What you should know about the covid-19 vaccine if you have a child under 5 years old

(CNN) — Parents of children under the age of 5 can finally vaccinate their children against the coronavirus. The US Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC) have given the green light to Pfizer/BioNTech and Moderna vaccines for children little ones. Now, everyone older than 6 months can be vaccinated.

Where can parents go to vaccinate their children? Which should they choose? What kind of side effects can be expected and how should they be treated? Can the covid-19 vaccine be given together with other childhood vaccines? And how long should children who have just received covid-19 wait before being vaccinated again?

To help us with these questions, I spoke with Dr. Leana Wen, CNN Medical Analyst, ER Physician, and Professor of Health Policy and Management at George Washington University’s Milken Institute School of Public Health. She is also the author of “Lifelines: A Doctor’s Journey in the Fight for Public Health” and mother of two children under 5 years old.

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

CNN: Let’s start with his family. She has a 4 year old and a 2 year old. Have you vaccinated them yet?

Dr. Leana Wen: Yes. I called my pediatrician’s office as soon as the vaccine was licensed by the FDA to let them know I wanted my children vaccinated as soon as possible. The earliest appointment was last Monday, about a week after children in the age group 6 months to 5 years began receiving their shots.

CNN: As was?

Wen: It was no different from any other appointment for the vaccine. My children are used to receiving childhood vaccinations. They went into the office, I checked in and signed some forms, and the nurse gave them their shots. There were no tears. The two children were very excited about their colored band-aids.

Instead, I got pretty excited. My daughter was born in April 2020, right at the beginning of the pandemic, when so much was unknown and our lives were full of fear. My son had so many upheavals in his life due to covid-19, including his school closing and not being able to have playmates.

Our family has waited so long for this moment. It really has been a long time, because it’s been more than a year and a half since adults started getting vaccinated. I am so relieved that my children can now get the same exceptional level of protection as everyone over the age of 5.

CNN: What vaccine have you chosen?

Wen: My children received the Moderna vaccine. It’s the one our pediatrician has right now.
I understand that parents who have a choice can make either choice. The Moderna vaccine consists of two doses, compared to Pfizer’s three, and many parents may prefer to finish the entire series quickly. Pfizer’s vaccine has been administered to children 5 years and older 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 history and possibly fewer side effects. Both vaccines are safe and effective, and I think many parents will do like me and choose the one that is best for them.

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

Wen: I would continue to call the pediatrician’s office and ask for recommendations. They may have a list of local pharmacies that vaccinate younger children. Be sure to check ahead of time because most pharmacies are likely not equipped to vaccinate very young children, so it’s important to know ahead of time which ones will. When you call, tell them the exact age of your children. Some pharmacies may employ additional age restrictions, such as only vaccinating those over 3 years of age.

The federal government website, www.vaccines.gov, is also a great resource. You can also call your city or state health department, as they may also have temporary vaccination clinics.

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

Wen: The types of side effects are similar to those that can be seen with many other routine childhood immunizations. Children may have arm pain or redness at the injection site. They may have a fever or be restless and moody. These symptoms are usually mild and resolve within a day or two. Also, many children do not have side effects; my kids didn’t have them.

The CDC does not recommend premedication, which means you should not give your child Tylenol or ibuprofen before the vaccination, in anticipation of possible side effects. However, if your child has a fever, he should give her Tylenol or ibuprofen in the appropriate dosage for her age and weight.

CNN: Can the covid-19 vaccine be administered together with other childhood vaccines?

Wen: Yes, the CDC has said that the covid-19 vaccine can be co-administered, at the same time as other childhood vaccines. A different injection site is used, for example, the covid-19 injection in one leg and another vaccine in another leg.

It is very important that children are up to date with other immunizations to prevent other infectious diseases. Be sure to check with your pediatrician to see if they should also receive other vaccines.

CNN: Do parents have to choose a specific day of the week to administer the vaccine?

Wen: Most children will not have symptoms significant enough to end up missing school. However, be aware that there is a chance they may feel cranky or more fatigued, and have a plan for the day after the shot. If they have to stay home from school, do you have a support plan for childcare?

CNN: How long should children who have just had covid-19 wait before receiving the vaccine?

Wen: The CDC says it’s okay to give the vaccine after symptoms are resolving and the post-infection isolation period 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 the 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 start the vaccine series, but also keep in mind that infection alone doesn’t provide as strong or long-lasting protection as hybrid immunity from infection and vaccination. The CDC recommends that your children get vaccinated, even if they have 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 is best for our children. Many parents will be very anxious to vaccinate their children. I am definitely in that camp, along with many medical moms I know.

Other parents may want to wait and see the experiences of those who want to go first. I would encourage families who are undecided to talk to their pediatrician and consult credible expert organizations such as the CDC and the American Academy of Pediatrics.