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Sophia Giemza, three, is given a band-aid after receiving the Moderna vaccine in Schwenksville, Pennsylvania.
Sophia Giemza, three, is given a band-aid after receiving the Moderna vaccine in Schwenksville, Pennsylvania. Photograph: Hannah Beier/Reuters
Sophia Giemza, three, is given a band-aid after receiving the Moderna vaccine in Schwenksville, Pennsylvania. Photograph: Hannah Beier/Reuters

Covid vaccines for US children under five: what to know

This article is more than 1 year old
Reuters

The US has begun to roll out vaccines for children under five – here are more details about the Moderna and Pfizer vaccines

The United States has begun rolling out Covid vaccines for children as young as six months after receiving the go-ahead from the Food and Drug Administration and the Centers for Disease Control and Prevention.

The following are some details about the two messenger RNA (mRNA) vaccines from Moderna and Pfizer/BioNTech for young children:

How many doses are needed?

Moderna’s vaccine is a two-dose regimen in children aged six months to six years old. The 25-microgram doses are given 28 days apart. Adults received 100 micrograms per shot for their first two doses.

The Pfizer/BioNTech vaccine is a three-dose course for children aged six months to five. The first two doses are given 21 days apart and the third is administered at least two months after the second. Each dose is 3 micrograms, below the 10 micrograms given to children aged five to 11 and 30 micrograms for people aged 12 and older.

Both companies had sought lower-dose versions for younger children to try to reduce side-effects.

How effective are the vaccines?

Moderna’s vaccine was estimated to be 50.6% effective at preventing symptomatic infections among children six months to two, and 36.8% effective at doing so in children two to six in a clinical trial of more than 5,000 subjects.

It is not yet known how effective the Pfizer/BioNTech vaccine is at preventing infection in children under five because of the low number of symptomatic Covid cases among the children in its trial. An early analysis based on 10 symptomatic cases suggested a vaccine efficacy of 80.3% in this group. Once 21 children in the trial contract symptomatic Covid, the companies can finalize the vaccine’s efficacy.

Both the company’s trials showed that the vaccines generated a similar immune response to those seen in older age groups.

Are the vaccines safe for children?

Neither vaccine has raised any serious safety issues in the trials.

Heart inflammation known as myocarditis and pericarditis has been found to be a rare side-effect of the vaccines in young men, but there have been few cases reported in the United States in children five to 11, and none in either of these trials for the youngest age group.

What are the side-effects?

Some children reported pain and swelling at the injection site after vaccination from both vaccines.

Pfizer’s low-dose vaccine was generally better tolerated, with only sightly more participants who received the vaccine complaining of fevers, irritability or fatigue when compared with those who received a placebo. In ages two to four, 33.7% of participants who received their second dose of the vaccine reported one of these side-effects, compared to 32.2% who received placebo.

For Moderna’s vaccine, 58.9% of three- to five-year-olds reported some type of reaction like fever, headache or fatigue after receiving their second dose, compared with 37.2% of participants who received placebo.

Why vaccinate young children?

Covid is generally milder in children than adults, but there have been more than 440 US Covid deaths among those under age five, according to FDA officials.

Data has shown that in older children and adults, vaccines protect against hospitalization and death, according to Dr Matthew Harris, a pediatric emergency medicine physician at Northwell Health in New York.

People who had a Covid infection and received a booster shot had the most protection against Covid, he said.

Where can young children get vaccinated?

Vaccines will be available in pediatrician offices, children’s hospitals, health clinics and pharmacies.

Not all pharmacies will offer the shots for this group and some will only provide them for children older than three. CVS, for instance, will offer shots for children aged 18 months, while Walmart and Rite Aid have said they would make them available for those three and older.

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