Covid-19 vaccine: What to consider for kids under 5?

Where can parents go to get the vaccine for their kids? Which one should they choose? What kind of side effects can be expected, and how should they be treated? Can the Covid-19 vaccine be given along with other childhood immunizations? And how long should kids who just had Covid-19 wait before they get the shot?

To help us with these questions, I spoke with CNN Medical Analyst Dr. Leana Wen, an emergency physician and professor of health policy and management at the George Washington University Milken Institute School of Public Health. She is also author of “Lifelines: A Doctor’s Journey in the Fight for Public Health” and the mother of two children under 5.

The following conversation has been lightly edited for length and clarity.

CNN: Let’s start off with your family. You have a 4-year-old and a 2-year-old. Have you gotten them vaccinated yet?

Dr. Leana Wen: Yes! I called my pediatrician’s office as soon as the FDA authorized the vaccine to let them know that I wanted my kids to get vaccinated at the earliest possibility. The earliest appointment was last Monday, about a week after kids in the 6 months to 5-year-old age group first started getting their shots.

CNN: How did it go?

Wen: It was no different from any other vaccine appointment. My kids are used to getting childhood immunizations. They went into the office; I checked in and signed some forms, and they got their shots from the nurse. There were no tears. Both kids were very excited by their colorful Band-Aids.

On the other hand, I felt quite emotional. My daughter was born in April 2020, right at the beginning of the pandemic when so much was unknown and our lives were filled with fear. My son had so many disruptions in his life due to Covid-19, including his school closing and being unable to have playdates.

Our family has waited so long for this moment. It’s really been a long time, because it’s been more than a year and a half since adults started getting their vaccines. I feel so relieved that my kids are now able to get the same level of exceptional protection that everyone 5 and over can.

CNN: Which vaccine did you choose?

Wen: My kids got the Moderna vaccine. That’s what our pediatrician’s office has at the moment.

I could see why parents who have a choice might make either decision. The Moderna vaccine is two doses compared (with) Pfizer’s three doses, and a lot of parents might prefer to get the full series done and over with quickly. The Pfizer vaccine has been given to 5-year-olds and above since last November. Preliminary studies also indicate that Pfizer may have milder side effects due to the lower dose. Some parents might prefer it because it has a longer track record and possibly fewer side effects. Both vaccines are safe and effective, and I think a lot of parents will do as I did and choose whatever is most convenient.

CNN: Where should parents go to get the vaccine if their pediatrician’s office doesn’t offer it?

The FDA has authorized Covid-19 vaccines for children under 5. What should parents know?

Wen: I’d still call the pediatrician’s office and ask for recommendations. They might well have a list of local pharmacies that will inoculate younger kids. Make sure to check in advance because most pharmacies won’t likely be equipped to vaccinate very young kids, so it’s important to know in advance which will. When you call, tell them the exact ages of your children. Some pharmacies may employ additional age restrictions such as vaccinations only for those 3 and older.

The federal government’s website, www.vaccines.gov, is also a great resource. You could also consider calling your local city or state health department since they might have temporary vaccine clinics set up, too.

CNN: What kind of side effects can be expected, and what can parents use to treat their kids?

Wen: The types of side effects are similar to what could be seen for lots of other routine childhood immunizations. Kids can have a sore arm or redness at the injection site. They could have fevers or be fussy and cranky. These symptoms are generally mild and resolve in a day or two. A lot of children also have no side effects — my kids didn’t.

The CDC does not recommend premedication — meaning that you shouldn’t give your child Tylenol or ibuprofen in advance of the vaccination, in anticipation of possible side effects. However, if your child develops fevers, you should certainly give Tylenol or ibuprofen in the appropriate doses for their age and weight.

CNN: Can the Covid-19 vaccine be given along with other childhood immunizations?

Wen: Yes, the CDC has said that the Covid-19 vaccine can be coadministered, given at the same time as other childhood immunizations. A different injection site is used — for example, the Covid-19 shot in one leg and another vaccine in another leg.

It’s really important children are up to date with other immunizations to prevent other infectious diseases. Make sure to check with your pediatrician to see if they are due for other shots, too.

CNN: Should parents choose a specific day of the week to give the vaccine?

Children get long Covid, too, and it can show up in unexpected ways

Wen: Most kids are not going to get significant enough symptoms that they will end up missing school. However, know that the possibility exists that they could feel cranky or more fatigued, and have a plan for the next day following the vaccine. If they have to stay home from school, will you have a backup child care plan?

CNN: How long should kids who just had Covid-19 wait before they get the shot?

Wen: The CDC says that it’s fine to give the vaccine after symptoms are resolving and the isolation period following infection is over. The agency also says that it may be advisable to wait three months after recent infection.

I think this is good advice. Recovery from recent infection conveys some protection for about two to three months. I think it’s reasonable to wait a couple of months after recent infection to begin the vaccine series, but also keep in mind that infection alone does not provide nearly as robust or long-lasting protection as hybrid immunity from infection and vaccination. The CDC recommends that your children are vaccinated, even if they’ve been infected.

CNN: What about parents who aren’t sure, who want to wait and see?

Wen: All parents and caregivers want to do what’s best for our children. A lot of parents will be super eager to get their kids vaccinated. I am definitely in that camp, along with a lot of physician moms that I know.

Other parents might want to wait and see the experiences of those who want to go first. I would encourage families on the fence to speak with their pediatrician and also consult credible expert organizations, such as the CDC and the American Academy of Pediatrics.

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