OSF pediatric experts: Kids ages 5-11 and the COVID-19 vaccine

This blog was updated May 23, 2022, to reflect new information from the CDC. 

The Centers for Disease Control and Prevention (CDC) has approved a two-dose COVID-19 vaccine by Pfizer specifically for kids ages 5 to 11.

U.S. data indicates that COVID-19 is now a top 10 cause of death for children in ages 5 to 11.

The ability to vaccinate this age group has the potential to have a major positive impact – not only for the health and safety of children, but also on the pandemic as a whole. OSF HealthCare, however, knows parents still have questions.

A panel of OSF pediatric experts – Marc Knepp, MD, and Frank Han, MD, pediatric cardiologists with OSF HealthCare Children’s Hospital of Illinois, as well as Raghu Kasetty, MD, a pediatrician with OSF Medical Group – offer insight to help parents navigate information when deciding whether to have their kids ages 5 to 11 vaccinated against COVID-19.

How do the COVID-19 vaccines work for kids age 5 to 11?

“The two-dose pediatric mRNA COVID-19 vaccine from Pfizer is identical to its adult cousin and has the same active ingredients as the vaccine given to adults and adolescents,” said Dr. Han.

The age-appropriate dose for kids ages 5 to 11 is one-third of the adult dose and is administered using smaller needles that are designed specifically for children, according to the CDC.

As Dr. Han explains, the vaccine delivers a recipe (mRNA) that teaches our cells to make a harmless piece of the “spike” protein found on the surface of SARS-CoV-2, the virus that causes COVID-19. Once the protein piece is made, our body’s cells display it on their surface and our immune system recognizes that it doesn’t belong. The immune system then produces antibodies to get rid of the virus.

Do younger kids need a booster?

The CDC has approved the Pfizer vaccine as boosters in kids age 5-17. The booster should be given five months after they receive the second dose.

Further, children age 5 to 11 who are moderately to severely immunocompromised should receive a third dose of the vaccine as part of their primary series. This should be given at least 28 days after receiving their second dose. A booster, or fourth dose, for these individuals can be given three months following the third dose.

Kids age 12 to 17 who are moderately to severely immunocompromised should receive a total of five doses. The first booster – or their fourth dose – should be given at least three months after completing the three-dose primary series. A second booster – or their fifth dose – can be given at least four months after the first booster.

What are the benefits of COVID-19 vaccination for kids 5 and older?

Questions? Talk to your pediatrician.

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“Immunizing kids age 5 and older is a big next step in reducing the spread of COVID-19 infection in schools, daycares and the communities where they live,” Dr. Kasetty said. “It also helps to protect family members, especially those who are elderly, people with pre-existing conditions and children and infants under age 5.”

The health of the child should be of the highest concern, Dr. Han said.

“While it is true that children age 5 and older do not generally get quite as ill as adults do, with variants like delta, more kids have been hospitalized, as compared to other earlier variants,” Dr. Han said.

Dr. Knepp agrees.

Vaccination decreases a child’s risk of getting seriously ill,” he said. “It decreases the risk of dying of COVID-19, it decreases the risk of transmission and it decreases the risk of long-term issues that may result from a COVID infection.”

Is the COVID-19 vaccine safe for children of this age group?

The doctors agree that the vaccine has been shown to be very safe. Based upon the study group of kids ages 5 to 11, the side effects were similar but milder compared to adults. Side effects were also very similar to those experienced from other vaccinations kids receive. Side effects include:

  • Swelling, redness and pain at injection site
  • Fever
  • Headache
  • Tiredness
  • Muscle pain
  • Chills
  • Nausea

Will the COVID-19 vaccine affect a child’s reproductive development?

“There has been no evidence that either the COVID-19 vaccine or infection from COVID-19 affects fertility,” Dr. Han said.

Unfortunately, Dr. Kasetty said, there is a lot of misinformation about the vaccine that confuses people, making it hard to make the correct decision.

“There is no proven link between getting the COVID-19 vaccine and a child’s reproductive organ development,” he said.

Are there any long-term side effects of this vaccine for children?

Dr. Knepp and Dr. Han want every parent to understand: In the history of vaccines, there has never been one that has side effects in patients occur decades later.

“All serious adverse events have been identified within the first few months of the vaccine roll out. The children who participated in the core clinical trial will be monitored for two years to see if any side effects occur, but due to the very short lifespan of the vaccine within the body, the vaccination is not expected to create any lasting side effects,” Dr. Han said. “Older children who have received a COVID-19 vaccination have not shown any evidence of long-term side effects.”

Dr. Kasetty agrees.

“In the United States and throughout the world, we’ve had a lot of experience with many different vaccines in children and we have not seen long-term side effects from vaccinations,” he said. “The first COVID-19 vaccine got approved on December 17, 2020. Since then, many millions of people have received the vaccine and we have not seen any notable long-term side effects from the vaccine.”

Can COVID-19 vaccines result in heart inflammation (myocarditis and pericarditis) in children this age?

Our pediatric heart experts, Dr. Knepp and Dr. Han, said while no heart inflammation was found in the 5 to 11 age group during the core clinical trials, surveillance of this possibility is ongoing.

“Myocarditis is an inflammation of the heart muscle. Pericarditis is inflammation of the outer lining of the heart. OSF Children’s Hospital and other collaborating hospitals have studied the issue of myocarditis occurring after a COVID-19 vaccine,” Dr. Knepp said. “Incidents of post-vaccine myocarditis has been relatively minor and seen in older children after a COVID-19 mRNA vaccination. Pediatricians across the country are aware to search for this and study it further.”

They recommend parents speak to their child’s pediatrician about the potential symptoms of myocarditis so they can be on the lookout should this very rare side effect happen.

“The risk of heart inflammation is more likely with infection from the COVID-19 virus in all age groups studied so far than after the vaccine,” Dr. Knepp said.

Dr. Kasetty said the statistics are very telling.

“For children under age 16, COVID-19 infection puts them at a 37 times higher risk of developing heart inflammation. In a large research study, myocarditis was noted in two out of 100,000 people getting the COVID-19 vaccine,” he said. “The highest incidence of myocarditis (10.69 cases per 100,000) was reported in males between the ages of 16 and 29 after getting the COVID-19 vaccine. Most of those cases were mild to moderate.

“The benefits of getting a COVID-19 vaccine,” he said, “clearly outweigh the risks for myocarditis after vaccination.”

Do children have to continue wearing a mask after they’re vaccinated?

The panel agrees, no public health tool used to combat an infectious disease works 100%. Masks and vaccines are both tools for everyone, with vaccines being more effective than masks. For maximum protection, multiple tools of protection should be used together.

“Public health tries to use as many tools as possible to minimize the potential total risk,” Dr. Han said. “The use of masks would be preferable in communities with high COVID-19 transmission. In a small gathering with everyone vaccinated, it is likely safe to remove the mask.”

Dr. Kasetty said the COVID-19 vaccine is highly effective in protecting yourself from contracting the virus in addition to reducing the spread.

“It is a good idea to continue to wearing masks in big indoor groups to reduce the asymptomatic spread of the virus,” he said.

The doctors recommend following guidance from the CDC about masks.

Last Updated: May 25, 2022

About Author: Lisa Coon

Lisa Coon is a Writing Coordinator for OSF HealthCare, where she has worked since August 2016.  A Peoria native, she is a graduate of Bradley University with a degree in journalism. Previously, she worked as a reporter and editor at several newspapers in Iowa and Illinois.

She lives in Groveland with her husband and son. In her free time she likes to cook, bake and read. She freely admits that reality TV is a weakness, and she lives by the quote, “The beach is good for the soul.”

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Categories: COVID-19, Kids & Family, Preventive Health