[Skip to Navigation]
Sign In
JAMA Pediatrics Patient Page
June 4, 2021

Children and COVID-19 Vaccines

Author Affiliations
  • 1Department of Pediatrics, University of Florida College of Medicine, Gainesville
  • 2Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville
  • 3Department of Epidemiology, University of Florida College of Public Health and Health Professions and College of Medicine, Gainesville
  • 4Department of Obstetrics and Gynecology, University of Florida College of Medicine, Gainesville
JAMA Pediatr. 2021;175(8):876. doi:10.1001/jamapediatrics.2021.1974

Nearly 4 million children in the US have been infected with COVID-19 as of May 2021.

While most children have had mild or no symptoms, thousands have been hospitalized and several hundred have died. Children with underlying conditions are more likely to experience severe effects of COVID-19, but even healthy children can be severely affected. Children can spread COVID-19 to others and also can have long-term effects that last months. For these reasons, children need to be protected from COVID-19.

What Vaccines Are Available?

Currently, 3 vaccines are authorized for adults in the United States. In studies of tens of thousands of people, these vaccines were safe and effective. The vaccine made by Pfizer was recently authorized for children 12 years and older. Two doses of this vaccine are recommended to be given 3 weeks apart. The other 2 vaccines were authorized for persons 18 years and older but are expected to be available for teenagers soon. Studies in younger children as young as age 6 months are ongoing and if these studies show that they are safe and effective, vaccines could be available for children 6 months and older by late 2021 or early 2022.

Are These Vaccines Safe?

Children who received the Pfizer vaccine in the studies were much less likely to get sick from COVID-19. Although these vaccines were developed quickly in response to the COVID-19 pandemic, no steps were skipped in testing for safety. Like adults, children can have adverse reactions from the COVID-19 vaccines, including sore arms, muscle aches, fever, and chills. In most, the adverse reactions are mild, lasting 1 to 2 days, and symptoms can be treated with Tylenol (acetaminophen). These adverse reactions are signs that the child’s immune system is building protection in response to the vaccine. Because the vaccine does not contain the COVID-19 virus, it is not possible to get sick with COVID-19 from the vaccine.

How Can Parents Protect Their Children?

The best way to protect children is for them to get the COVID-19 vaccine when it is authorized for their age group, even if they have had COVID-19 in the past. Children are considered fully vaccinated 2 weeks after the second dose of the vaccine. Parents who are feeling unsure about the COVID-19 vaccine should speak with their pediatrician who can answer their questions. Studies are underway to learn how long the vaccines provide protection.

Children who are too young to be vaccinated can be protected in other ways. We now know a lot about how the virus spreads. Children should continue with physical distancing (at least 6 ft whenever possible), wearing masks, and washing their hands. Outdoor activities are safer than indoor ones, and crowded events, even outdoors, should be avoided.

What Else Can Parents Do?

Many children have fallen behind on well-child checks and childhood vaccines during the pandemic, so visit your child’s physician. The COVID-19 vaccine can be given with other vaccines so it is a great time to catch up. Finally, to keep themselves, their children, and our communities healthy, parents also need to be vaccinated with the COVID-19 vaccine.

Box Section Ref ID
The JAMA Pediatrics Patient Page is a public service of JAMA Pediatrics. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your child’s medical condition, JAMA Pediatrics suggests that you consult your child’s physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, email reprints@jamanetwork.com.
Back to top
Article Information

Published Online: June 4, 2021. doi:10.1001/jamapediatrics.2021.1974

Conflict of Interest Disclosures: None reported.

1 Comment for this article
Covid 19 vaccines for our vulnerable children
Ediriweera Desapriya, PhD | Department of Pediatrics, Faculty of Medicine, UBC
The first clinical trial study published last week in the New England Journal of Medicine (NEJM) shows very promising results. More than two thousand two hundred child volunteers were involved in this clinical trial for the vaccines to understand the efficacy and the adverse events. This study showed that the COVID-19 vaccines are remarkably safe and effective before they got emergency use authorization. Clinical trial published shows a vaccine highly effective in preventing serious disease, with no severe adverse reactions. More significantly, the results of this clinical trial are notable because they demonstrate good antibody responses and 90% efficacy at this lower dose (1).
More than 75% of younger kids 12- to 17 years old in Canada have been fully vaccinated. The preliminary data on vaccine's effectiveness in this age group is astonishing and this evidence can be useful and can be very well a strong motivator to inoculate our younger children. A recent vaccine real world data based evaluation study demonstrated that 2 doses of Pfizer-BioNTech vaccine were highly effective in preventing COVID-19 hospitalization among persons aged 12-18 years. Findings reinforce the importance of vaccination to protect U.S. youths against severe COVID-19 These real world data from 19 pediatric hospitals further suggest that increasing vaccination coverage among this group could reduce the incidence of severe COVID-19. Further, as in-person school attendance increases, multicomponent preventive measures to reduce the incidence of severe COVID-19 among school age children, including vaccination, are imperative (2).

1. Walter EB, Talaat KR, Sabharwal C, Gurtman A, Lockhart S, Paulsen GC, Barnett ED, Muñoz FM, Maldonado Y, Pahud BA, Domachowske JB, Simões EAF, Sarwar UN, Kitchin N, Cunliffe L, Rojo P, Kuchar E, Rämet M, Munjal I, Perez JL, Frenck RW Jr, Lagkadinou E, Swanson KA, Ma H, Xu X, Koury K, Mather S, Belanger TJ, Cooper D, Türeci Ö, Dormitzer PR, Şahin U, Jansen KU, Gruber WC; C4591007 Clinical Trial Group. Evaluation of the BNT162b2 Covid-19 Vaccine in Children 5 to 11 Years of Age. N Engl J Med. 2021 Nov 9. doi: 10.1056/NEJMoa2116298. Epub ahead of print. PMID: 34752019.

2. Olson SM, Newhams MM, Halasa NB, et al. Effectiveness of Pfizer-BioNTech mRNA Vaccination Against COVID-19 Hospitalization Among Persons Aged 12–18 Years — United States, June–September 2021. MMWR Morb Mortal Wkly Rep 2021;70:1483–1488. DOI: http://dx.doi.org/10.15585/mmwr.mm7042e1