Eastern Ontatio Health Unit / Bureau de santé de l'Ontario

Ask Dr. Paul: COVID-19 Vaccines for Children

Hi, I’m Dr. Paul. As a pediatrician of 35 years and the Eastern Ontario Health Unit’s Medical Officer of Health, I understand that parents only want the best for their children, and that many are questioning whether they should get their children vaccinated against COVID-19.

I wholeheartedly believe that the COVID vaccines are safe for our children and that they represent our way out of this pandemic. Below you’ll find the questions I receive most often from parents regarding the COVID vaccines, and my answers. Please consult this page often as I’ll be updating it regularly throughout the rollout of the COVID vaccines for children.

Development and approval of the vaccine

Side effects

Eligibility and special considerations

Dosage

General Questions

What COVID vaccines have been approved by Health Canada for use in children?

  • Moderna’s COVID-19 vaccine for children aged 6 months to 5 years old
  • Pfizer-BioNTech’s COVID-19 vaccine for children aged 5 to 11
  • Moderna’s COVID-19 vaccine for children aged 6 to 11
  • Moderna’s COVID-19 booster vaccine for children aged 5 to 11

The development and testing of vaccines usually takes longer. How can Health Canada approve new vaccines so quickly?

As a pediatrician and a parent, I understand that parents don’t want to give their children a vaccine that some still perceive as experimental. The truth is that Health Canada only gives approval to a vaccine after subjecting it to the same rigorous standards as all other drugs approved for use in the country.

The main reason COVID vaccines were developed so quickly is that scientists from all around the world collaborated on the research and development, in a global effort to end the pandemic. In the past, that wasn’t always the case.

The other element to keep in mind is that mRNA technology is not new. The technology has been studied in humans for 20 years and scientists had been working on mRNA vaccines for a decade before the pandemic hit.

In fact, researchers are developing mRNA vaccines for several infectious diseases, like Influenza, Zika, Rabies and Malaria. I predict a growing number of vaccines in the future will use mRNA technology.

What are the known side effects of the COVID-19 vaccines in children?

Studies performed by the vaccine manufacturers have shown no major side effects. Researchers know that most side effects from vaccines occur within the first week after vaccination, and some children may not experience any side effects at all.

The side effects children have experienced in the clinical trials are mild and like the ones experienced by adults:

  • Sore arm at the injection site
  • Fatigue
  • Headache
  • Muscle aches
  • Fever and chills

Can the children's COVID-19 vaccines cause myocarditis or pericarditis?

While a very small number of adolescents and young adults (especially males) have experienced myocarditis (inflammation of the heart muscle) or pericarditis (inflammation of the lining around the heart) following COVID-19 vaccination, it’s important to emphasize that these side effects are extremely rare.

The current data shows that the risks of developing myocarditis or pericarditis are far higher following COVID-19 infection than following vaccination.

Can the COVID-19 vaccines impact fertility?

There is no evidence that COVID-19 vaccines cause male or female infertility, or that they will cause infertility. I believe these concerns are the result of misinformation spread on social media.

Can mRNA vaccines alter a person’s DNA?

No, once again, this is a myth. Vaccines using mRNA technology can’t change a person’s genetic makeup as they never interact with a person’s DNA.

Could receiving the vaccine cause a COVID-19 infection or cause the person to shed the virus and infect others?

No, the vaccines currently in use can’t infect people with the COVID-19 virus because they do not contain the virus. Receiving the vaccine does not create a risk of shedding the virus and infecting others because a person can only shed a virus if they are infected.

The vaccines that have been approved for use in Canada strictly teach the immune system how to recognize the virus so the body can fight it off. Getting vaccinated remains the best way for folks to protect their family and friends.

If a child is currently under 6 months old, are they eligible to receive the COVID-19 vaccine?

No, children must be 6 months or older when they receive the COVID-19 vaccine.

Can parents book a vaccination appointment if their child is under 6 months old?

Parents and caregivers can schedule a vaccination appointment at a later date for their child who is under 6 months old. However, children must be at least 6 months old on the day of their appointment.

At what interval must children receive the two doses of the COVID-19 vaccines to be fully vaccinated from COVID-19?

For optimal protection, it is recommended that children receive their second dose 8 weeks (56 days) after their first one.

Though cases of myocarditis/pericarditis in children following the second dose of an mRNA COVID-19 vaccine are rare, waiting eight weeks between the first and second dose may also reduce this risk.

At what interval must children receive their first booster dose of the COVID-19 vaccine following their primary series?

Eligible children can receive their first booster dose at a recommended interval of at least six months following their most recent dose.

Can children receive their COVID-19 vaccine at the same time as other vaccines?

At this time, the National Advisory Committee on Immunization (NACI) recommends that children aged 6 months to 4 years old receive the COVID-19 vaccine at least 14 days before or after any other vaccines. Older children may receive their COVID-19 vaccine at the same time as other vaccines.

That being said, there will be exceptions when a COVID vaccine and other vaccine may have to be administered at the same time. When this is the case, I recommend parents speak to their child’s healthcare provider.

If a child has medical issues, should they receive the COVID-19 vaccine?

Yes, while parents should consult their child’s healthcare provider, I strongly encourage children with medical conditions to receive the vaccine as their medical condition may put them at higher risk of complications from COVID-19.

Can children with allergies get the COVID-19 vaccine?

Yes, children with severe allergies to food, medication or insect bites should all receive the COVID-19 vaccine. However, I recommend parents speak to their child’s healthcare provider if their child has had a severe allergic reaction to a vaccine or other medical product in the past.

Can children on medication get the COVID-19 vaccine?

Yes, children on medication can generally get the COVID vaccine as it doesn’t interfere with other medications. But, just to be sure, I recommend parents speak to their child’s healthcare provider before they receive their COVID vaccine.

If a child has already had COVID-19, should they still get the COVID-19 vaccine?

Yes, I strongly recommend that children receive the COVID-19 vaccine, even if they have already had COVID-19. However, children who have recently had a COVID infection must wait 8 weeks following the onset of symptoms (or a positive test if they’re asymptomatic) before receiving their COVID-19 vaccine. We don’t currently know how long the protective antibodies from a COVID-19 infection last, so the vaccines are our best bet to ensure that children are protected from future COVID-19 infections.

Are the COVID vaccines for children the same as the ones given to adults?

No, the COVID vaccines for children contain the same active ingredients as the ones for adults, but in smaller doses. This is common practice amongst vaccines for children.

  • Moderna’s vaccine for children aged 6 months to 5 years old is ¼ the size of the dose for teenagers and adults (25 micrograms compared to 100 micrograms for adults).
  • Pfizer’s vaccine for children aged 5 to 11 is 1/3 the size of the dose for teenagers and adults (10 micrograms compared to 30 micrograms for adults).

Do the COVID vaccines for children offer the same level of protection as the adult vaccines despite the smaller dose?

The short answer is yes. In fact, the vaccines may even offer children better protection from the COVID virus than the adult version. That’s because younger children generally have stronger immune systems than teenagers and adults, so their body generates more protective antibodies when they receive a vaccine.

As a bonus, smaller doses usually mean fewer side effects, if any.

If my child is 5 years old, can I choose which vaccine they will receive?

The three following vaccines for children are available at the EOHU's community clinics, based on their age:

  • Moderna’s COVID-19 vaccine for children aged 6 months to 4 years old
  • Pfizer-BioNTech’s COVID-19 vaccine for children aged 5 to 11 years old
  • Moderna’s COVID-19 booster vaccine for children aged 5 to 11 years old

With informed consent, parents can request to have their children aged 5 and over vaccinated with Moderna’s vaccine by calling the EOHU at 613-933-1375 or 1 800 267-7120.

If a child received a first dose of Moderna’s COVID-19 vaccine when they were 4, but have since turned 5, should they receive a second dose of the Moderna vaccine for children aged 6 months to 5 years old, or the Pfizer vaccine for children aged 5 to 11?

If your child received a first dose of Moderna’s COVID-19 vaccine when they were 4 years old, and have since turned 5, they will receive a second dose (or third dose if they are moderately to severely immunocompromised) of the Moderna vaccine to complete their vaccination series.

If a child is 11 years old, should they wait to receive the adult dose when they turn 12, or receive the child-sized dose now?

I recommend that children who are 11 years old receive the child dose. As previously mentioned, the vaccines children receive are often not based on their size or weight, but their body’s immune response, which is based on their age.

If a child received a first dose of the COVID-19 vaccine when they were 11, but have since turned 12, should they receive a second dose of the child version, or the adult version?

A child who received a first dose of the child COVID-19 vaccine should receive a second dose of the adult version if they have since turned 12. However, a 12-year-old who receives a second dose of the child vaccine will still be considered fully immunized.

Why should children receive the vaccine?

While it’s true that the original strain of COVID that appeared in late 2019 spared children of its worst effects, the same cannot be said about the variants that have emerged since then, such as the Delta and Omicron variants. Due to these variants, which are more contagious than the original strain, doctors are now seeing more children with COVID symptoms, and a small number have become severely ill.

Sadly, some children have died from a serious condition known as multisystem inflammatory syndrome due to the COVID virus (MIS-C). Children who develop this syndrome suffer from severely inflamed organs and tissues. The syndrome can affect several organs, such as their brain, heart, lungs, and digestive system, amongst others.

I don’t want to see any children get seriously ill or die from this virus, and I believe the COVID vaccines can help us achieve that goal.

What should parents do if they’re on the fence about having their children vaccinated against COVID-19?

I recommend that parents who are worried about vaccinating their children against COVID-19 speak to their healthcare provider. Parents can also consult alternate sources of information, as long as they ensure they’re credible. I have seen lots of misinformation shared on social media.

Where can I get more information?

Additional Resources

Eastern Ontatio Health Unit / Bureau de santé de l'Ontario