Younger kids are looking forward to sleepovers, playdates and some sense of normalcy now that federal health officials have approved the Pfizer COVID-19 vaccine for children ages 5 to 11.

Here, NorthShore Infectious Disease Physician Jennifer Grant, MD, answers questions from parents about its safety and efficacy. If you have additional questions, check with your pediatrician or primary care physician.

Were there any side effects from the Pfizer vaccine in the clinical trial?

No serious safety concerns were identified. The most common reactions to the vaccine in this age group were pain, redness and swelling at the injection site, muscle aches, and fatigue, but these were mild and went away within a few days.

No children in the trial had a dangerous allergic reaction or developed myocarditis. Because these conditions have on rare occasions occurred in people ages 12 and up after vaccination, health officials say they may occur in this younger group as the vaccine is rolled out to millions of children. It is important to note that myocarditis is less likely to happen in this age group after vaccination because myocarditis, in general, is rarer in kids under age 12. 

How effective is the Pfizer vaccine for this younger age group?

Clinical trials in this younger group found the vaccine to be 90.7% effective in preventing symptomatic COVID-19.

How does the vaccine dose differ from the adult dose?

The vaccine contains a third as much mRNA — 10 micrograms instead of 30 — but it is otherwise virtually identical to the adult version and is also given in two shots three weeks apart. The trial study helped investigators determine the best dose for children in this age group, meaning they determined the dose that is most effective against the virus with the least side effects.

What do you say to parents who want to wait and see what happens with other vaccinations before getting their children vaccinated?

As a parent, I completely understand this natural perspective. ‘Pandemic parenting’ is full of hard decisions that we don’t always feel confident in. Choosing vaccination, however, is a decision that I actually feel very confident in based on the data. I think the benefits of vaccinating early far outweigh the benefits of taking a ‘wait and see’ approach. COVID-19 is unpredictable and another variant or surge in cases may be lurking around the corner. By vaccinating our kids sooner rather than later we protect them *now* against getting sick from COVID itself, but also against other consequences of COVID like Multisystem Inflammatory Condition in Children (MIS-C), which is most common in children ages 5 to 11. Vaccinating our kids sooner also helps protect their more vulnerable family members, teachers and caregivers - and slows the spread of COVID in the community. This in turn benefits your children by reducing missed school and cancelation of other events and activities due to COVID-19 cases. Although my son doesn’t understand all of the reasons listed above, he knows his vaccine provides him COVID fighting superpowers!

If a child is 11 years old, should parents wait to get them the higher, adult dose at age 12?

I recommend not waiting. Parents should get their children ages 5 and up vaccinated against this devastating virus as soon as possible. Why put your child at risk to become infected while waiting for a higher dose? A smaller dose does not mean it is less effective. If your child turns 12 in between doses, he or she will likely get the higher dose for their second shot, but the CDC says it’s okay if kids in this situation get both lower doses as well. There will not be much of a difference in the immune response of children ages 11 compared to those age 12 who get a higher dose.

Does it make a difference if my child weighs as much as a teen or is as tall as a teen?

No, the doses are determined by age, not by weight or height. Body size doesn’t impact a child’s ability to make antibodies in the same way that it would impact a child’s ability to metabolize certain medications. This particular vaccine dose was identified in this patient group as providing excellent protection against COVID while minimizing the side effects.

Why do I need to get my children vaccinated when it’s been shown that younger kids don’t get as sick as adults from COVID?

It is correct that most children do not get as sick as adults from COVID-19, but children are still getting sick and dying and also getting long COVID symptoms and the post-COVID inflammatory syndrome called MIS-C. This virus is unpredictable! Experts looked at this very closely, to weigh the risks and benefits, and clearly found vaccination to be favorable in this age group. Plus, this is a wonderful opportunity to teach our children that vaccinations not only help save their lives, but also the lives of their grandparents, siblings, community members.

Do vaccinated kids still need to wear face masks?

Fully vaccinated children fall under the same guidelines and local ordinances as adults who are fully vaccinated. They can remove their masks if local ordinances say they are allowed.