Does my child need the bivalent COVID-19 booster?

Bivalent COVID-19 boosters for kids ages 6 months to 4 years, 5 to 11 years,12 to 17 years and 18 years and older

Bivalent COVID-19 doses and boosters are approved and recommended for all kids by the Centers for Disease Control and Prevention (CDC) and U.S. Food and Drug Administration (FDA). However, parents may understandably have questions about the bivalent booster and when/if their child should receive it.

In this Q&A with Dr. Angela Dangvu, a pediatrician in CHOC’s primary care network, she addresses parents’ frequently asked questions about bivalent COVID-19 boosters for kids.

What is the bivalent COVID-19 vaccine?

The virus that causes COVID-19 has changed over time, creating more contagious variants of the virus (like the omicron variant) that are spreading faster and infecting more people.

To help protect everyone from the different variants of the COVID-19 virus, scientists have developed an updated COVID-19 vaccine that includes components from the original COVID-19 virus strains and a component of the omicron variant. These are called bivalent COVID-19 vaccines because they contain these two components.

The bivalent COVID-19 vaccine may also be referred to as the “updated” COVID-19 dose or booster.

Can kids get the updated, bivalent COVID-19 booster?

Yes. Updated (bivalent) doses or boosters from Moderna and Pfizer-BioNTech are now available for infants ages 6 months to adults ages 18 years and older. The CDC recommends that everyone stays up to date with COVID-19 vaccines for their age group.

Children ages 6 months to 4 years who received their primary two-dose series from Moderna are eligible to receive the updated Moderna bivalent third dose two months after their second dose. Children 5 years and older can receive either the Moderna or Pfizer-BioNTech booster two months after their second dose of the primary series.

For children ages 6 months to 4 years, Pfizer-BioNTech’s primary series has three doses. In December, Pfizer updated their third dose to be bivalent for both the original COVID-19 virus and the omicron variant. If your child has not received their third dose of Pfizer’s primary series yet, they will receive the updated dose. If they have already completed their three-dose primary series from Pfizer, they are not eligible for an additional bivalent booster at this time.

Children 5 years of age who received the two-dose Pfizer-BioNTech primary series are only eligible to receive the Pfizer-BioNTech booster. Children 6 years and older can receive either the Moderna or Pfizer-BioNTech booster two months following the second dose of the primary series.

COVID-19 vaccine and booster chart for kids

Please review the following chart to determine what booster dose your child should receive based on their age and which vaccine they received for their primary series.

Should my child get the bivalent COVID-19 booster?

It’s recommended that children stay up to date with COVID-19 vaccines because they have proven to be effective in reducing hospitalizations and deaths related to COVID-19.

Studies show that people who are not vaccinated and become infected with COVID-19 may be at a higher risk for developing long-term effects from their infection.

Are there side effects for the bivalent COVID-19 booster?

The reported side effects of the bivalent COVID-19 booster are like what some kids felt after the two-dose primary vaccines like fever, headache, tiredness and pain at the injection site.

Side effects should be mild and temporary. It is fine to treat side effects once they surface with over-the-counter pain medicine. You can give your child ibuprofen or acetaminophen, so long as they haven’t had previous reactions to these medications.

Do kids need to wait to get the bivalent booster if they already had COVID-19?

Talk to your pediatrician about the best time to get the COVID-19 booster dose following a COVID-19 infection. If your child becomes infected with COVID-19 when they are supposed to receive their vaccine or between doses, they should wait to get vaccinated until they’ve recovered and aren’t contagious.

If your child becomes infected before they receive the bivalent COVID-19 booster, you can consider waiting three months before they receive the booster to maximize their immunity since they aren’t as likely to become sick with COVID-19 again during that time. However, it is still possible for people to be infected with other variants of COVID-19 again within three months.

Both adults and children should still get the recommended doses and boosters even after being infected with COVID-19. The vaccines have been proven to effectively reduce the risk of severe illness, hospitalizations and death.

Will my children need to receive the covid-19 booster every year?

It’s possible. Depending on how the COVID-19 virus evolves and how the vaccines work in response, it may be recommended for children and adults to receive an annual COVID-19 booster, much like the flu shot.

Scientists and healthcare providers are still studying the virus and will determine what will be best for adults and children in the future.

Besides getting the booster, how can I reduce the risk of COVID-19 for my child?

COVID-19 is spread primarily through person-to-person contact. To reduce the risk of COVID-19 infections, kids should:

• Receive a COVID-19 vaccine and booster, if eligible.
• Mask when indoors or in large group settings.
• Avoid close contact with people who are sick.
• Avoid touching their eyes, nose and mouth.
• Stay home when they are sick.
• Practice good cough etiquette by coughing into elbow.
• Wash their hands often.

Families should also make sure that all eligible members of their household receive their COVID-19 vaccine and booster.

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