Ask the expert: Are COVID-19 vaccines safe for young children?

On Oct. 26, the Food and Drug Administration approved COVID-19 vaccinations for children ages 5 to 11. The decision will now go before the CDC Advisory Committee on Immunization Practices’ (ACIP) for a final recommendation Nov. 2-3. Once final ACIP recommendations are received, updates and details about UT Health San Antonio’s administration of vaccines for this age group will be posted on institutional websites and social media outlets.

Tess Barton, MD, associate professor of pediatrics who has a specialty in pediatric infectious diseases, shared her knowledge about vaccinations for younger children.

How safe is the vaccine for 5- to 11-year-olds?

Data from the clinical trials of vaccines in children, as well as the experience we have had so far with teenagers, show that the COVID vaccines are very safe. Minor side effects like fever, body aches and headaches are common. Serious side effects are rare. No major safety concerns were seen during the clinical trial in children.

How effective is the vaccine for 5- to 11-year-olds?

Studies in children show that they mount a strong and robust antibody response to vaccines, even at the lower doses. We saw this in the adolescent studies, as well. The adolescents seemed to mount a better antibody response than adults.

Besides Pfizer, are there any other COVID vaccine options for children in the 5 to 11 age range?

At the moment, the only vaccine we are expecting to have FDA authorization for is the Pfizer mRNA vaccine. The other vaccine makers have ongoing pediatric trials, but they have not yet presented their data to the FDA for approval.

What are the differences from the adult version? Is the dosage different? Will it require two doses?

Children will be receiving lower doses than adults. Children mount such a good immune response to the vaccine that they have achieved the same antibody levels as adults with this lower dose. The two-dose schedule will be the same as adults and teenagers, which is three weeks apart.

What are the possible side effects in children?

It’s common for children to have a sore arm, body aches, headache and even fever, just like adults have experienced when they got vaccinated. About 70 per million (or about 1 in 15,000) children can have some heart inflammation. For most children, symptoms have been mild and they go away over a few weeks, but it’s obviously something we will be watching.

It’s important to remember that COVID infection itself causes heart inflammation. In one study in healthy college athletes, they found heart inflammation in about 1 in 50 students. So comparing the risk of heart involvement with disease versus with the vaccine, you can see the vaccine is much safer for the heart than getting COVID.

If there are side effects and the illness is typically mild in children, what do you tell parents who ask why they should vaccinate their child at all against COVID-19?

It’s true that most children will not be severely ill or require hospitalization when they catch COVID, but it is not as easy to predict which children will get sick. We have seen plenty of previously healthy kids getting hospitalized, and some also get some of the COVID complications like strokes and long-hauler COVID symptoms. So if we have an opportunity to protect them, we should.

What we have seen with the Delta variant that surged right as school was starting is that kids can pick up this infection and bring it home. We didn’t see that early in the pandemic because kids’ activities were really restricted. Now we see COVID getting passed from kids to adults, just like all the other infections that they traditionally bring home from school or day care to their families.

For families who have someone at home or someone in their close circle, like a grandparent or someone with diabetes or cancer, who might have a higher risk of getting sick, vaccinating children can be a part of all the little things they can do to keep this virus away from that person. So each family can look at their situation to see if they have someone they want to protect, and they can discuss all the different steps they can take to do that. Keeping kids from catching and spreading the virus is part of that strategy.

Where can I go to get the vaccine for my child once it is made available?

Check with your pediatrician first. Many doctor’s offices are preparing to offer the vaccine. Lots of places around town like local pharmacies will be giving it. Of course, UT Health San Antonio and University Health will have the vaccine as well.

Vaccine appointments are available for all currently eligible age groups and can be scheduled at


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