COVID-19 vaccines FAQ for children aged 5 to 11

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Getting the vaccine

What COVID-19 vaccine will children aged 5 to 11 get?
 
Children in BC who are 5 to 11 years of age will be offered a Pfizer-BioNTech (CormirnatyTM) mRNA vaccine made for children their age. Health Canada approved this vaccine for children aged 5 to 11 on November 19, 2021.
 
The vaccine:
 
  • Works and is safe.
  • Is specially made for children.
  • Was tested in children 5 to 11 years of age.
  • Is a smaller dose than the vaccine given to those 12 years of age and older. 
You can register your child to get vaccinated with the Get Vaccinated System. After you register, you will receive a text, email, or phone call when it's your turn to book a vaccine appointment. 
 
How can I register my child to get vaccinated?


You can register your child to get vaccinated with the Get Vaccinated System
. You can register online or by phone. After you register, you will receive a text, email, or phone call when it's your turn to book a vaccine appointment. 

Who is eligible for the COVID-19 vaccine for children?

 

This vaccine is for any child between 5 and 11 years. If your child is 4 years old, you will not be able to get them vaccinated until after their 5th birthday. The vaccine is free, and your children do not need BC Care Cards to receive them.

Does a child who has had a COVID-19 infection still need the vaccine?
 
Children with previous COVID-19 infection may be offered two doses of the vaccine once symptoms of acute illness have resolved and the child is no longer considered infectious and has completed their isolation period. This includes children with 'long COVID', the condition which causes people to experience symptoms well after their infection goes away. Children with a history of multi-system inflammatory syndrome (MIS-C) may be vaccinated once they have recovered or once it has been more than 90 days since diagnosis, whichever is longer.  
 
Not everyone develops a strong immune response after a COVID-19 infection, and the vaccine is the best way to ensure immunity. Although the body naturally generates antibodies when you get COVID-19, we don’t know how long immunity lasts or how many antibodies your body produces. This is why some people get COVID-19 more than once and why it’s recommended that children who have had a COVID-19 infection still get vaccinated. 
 
How can I help support a child who is afraid of needles? 

 

Vaccines can cause some pain, stress, and anxiety for children of all ages. Go to our reducing pain, stress, and anxiety with vaccinations section for tips on how to have a more positive vaccination experience. 

You can also contact your local health unit and ask to speak with a public health nurse about supports available in your area. 
 
How can I explain how the COVID-19 vaccination works to my children?

 

Explain that the vaccine helps make sure they don’t get sick by quickly fighting off the virus that causes COVID-19. The vaccine is so powerful that it even helps to protect the people around them, including their family and friends.  Kids Boost Immunity has videos that explain more. 


Dose & schedule 

Will children aged 5 to 11 get the same dose as youth and adults?

 

No. Children aged 5 to 11 will get a smaller dose. The Pfizer-BioNTech (CominartyTM) mRNA vaccine used for children aged 5 to 11 has 10 micrograms of mRNA. The vaccine used for youth and adults has 30 micrograms. The smaller dose works well because children have stronger immune responses than youth and adults. This means they can get a similar level of protection with a smaller dose.  The smaller dose may also mean a lower frequency of common reactions, such as redness and swelling at the injection site. 

Should children who weigh more get a bigger dose?

 

No. Vaccine doses are based on age, not a child’s size or weight. 

How many doses will children aged 5 to 11 get?

 

Children aged 5-11 will be offered two doses about 8 weeks apart. This includes children who have weakened immune systems. Although adults and teens with weakened immune systems need a 3rd dose to create more antibodies to better protect them from COVID-19, younger children seem to respond well to a two-dose series. A booster dose for this age group is not yet recommended.
 

Why is the time between dose one and two for 5- to 11-year-olds eight weeks, not the 21 days used in the clinical trials?

 

The eight-week interval in youth and adults has resulted in a stronger immune response, better protection against COVID-19 infection, and lower risk of myocarditis (inflammation of the heart muscle) and pericarditis (inflammation of the lining around the heart). It is expected that it will be the same for 5- to 11-year-olds.
 

Can children get the COVID-19 vaccine at the same time as other vaccinations?
 
Yes. The COVID-19 vaccine can be given at the same time as other childhood vaccinations, including the flu shot.
 

 

Risks of COVID-19 infection & benefits of vaccination 

What are the risks of COVID-19 infection in children aged 5 to 11? Isn’t it usually a mild disease in children?
 
While most children with COVID-19 have mild or no symptoms, some do become very sick and require hospitalization. Children with certain underlying medical conditions may be at higher risk of getting very sick from COVID-19.
 
Unfortunately, with new variants such as the Delta variant, we are seeing more children getting sick with COVID-19. According to the BCCDC Data Summary, as of October 14, 2021, there have been a total of 24,554 cases and 94 hospitalizations in the 5- to 17-year-old age group in BC. 
 
COVID-19 infection can cause myocarditis (inflammation of the heart) very rarely in children.
 
Children are also at risk of multisystem inflammatory syndrome in children (MIS-C) following COVID-19 infection. MIS-C is a serious condition where different body parts become inflamed, including the heart, gastrointestinal system, lungs, kidneys, brain, skin, eyes, and lymph nodes. The rare condition seems to appear in children several weeks after they have been infected with COVID-19. Most children who have had this illness have recovered. 
 
We don't know the long-term side effects of COVID-19 infection at this point. We're still learning about 'long COVID', which causes people to experience symptoms well after their infection goes away. While we do not yet know how often 'long COVID' occurs in children, it’s clear that some young people suffer similar long-term effects. 
 
 
What are the benefits of COVID-19 vaccination in children? 

 

Vaccinating children is the best way to protect them from getting sick with COVID-19. While most children with COVID-19 have mild or no symptoms, some do become very sick and require hospitalization. 

Vaccinating children also helps: 
  • Protect family members, including siblings who are too young to get vaccinated and family members who may be at increased risk of getting very sick if infected. 
  • Reduce the spread of the virus in the community. This helps protect people who are most at risk of getting really sick from COVID-19, including the elderly and people who are immunocompromised (have a weakened immune system, which means their body can’t fight off diseases like COVID-19 as well as people with a fully functioning immune system). 
  • Reduce the risk of new variants of concern emerging. We don’t know if there will eventually be a variant of concern that causes more serious illness in children. 
  • Give children an added layer of protection in school or while particpating in sports, playdates, and other group activities.


Safety

Are mRNA COVID-19 vaccines safe for children? 
 
Health Canada approved a Pfizer-BioNTech (ComirnatyTM) mRNA vaccine for children aged 5 to 11. This vaccine works and is safe for children aged 5 to 11. 
 
There is a very strict process to test and approve vaccines in Canada. Health Canada only approves a vaccine if the data from clinical trials show the vaccine is safe and effective and that the benefits of the vaccine outweigh any risks. 
 
The Pfizer-BioNTech (Comirnaty) mRNA vaccine was tested in children aged 5 to 11 through clinical trials that included more than 3,000 children. The clinical trials compared the immune response, safety, and effectiveness of the vaccine to a placebo. In the clinical trials:
 
  • No safety issues were detected.
  • The vaccine provided strong protection against COVID-19 in the couple of months after vaccination.
The vaccine manufacturer will continue to collect safety information from those who participated in the clinical trials. Canada's vaccine safety monitoring system will also help detect any possible side effects that are too rare to appear in the clinical trials. When millions of people receive a vaccine, rare side effects may be detected. Ongoing vaccine safety monitoring is essential for the detection of and timely response to vaccine safety concerns.  
 
It’s important to remember that millions of doses of mRNA vaccines have been given worldwide to those as young as 12. The Pfizer-BioNTech (Comirnaty) COVID-19 mRNA vaccine has an excellent safety profile for those 12 and older. There is no reason to believe that the safety profile would be any different for children 5 to 11 years of age. 
 
 
What are the side effects of mRNA COVID-19 vaccines in children aged 5 to 11? 

 

Side effects are part of the body's natural response to a vaccine. Some people have no side effects, while others may have some type of side effect.

Common vaccine side effects may include:

  • Symptoms at the injection site, such as pain, redness, and swelling. 
  • More general symptoms, such as fatigue, headache, muscle pain, joint pain, chills, and fever. 

No serious side effects were detected in the clinical trials for children in the 5- to 11-year-old age group. 

Vaccine manufacturers will continue to collect information about safety from clinical trial participants. Canada's vaccine safety monitoring system will also help detect any possible rare side effects that didn't appear in the clinical trials. When millions of people receive a vaccine, rare side effects may be detected. Ongoing vaccine safety monitoring is essential for the detection of and timely response to vaccine safety concerns.  
 
It’s important to remember that millions of doses of mRNA vaccines have been given worldwide to those as young as 12. The Pfizer-BioNTech (Comirnaty) COVID-19 mRNA vaccine has an excellent safety profile for those 12 and older. There is no reason to believe that the safety profile would be different for children 5 to 11 years of age. 
 
 
Can mRNA vaccines cause inflammation of the heart?  

 

In rare cases, people have experienced myocarditis (inflammation of the heart muscle) and pericarditis (inflammation of the tissue surrounding the heart) after getting a mRNA COVID-19 vaccine. These events have been reported in BC at a rate of about 1.5 per 100,000 doses of mRNA vaccines given. Cases of myocarditis/pericarditis following COVID-19 mRNA vaccination occur most commonly in adolescents and young adults (12 to 30 years of age), more often after the second dose, and more often in males than females. The available short-term follow-up data shows that the majority of affected people, even if hospitalized, experience relatively mild illness, respond well to conservative treatment, and recover quickly. It's important to note that the risk of myocarditis is much greater following COVID-19 infection than following vaccination.

At this time, it is not known if myocarditis and pericarditis will happen after the lower doses of mRNA in the COVID-19 vaccines for children 5 to 11 years of age. Symptoms to look out for:

  • Chest pain
  • Shortness of breath
  • Feeling of a rapid or abnormal heart rhythm
If your child experiences these symptoms, seek medical attention right away. Inform the health care provider that your child received a COVID-19 vaccine recently.
 
Are there long-term side effects of mRNA COVID-19 vaccines in children? 

The medical and scientific community is confident in the long-term safety of the mRNA COVID-19 vaccines for several reasons:

  • The history of vaccines shows that delayed effects after vaccination can happen. But when they do, these effects tend to happen within six weeks of receiving a vaccine. This is why regulators in Canada and many other countries require at least eight weeks of safety data before approving a vaccine. The vaccines have now been in use for months, with over 2.7 billion doses given worldwide.
     
  • This is not new vaccine technology. The mRNA vaccines have been in development for many years and have been studied before for flu, Zika, rabies, and cytomegalovirus (CMV). In addition, cancer research has used mRNA to trigger the immune system to target specific cancer cells. Years of studying mRNA vaccines has shown no long-term side effects.
     
  • Canada’s vaccine safety system has proven time and again that the data necessary to get through the approval process is sufficient to prove safety, even for the long term. The end data and safety tests for the COVID-19 mRNA vaccines met the same standards as other vaccines that have been approved in Canada. 
When considering long-term risks, a COVID-19 infection is a much more serious concern. 
 
Can mRNA COVID-19 vaccines alter a person’s DNA? 
 
 
  • Location - mRNA is active in the cytoplasm of a cell, whereas DNA is protected in the cell’s nucleus. The mRNA CANNOT enter the nucleus, so the two nucleic acids are never in the same place in the cell.
     
  • Process - mRNA is not DNA. So if a person’s DNA were going to be altered, the RNA would have to be made into DNA. This would require a special enzyme that only exists in some viruses. Coronaviruses are not one of them, as they have only single-stranded RNA, which means that when they enter into a cell’s cytoplasm, they don’t need to be translated. Proteins (like the spike protein) can be made directly from the RNA.
     
  •  Stability - mRNA is not very stable. Its half-life in human cells is estimated in hours. For purposes of mRNA-based therapies, modifications have been developed to keep the molecule in cells long enough to allow for the therapy to be successful. But even with this, the mRNA will not lead to protein production for more than 10-14 days.


Reproductive health 

Can COVID-19 vaccines cause infertility?

COVID-19 vaccines do not cause infertility, and there is no scientific reason to believe that they will cause infertility. Recent studies have shown that they do not impact fertility. In response to the online rumours suggesting that COVID-19 vaccination may affect future fertility, the Society of Obstetricians and Gynaecologists of Canada released a statement.
 

Can COVID-19 vaccines affect menstruation? 
 
The Canadian Society of Obstetricians and Gynaecologists states the following in regards to COVID-19 vaccination and the menstrual cycle:
 
“The menstrual cycle is a complicated process impacted by multiple factors including sleep, stress, infection, diet, and exercise. In fact, getting COVID-19 itself can impact the menstrual cycle, with more than 35% of women and persons who get COVID-19 noting changes in their menstrual cycle after infection.
 
While there are many theories around how changes in menstrual cycles may occur (e.g., inflammation) none have been proven. 
 
In the UK, over 41 million doses of COVID-19 vaccines have been given, with only 21,680 (0.0005%) of women per dose reporting changes in the menstrual cycles.
 
Other vaccines have not impacted the menstrual cycle. 
 
Studies to determine if the impact of the COVID-19 vaccine on menstrual cycle are ongoing, and if it does impact the menstrual cycle, we would expect it to be limited to one or two cycles. What we do know is that having a severe illness such as COVID-19 does impact the menstrual cycle and can impact the menstrual cycle for much longer.”
 


Informed consent 

Do children need a signed consent form to get the COVID-19 vaccine?
 
A COVID-19 consent form is not required. However, there are consent forms that the BCCDC has created that the clinic may choose to use. If a parent/guardian is unable to attend the clinic with the child, the form can be completed and brought with the child.
 
Who can give consent for a child to get their COVID-19 vaccine?
 
Parents or guardians typically provide consent for their child to be vaccinated. However, there are other individuals who may have the authority to consent to vaccination on behalf of the child, including foster parents and custodial caregivers (for example, a grandmother or aunt raising the child). A parent/guardian can also give another individual permission to give consent for their child’s vaccination. A note must be provided that includes the following information: 
  • Name of the parent/guardian
  • Name and date of birth of the child
  • Name of the individual given authority to consent
  • Date and signature of the parent/guardian who has given their authority to another individual
Only one parent or legal guardian is required to give consent. The process for collecting consent may be different depending on the immunization clinic you attend.
 

 

Other

What does the World Health Organization (WHO) say about children getting the COVID-19 vaccine? 
 
The WHO plays an important role in providing recommendations globally, not regionally. This means the WHO prioritization for vaccination at a global level may be different than that of Canada or BC, because they have to look at the big picture worldwide. 
 
The WHO (June 2021) states: “Children and adolescents tend to have milder disease compared to adults, so unless they are part of a group at higher risk of severe COVID-19, it is less urgent to vaccinate them than older people, those with chronic health conditions, and health workers.”   
 
This statement reflects the fact that, as a global community with a limited vaccine supply, it's more urgent to vaccinate people most at risk around the world, such as older people, those with chronic health conditions, and healthcare workers before we turn our attention to vaccinating those who are less at risk. 
 
We are fortunate in BC that we have vaccinated the majority of our population and still have vaccines, and we can offer them to children and youth. This is a privilege that much of the world does not have, which is why the WHO recommendation focuses on vaccinating those most at risk. 
 

 

Talk to a Doc with Dr. Danièle Behn Smith: Should I get my child vaccinated?

 

Date last reviewed: 
Friday, Nov 26, 2021