot, your teen will be monitored for 15 minutes to ensure no adverse reactions. Your teen will also receive a card indicating when they received the vaccine and information about the vaccine.

What should I do with their vaccination card?

Take a picture of it just in case anything happens to it and store in a safe place. There is no need to laminate it.

Do we really need to come back for a second vaccine?

Yes. Clinical trials that led to the Pfizer vaccine’s licensing incorporated two doses. So, the determined efficacy is based on two doses and we don’t yet know how effective one dose alone is. The Johnson & Johnson/Janssen vaccination is administered in one dose, but at this time it is only approved for people ages 18 and older.

Do children receive the full-size dose of the Pfizer COVID-19 vaccine?

According to Pfizer’s clinical trial data, the company has determined that kids ages 5-11 years should receive a 10-microgram dose size – one-third of the COVID-19 vaccine dose that everybody else receives.

With the one-third-sized dose, children have demonstrated the same amount of robust immunity to COVID-19 as adolescents, teens and adults.

Are the vaccine vials for children ages 5 to 11 the same as for older children and adults?

No. Vials of the vaccine for younger children will contain 10-microgram doses, while the vials for older children, teens and adults contain 30-microgram doses. This means that pharmacies and doctors’ offices will have separate stocks for these populations. They won’t, for example, be able to draw a smaller dosage amount from an adult vial to give to a younger child. They will also need to use smaller needles to administer the vaccine to younger children.

What are the side effects? Are there any different side effects for kids?

The most common side effects are fever and feeling achy or tired. Any side effects should be relatively short-lived and ease within 24 hours. Because teens and children have more robust immune systems, it’s possible that they may feel these side effects more strongly than adults would. This is a sign that their immune system is mounting a response against the virus.

If side effects do appear after the vaccination, what can I use to treat them?

It is fine to treat side effects once they surface with over-the-counter pain medicine. Either ibuprofen or acetaminophen is fine, so long as your child hasn’t had previous reactions to these medications.

Should my child stay home from school after the shot?

If they have a fever, your child or teen should stay home. Beyond that, so long as they are feeling well, there is no need to limit activities.

What if my child is exposed to COVID-19 after they’ve been vaccinated?

The U.S. Centers for Disease Control & Prevention has updated its guidance and recommends that fully vaccinated people who have a known exposure to someone with suspected or confirmed COVID-19 to be tested three to five days after exposure, and wear a mask in public indoor settings for 14 days or until they receive a negative test result.

After receiving both doses, can my child stop wearing a mask?

No. It’s important that they continue to take precautions against COVID-19. Though they are highly effective, the vaccine is not 100 percent effective, and while among a group of people, it’s impossible to know who is and who isn’t vaccinated.

How will this change socializing for my child?

Teens, children and families alike can definitely have more peace of mind about the safety of resuming more typical activities, which will be wonderful for mental health. In group activities, kids ages 12-15 and teens 16 and older should still continue to wear masks. In one-on-one activities where a child or teen and their friend are fully vaccinated, they can feel comfortable removing their masks so long as no one in either household is high-risk and unvaccinated.

Should I be concerned about having my older vaccinated teen or child around their younger siblings who are not?

No. These children were already interacting with each other in the same household before one received the vaccine. The entire family can take comfort in knowing that one more person in household who has been vaccinated offers more protection for the whole family.

Will children need to receive a booster vaccination in the future?

Right now, additional doses of the Pfizer and Moderna COVID-19 vaccines are recommended for people with compromised immune systems, who are in a high-risk age group for developing COVID-19 or who work in high-risk settings.

There is still research being collected on how long COVID-19 protection lasts with the vaccination. Watch for guidance from the U.S. Centers for Disease Control & Prevention (CDC).