Overview: Getting it, dosing, side-effects, effectiveness
“Yes!” says Dr. Anne Pham-Huy. She’s an infectious diseases physician at CHEO and a member of the National Advisory Committee on Immunization. “If I had a child under five years old, there’s no doubt I would make sure they got their vaccine. I’d expect them to catch COVID at some point, but I’d rather not have them go through it without any kind of protection.” Available vaccines are very effective in preventing symptomatic COVID-19 (see question 2 below for more details).
In clinical trials for the under five population, the vaccines have been shown to be effective in preventing symptomatic COVID-19. In one study, compared to children that were not vaccinated, the Moderna vaccine reduced the risk of contracting symptomatic COVID-19:
- Children aged 6-23 months who received the vaccine were at 51 per cent lower risk
- Children aged 2-5 years who received the vaccine were at 37 per cent lower risk
More generally, COVID-19 vaccines have been show to be very effective at reducing hospitalization, serious disease and death.
For this age group, the Moderna vaccine has two doses and the Pfizer vaccine has three. It takes all doses for a child to be considered fully vaccinated. Having all doses helps the vaccine work as best it can.
- For Moderna: The National Advisory Committee on Immunization (NACI) recommends that children under the age of five wait at least eight weeks before getting their second dose.
- For Pfizer: As of September 2022, NACI has not provided a dosing interval recommendation for children under five years of age.
Contact your family doctor or primary care provider to discuss any questions or special considerations such as being immunocompromised. You can also reach out to the SickKids COVID-19 vaccine consult service. This service provides a safe, judgment-free space for Ontario residents to discuss the COVID-19 vaccine with a pediatric nurse. Book an appointment online at www.sickkids.ca/vaccineconsult or by calling 1-888-304-6558. The service is available in multiple languages, using over-the-phone language interpretation.
In the Moderna trial, the majority of children had no side-effects, and any of the side-effects that were observed were mild or typically went away after a few days.
Side-effects may include:
- feeling tired
- muscle aches or pains; a sore or red arm.
No serious side-effects, like myocarditis (heart inflammation), or other safety concerns were identified. Health Canada will continue to closely monitor this vaccine for serious side-effects and will take action if any safety concerns are identified.
Contact your family doctor or primary care provider if you have concerns or if your child has had a negative reaction to a previous vaccine. You can also reach out to the SickKids COVID-19 vaccine consult service. Book an appointment online at www.sickkids.ca/vaccineconsult or by calling 1-888-304-6558. The service is available in multiple languages, using over-the-phone language interpretation.
Yes, kids (and adults) should still get the vaccine, even if they had COVID-19. This is because:
- We do not know how long antibodies against COVID-19 stay in the body after infection
- People can get COVID-19 again (and sometimes be even more sick)
- The vaccine can help support a person's antibodies to fight against COVID-19
- The clinical trials found that the vaccine was safe for people who previously had COVID-19.
The National Advisory Committee on Immunization suggests children in this age group wait eight weeks after getting COVID-19 before they have their first or second dose. For children who are moderately to severely immunocompromised, they may wait four to eight weeks after getting COVID-19 before they get their first or second dose.
Vaccine options: Should I wait?
There are two approved vaccines for children, Moderna and Pfizer. As of September 2022, only the Moderna vaccine is generally available in Ontario.
No. There is no reason to wait. We encourage you to get the first vaccine that is available.
The first COVID-19 vaccine (regardless of brand) that is available for your child will be the best vaccine to get, as it will provide protection against COVID-19 to your child as soon as possible. Vaccine doses are based on age and the maturity of the immune system and not size or weight of your child.
Breastfeeding and other routine vaccinations: Recommendations
All available COVID-19 vaccines approved in Canada can be used while breastfeeding. Presently, the Pfizer and Moderna vaccines are preferred because they have the most data available on safety and effectiveness during pregnancy.
Vaccinated people can pass antibodies to their baby through pregnancy and breastmilk, which can protect infants until at least six months of age. Providing a COVID-19 vaccine to a child over 6 months old is the best way to protect them against COVID-19.
For anyone over five years of age, the National Advisory Committee on Immunization recommends that COVID-19 vaccines may be given at the same time with any other non-COVID-19 vaccine. In younger children, they suggest waiting 14 days between a child’s COVID-19 vaccine and other routine vaccinations.
Both routine (including for mumps, measles, rubella, chickenpox, polio, diphtheria) and COVID-19 vaccinations are important and should be taken as soon as possible. If your community is experiencing an increase of COVID-19 cases, you may decide to have your child get their COVID-19 vaccines first, based on the personal risk factors for your child and your family.
Additional resources: Support for you and your child
Contact your family doctor or primary care provider to discuss your concerns. You can also reach out to the SickKids COVID-19 vaccine consult service. This service provides a safe, judgment-free space for Ontario residents to discuss the COVID-19 vaccine with a pediatric nurse. Book an appointment online at www.sickkids.ca/vaccineconsult or by calling 1-888-304-6558. The service is available in multiple languages, using over-the-phone language interpretation.
Some parents and caregivers have found that a “social story” (visual depiction) can be helpful to reduce anxiety and aid in explaining the entire vaccination process to children. Here’s an example from Holland Bloorview.
CHEO also has a resource on how to distract your child during medical procedures.
SickKids also has a resource to help kids cope before and during vaccination and needle procedures.
McMaster Children’s Hospital has a video on supporting children for vaccination.
Other resources that may be helpful:
- About the COVID-19 vaccine, includes activity books and videos (Holland Bloorview)
- Kids #Under5 Vaccines includes questions, answers and videos (Science Up First)
- COVID-19 vaccination for under five includes questions and answers (AboutKidsHealth.ca)
- Max the Vax includes questions and answers in multiple languages (Canadian Medical Association, Children’s Aid Foundation of Canada)
- Here's what you should know about the COVID vaccine for kids under 5 (Today’s Parent article)
In Ontario, you can get book a vaccine through the provincial booking site.
You can reach out to the SickKids COVID-19 Vaccine Consult Service which is a by-appointment phone service that provides a safe, judgment-free space to have an open conversation about the COVID-19 vaccine. The consult service provides expert guidance for children, youth and those who are pregnant, breastfeeding, or planning to conceive. It is available in multiple languages, using over-the-phone language interpretation. Book an appointment online at www.sickkids.ca/vaccineconsult or by calling 1-888-304-6558.