What to know about COVID-19 shots for children under 5

The approval Saturday from Dr. Rochelle Walensky, the CDC’s director. expands the nation’s coronavirus vaccination campaign to children as young as 6 months old.

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Vial filled with the Moderna COVID-19 vaccine rests by syringes waiting to be loaded by nurses from the Jackson-Hinds Comprehensive Health Center

A vial filled with the Moderna COVID-19 vaccine rests by syringes waiting to be loaded by nurses from the Jackson-Hinds Comprehensive Health Center, at a vaccination station next to Jackson State University in Jackson, Miss., Tuesday, Dec. 7, 2021. Children as young as 6 months old are now eligible to receive COVID-19 vaccinations.

Rogelio V. Solis, AP Photos

The federal government opened COVID-19 vaccinations Saturday to infants, toddlers and preschoolers as young as 6 months old, with shots available starting in the coming week.

Advisers to the federal Centers for Disease Control and Prevention recommended the vaccines for the littlest children, and the final signoff came hours later from Dr. Rochelle Walensky, the agency’s director.

“We know millions of parents and caregivers are eager to get their young children vaccinated, and with today’s decision, they can,” Walensky said.

While the federal Food and Drug Administration approves vaccines, the CDC decides who should get them.

The shots offer young children protection from hospitalization, death and possible long-term complications that are still not clearly understood, the CDC’s advisory panel said.

The government already has been gearing up for the vaccine expansion, with millions of doses ordered for distribution to doctors, hospitals and community health clinics around the country.

Roughly 18 million kids will be eligible, but it’s anyone’s guess how many will get the shots. Fewer than one-third of children 5 to 11 years old have done so since vaccination were opened to them last November.

What vaccines are available?

Pfizer and Moderna got the green light Friday from the FDA and Saturday from the CDC. The vaccines use the same technology but are being offered at different dose sizes and with a different number of shots for the youngest kids.

Pfizer’s vaccine is for children 6 months to 4 years old. The dose is one-tenth of the adult dose, and three shots are needed. The first two are given three weeks apart, the last at least two months later.

Moderna’s is two shots — each a quarter of its adult dose, given about four weeks apart for kids 6 months through 5 years old. The FDA also approved a third dose, at least a month after the second shot, for children with immune conditions that make them more vulnerable to serious illness.

How well do they work?

In studies, vaccinated children this young developed levels of virus-fighting antibodies as strong as young adults, suggesting that the kid-size doses protect against coronavirus infections.

Exactly how well they work is hard to pin down, especially when it comes to the Pfizer vaccine.

Two doses of Moderna appeared to be only about 40% effective at preventing milder infections at a time when the omicron variant was causing most COVID.

Pfizer presented study information suggesting the company saw 80% with its three shots. But the Pfizer data was so limited — and based on such a small number of cases — that experts and federal officials say they don’t feel there is a reliable estimate yet.

Should my little one be vaccinated?

Yes, according to the CDC’s advisers. While COVID has been the most dangerous for older adults, younger people, including children, also can get very sick.

Hospitalizations surged during the omicron wave. Since the start of the pandemic, about 480 children under 5 are counted among the nation’s more than one million coronavirus deaths, according to federal data.

“It is worth vaccinating even though the number of deaths are relatively rare because these deaths are preventable through vaccination,” said Dr. Matthew Daley, a Kaiser Permanente Colorado researcher who’s on the CDC’s advisory committee.

Which vaccine should my child get?

Either one, said Dr. Peter Marks, the FDA’s vaccine chief.

“Whatever vaccine your health care provider, pediatrician has, that’s what I would give my child,’’ Marks said.

The doses haven’t been tested against each other, so experts say there’s no way to tell whether one is better.

One consideration: It takes roughly three months to complete the Pfizer three-shot series, but just one month for Moderna’s two shots. So families eager to get children protected quickly might want Moderna.

Who’s giving the shots?

Pediatricians, other primary care physicians and children’s hospitals are planning to provide the vaccines. Limited drugstores will offer them for at least some of the under-5 group.

Officials expect most shots to take place at pediatricians’ offices. Many parents are likely to be more comfortable getting the vaccine for their kids at their regular doctor, White House COVID-19 coordinator Dr. Ashish Jha said. He predicted the pace of vaccination will be far slower than it was for older populations.

“We’re going see vaccinations ramp up over weeks and even potentially over a couple of months,” Jha said.

Can children get other vaccines at the same time?

It’s common for little kids to get more than one vaccine during a doctor’s visit.

In studies of the Moderna and Pfizer shots in infants and toddlers, other vaccinations were not given at the same time, so there is no data on potential side effects when that happens.

But problems haven’t been identified in older children or adults when COVID shots and other vaccinations were given together, and the CDC is advising that it’s safe for younger children as well.

What if my child recently had COVID-19?

About three-quarters of children of all ages are estimated to have been infected at some point. For older ages, the CDC has recommended vaccination anyway to lower the chances of reinfection.

Experts have noted re-infections among previously infected people and say the highest levels of protection occur in those who were both vaccinated and previously infected.

The CDC has said people might consider waiting about three months after an infection to be vaccinated.

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